Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital
There is a group of diseases that are less obvious to people but can be
very distressing to those who are afflicted. Anxiety attacks or panic
attacks are characterized by agitation, anxiety and vague complaints, such
as chest pains, sweating, dizziness, weakness and pains in various areas of
the body. They may be accompanied by rapid pulse, and shortness of breath.
Since these symptoms can be present in many serious diseases, care must be
exercised by the physician. Stress, or phobias, can precipitate an attack,
but often the attacks come spontaneously. Treatment for an acute attack
includes valium and similar tranquilizers.
Phobias can produce a similar response. These include most commonly
agoraphobia, which is fear of open places, claustrophobia, which is fear of
closed spaces, fear of heights, and others. Also included are fears of
social situations, which causes people to avoid social contacts and can
even be to the extent of not leaving the house. Treatment of these requires
intensive psychotherapy.
Obsessive-compulsive disorder is a similar disease where people do
activities obsessively in order to reduce their anxiety level to a
manageable level. An example is a person who is constantly washing his or
her hands because of fear of germs. Psychotherapy may help here as well.
What is interesting is that in all of the above, the medication called
Seroxat has been very useful. It is made by our sponsor and has been
approved for the above diseases. It may also be useful in extended grief
reactions and post-traumatic stress reaction, which is when a person has
had a traumatic event such as an accident and it has affected his behavior
or coping.
The last diseases I would like to discuss are the personality disorders
which are extremely difficult to treat. They include histrionic
personality, people prone to hyperbole and hysteria; the passive-aggressive
personality, people who express their aggressions through sabotaging; the
antisocial personality and the borderline personality, both of whom have
trouble blending into society and have tendencies to unusual or criminal
behavior. Many people have a combination of these and medication plus
psychotherapy may help if the patient is motivated to seek help.
Psychiatric diseases are real diseases and these people need help, but can
live normal lives. Also, all that I have said is based on knowledge that
the patient actually has a psychiatric illness. Many times new behavior may
be due to an organic disease or a new medication, so a good medical work-up
must be done as well. People can also just choose to do evil. Write me in
care of the Yated.
