Luigi ha seriamente pensato di morire mentre si trovava alla guida della sua auto. Riferisce di aver provato un improvviso forte dolore al petto, un aumento repentino del ritmo cardiaco e uno strano formicolio agli arti superiori. Convinto di essere stato colpito da un infarto, ha chiesto al fratello d prendere il suo posto alla guida. Ha poi chiesto di essere accompagnato subito al pronto soccorso dove, dopo un attento esame, i medici hanno escluso la presenza di cardiopatie
Riconoscere un attacco di panico
Come si può riconoscere un attacco di panico? Un attacco di panico viene può essere definito come un periodo preciso di intensa paura o disagio, durante il quale quattro (o più) dei seguenti sintomi si sono sviluppati improvvisamente e hanno raggiunto il picco nel giro di 10 minuti: palpitazioni, cardiopalmo o tachicardia; sudorazione; tremori fini o grandi scosse: dispnea o sensazione di soffocamento; sensazione di asfissia; dolore o fastidio al petto; nausea o disturbi addominali; sensazione di sbandamento, di instabilità, di testa leggera o di svenimento; derealizzazione (sensazione di irrealtà) o depersonalizzazione (essere distaccato da se stessi);paura di perdere il controllo o di impazzire; paura di morire; parestesie (sensazioni di torpore o di formicolio); brividi o vampate di calore (APA 2000).
L’incapacità di rassicurarsi
L’elemento costitutivo dell’attacco di panico è l’ansia, ossia l’emozione che gli esseri umani sperimentano quando credono di essere esposti a una minaccia più o meno grave ed imminente. La differenza fra un ansia cosiddetta “normale” da una patologica è il fatto che il soggetto ha il desiderio di modificare la sua risposta ansiosa, ma non lo fa. Il paziente nonostante le informazioni in suo possesso (ad esempio il verbale di pronto soccorso che esclude un infarto) e la convinzione, data dalle esperienze, che difficilmente accadrà qualcosa di terribile alla sua vita, non trova pace.
Le conseguenze dell’ansia e il circolo vizioso
La risposta dell’incapacità del paziente di stare bene e di riuscire a gestire la propria ansia è nelle conseguenze dell’ansai stessa e nel circolo vizioso che si innesca. Si innesca un meccanismo per cui il paziente sempre di più ricercherà sintomi che gli proveranno che la sua salute è in pericolo (noterà ogni minimo cambiamento, farà caso alle sue pulsazioni e alla sua respirazione ad esempio) ciò avrà come conseguenza un notevole aumento dell’ansia percepita scatenando così un circolo vizioso: più temo che mi accadrà qualcosa di brutto, più cerco conferme dal mio corpo che sto male, più aumenta l’ansia in questa ricerca spasmodica di segnali, fino all’apice dell’attacco di panico.
La complessità dell’attacco di panico
Quello sopra descritto è solo uno dei meccanismi, ne esistono molti altri che possono portare all’attacco di panico, non solo conseguenze comportamentali come quella descritta, ma anche molte cognitive e altrettante emotive. Il panico non si differenzia dall’ansia solo per un aspetto quantitativo (ansia molto intensa), ma in realtà c’è una forte componente qualitativa. L’ansia in qualche modo può preparare al panico successivo, mentre il panico è uno stato emotivo indirizzato alla gestione di un evento traumatico in atto, caratterizzato da un soggettivo senso di estrema paura o di morte imminente, un intenso arousal autonomico e tendenza al comportamento di fuga o di lotta: la minaccia è vissuta come presente.
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