Psychiatrist Prof. Dr. Nevzat Tarhan, stating that excessive health anxiety develops in those who make narcissistic investments in their body and health, said, '57% of cases who apply to the emergency room saying 'I'm having a heart attack' and undergo angiography turn out to have panic disorder, with no physical findings. 57% is a very high number. They undergo unnecessary tests.'
Prof. Dr. Tarhan: 'Stress control is beneficial, but panic is harmful… Therefore, if we have a personality prone to panic attacks, we need to know that we tend to catastrophize situations and events.'
Prof. Dr. Tarhan: 'Children do not experience panic attacks. A certain mental level is required for a panic attack.'
Founding Rector of Üsküdar University, Psychiatrist Prof. Dr. Nevzat Tarhan, evaluated the subject of panic attacks.
Tarhan: 'The person feels like they're losing their mind at the same time, there's a fear of death'
Prof. Dr. Tarhan noted that panic attack is the name given to the attacks within a disease defined as panic disorder and entered into classification books, saying, 'Panic attack is described within a disease definition characterized by physiological and mental symptoms such as palpitations, sweating, trembling, shortness of breath, feeling of choking, chest pain, and tightness. The person feels like they're losing their mind at the same time, there's a fear of death. What does a person feel when losing steering control while driving fast? For a moment, they are horrified, thinking 'I'm going to flip, I'm going to die.' People with panic disorder feel such a sensation during a panic attack. The feeling of losing control.'
57% of cases applying to the emergency room saying 'I'm having a heart attack' have panic disorder
Stating that the unexpected onset of these attacks is called panic disorder, Prof. Dr. Tarhan continued as follows:
'Now, if a person gets upset about something, experiences stress, and then has palpitations and excitement. This is not a panic attack. Its cause is clear. In panic disorder, it occurs unexpectedly, even during sleep without a causal link, and the person wakes up with a panic attack. Doctors call this 'panic attack.' This person wakes up and, unable to explain the reason at that moment, thinks, 'Why is this happening all of a sudden?' Because there's a feeling of palpitations, sweating, trembling, feeling like dying, losing one's mind, and it's uncertain, they feel even worse. And they apply to the emergency room.
57% of cases who apply to the emergency room saying 'I'm having a heart attack' and undergo angiography turn out to have panic disorder, with no physical findings. 57% is a very high number. They undergo unnecessary tests. This significantly affects medical expenses. Individuals with panic disorder have high health anxiety. They are constantly interested in disease-related topics. If any part of their body goes numb, they go to a healthcare facility. They experience anticipatory anxiety. Because constant attacks evoke a terrible feeling of catastrophe, the person starts avoiding and fearing, thinking 'I'm going to have an attack.''
Zeki Müren also retreated to Bodrum due to his panic attacks
Prof. Dr. Tarhan explained that because attacks can occur in any environment, people start being unable to go out alone, cannot enter the bathroom alone, and some even crawl at home for fear of having an attack, saying, 'They cannot walk, cannot go out alone; there are those who go to their mother's house when their spouse goes to work. There are also agoraphobic panic attacks, a fear of open spaces. They cannot take ferries or buses, cannot enter tunnels, cannot travel. These seriously affect their lives. The person avoids many functions of life. You know Zeki Müren. It wasn't talked about much then, but it later became clear that he also didn't want to be among people due to panic attacks. And he retreated to Bodrum. He experienced the terror of that feeling, thinking he was going to have a heart attack. At that time, these diagnoses were not widely known. They were discussed but not widespread. And afterwards, he went on stage, and then he had an attack.'
Tarhan: 'We invite our own panic attacks'
Prof. Dr. Tarhan noted that feared situations have an effect on the brain, and due to a person's mistaken beliefs and excessive stressors, the brain takes a position related to them and starts forming connections and giving similar reactions, saying, 'In some advanced cases, we invite our own panic attacks. It enters a vicious cycle. The more a person thinks, the more it increases, and the more it increases, the more they think.'
Prof. Dr. Tarhan, stating that excessive health anxiety develops in those who make narcissistic investments in their body and health, said, 'What is narcissistic investment? It's when a person invests in what they love most. An investment of love. The most narcissistic being is a child; they love themselves. They are born with an innate narcissistic capacity to love something. Narcissistic people direct this towards themselves. If a person has transcended themselves, they distribute their narcissistic investment in a balanced way by directing it towards their country, homeland, people, existence, creation, and the Creator. These people, however, invest their narcissism in their body and health. Excessive health anxiety develops, and there are interesting statistics. The prevalence rate in society is 3% in Europe and 11% in America.'
Panic attacks are more common in individuals diagnosed with cancer
Prof. Dr. Tarhan stated that panic attacks are more common in individuals who live fast and take risks, as well as those diagnosed with cancer, and noted that health anxiety increases in these individuals, fearing 'I will get sick again, I will have an attack.'
Prof. Dr. Tarhan, stating that the hypothalamus in the anterior part of the brain manages the autonomic nervous system, and that the autonomic nervous system has sympathetic and parasympathetic activation, continued as follows:
'Sympathetic activation is fight-or-flight activation. Fight in a moment of danger. Or flee if you can't fight. In a moment of danger, the body immediately enters a fight-or-flight response. All muscles tense, blood pressure rises, vascular resistance increases, all attention increases, the whole body pumps energy sources into the blood; glucose, fats, all are pumped into the blood. All energy sources give a fight-or-flight response. This works momentarily, keeps the body upright, keeps it awake, or if it's scared, blood pressure drops, the person faints. If the person is trained in such situations, and their mental and psychological resilience is good, they activate the parasympathetic nervous system. It is called the vacuum system. The vacuum system is the longest nervous system in our body. The vacuum system is a system that brings messages from the body to the brain, saying 'The danger has passed, everything is under control, everything is going well.' If the parasympathetic system is activated, the person remains calm at that moment, does not overreact, and overcomes the danger,' he explained.
Tarhan: 'If there is a perception of danger in the brain, it can happen even while sleeping'
Prof. Dr. Tarhan said, 'If there is a perception of danger in the brain, it can happen even while sleeping. That's why the saying 'Our perceptions are our realities' perfectly applies to it,' and explained that studies on panic attacks also mention familial predisposition, and in some families, this condition is not entirely genetic but familial, meaning the gene has not been found.
Prof. Dr. Tarhan also noted that the disease related to epigenetics, where lifestyle later changes genes, is not passed down from generation to generation, saying, 'If not experienced, it disappears. There is such a familial trait. Due to this trait, it is also very common in families where individuals have had heart attacks in the past, received a cancer diagnosis, and those with traumatic experiences, meaning childhood trauma.'
Prof. Dr. Tarhan, stating that numbness occurs in the hands and feet during a panic attack, explained, 'There is dizziness, palpitations, shortness of breath, a feeling of tightness in the chest. Pay attention to people who have panic attacks. They always carry water with them. When we ask, 'Do you have water in your bag?', most say yes. Saying yes confirms the diagnosis, because this becomes their fear. They carry an antidepressant or a sedative medicine.'
Panic attacks do not occur in children
Prof. Dr. Tarhan, also addressing the topic of panic attacks in children, said, 'Children do not experience panic attacks. A certain mental level is required for a panic attack. It needs to be investigated, but as far as I remember, there are no childhood panic attacks listed in diagnostic books related to children. However, there are anxiety disorders in childhood. In such situations, it falls into a risk group. Therefore, it is related to errors in evaluating and interpreting a person's health. In treatment, we try to change thought habits. These individuals catastrophize the symptom. Usually, they are people with a high intellectual level.'
Tarhan: 'Panic attacks occur in adolescence'
Prof. Dr. Tarhan also provided information about anxiety disorders in children, saying, 'They experience it according to their age group. Anxiety disorder between 0-6 years old is usually related to the mother… When a child wakes up in the morning, they look at their mother's face and understand from her face whether that day will go well or not. If the mother is comforting, reassuring, and able to form a bond, the child expects the day to go well. If there's an earthquake, the child doesn't look at the television at all, what does the child do? They look at their mother, their father. Panic attacks, of course, occur in adolescence… Especially those over 15 years old are equivalent to adults. These are what we call 'Type C' individuals, who are dependent. They are always seeking approval from others. They are unable to take initiative or make decisions. They have social anxieties, which are also very common in adolescents. These are individuals described as having low self-confidence, quiet, you know, they say 'they take the food out of their mouths'… They always keep things to themselves. Not entrepreneurial, not assertive, not self-confident. Such people always want to live dependent on someone else. If they cannot satisfy their need for dependency, panic attacks, anxiety disorder, and various health anxieties can emerge,' he informed.
Tarhan: 'If we have a personality prone to panic attacks, we need to know that we tend to catastrophize events'
Prof. Dr. Tarhan stated that when people see a blood pressure monitor from a distance during a panic attack, their blood pressure rises to twenty-four, and said that because of the disproportionate reaction, the situation is considered panic.
Prof. Dr. Tarhan, stating, 'Stress control is beneficial, but panic is harmful… Therefore, if we have a personality prone to panic attacks, we need to know that we tend to catastrophize situations and events,' continued as follows:
'If a person has had a panic attack, we tell them, 'Now, definitely do not go to the hospital.' We say, 'Your diagnosis is clear, at most take this sublingual pill.' There are sublingual pills, there are drops. When we show them the affected areas in the brain, they are convinced faster. There are brain mappings. In some people, the right brain and left brain do not work in harmony. If the BETA wave is particularly high in the middle regions of the brain in these individuals, that person's stress is high. We say, 'Your diagnosis is clear, and this is a treatable condition; we are making a treatment plan for you, follow it.' The person feels relieved because they understand the uncertainty and conceptual confusion in their mind. Even that provides a 50% improvement.'
Prof. Dr. Nevzat Tarhan also noted that when patients trust their physician, they start to recover without waiting 6 months, adding, 'But it needs to be thoroughly examined, and all tests must be done. One must be sure.'
Tarhan: 'We teach them to produce ALPHA waves in their brains'
Prof. Dr. Tarhan, pointing to the importance of patients returning to their routine work and life, explained the following:
'Excessive mental preoccupation increases the illness. Sitting and constantly thinking, 'What if I have a panic attack? Will my life be like this from now on?'… If there's health anxiety, anticipatory anxiety in this person, in therapy, we already try to eliminate the uncertainty in their mind and replace wrong thought patterns with correct ones. Therapy is needed. If the person cannot do this on their own, therapy is needed. There are some methods. We take the person's brain waves and show them how to reduce BETA waves and increase ALPHA waves. We teach them to produce ALPHA waves in their brains. When a person learns this, they learn to control their brain.'
Informing and cooperating with patient relatives is important
Prof. Dr. Tarhan, also stating that patient relatives make mistakes with advice such as 'you're overthinking it,' 'don't worry about it,' or 'be your own doctor,' concluded his words as follows:
'At that moment, they experience a feeling of losing control. We usually also inform the people they live with about such situations. This is the diagnosis, this is the treatment. If you create a treatable plan and apply it, they also act constructively towards it. If they behave in a way that nourishes the illness, for example, if someone says 'wait at the bathroom door, don't leave me alone' and they say 'Okay,' this can have a reinforcing effect on the illness. It's not necessary to suddenly dismiss it by saying, 'There's nothing wrong with you!' If relatives act balanced and in accordance with scientific guidance, this is one of the areas where we are most successful in treatment.'