Can sugar cause anxiety attacks

5 Common Foods That Can Trigger Anxiety Symptoms : Intrepid Mental Wellness, PLLC: Psychiatric Nurse Practitioners

5 Common Foods that Can Trigger Anxiety Symptoms

Food can have a powerful impact on mood, stress levels, and mental health. Some foods have been shown to cause or worsen the symptoms of anxiety, depression, and other chronic mental-health conditions. While symptoms and triggers are unique to every individual, research studies have found several common foods that can induce anxiety.

Sugar

High sugar intake has been linked to many different health conditions, including obesity, high blood pressure, and tooth decay. Sugar has also been linked to depression, mood swings, and symptoms of anxiety. The initial energy boost gained from eating sugar keeps many people craving sugary foods and drinks. However, once the energy boost has peaked, blood sugar levels drop quickly; this leads to lethargy, low mood, and further cravings. The continual boosts and drops in blood sugar levels can trigger the release of adrenalin and cortisol into the bloodstream, causing anxiety and sometimes even panic attacks.

Fried Foods

Junk food and fried foods, such as pizza, fried chicken, hamburgers, and fries, have little nutritional value and are extremely difficult for the body to digest. When the body is unable to digest and process food, excess gas, acid reflux, and other gastrointestinal complaints can produce symptoms that trigger anxiety. Long-term digestive health complaints, such as gastroesophageal reflux disease (GERD), sometimes cause sufferers to wake in the night gasping for breath, as acid reflux can bring about light vomiting that results in choking sensations.

Processed Foods

Processed foods, such as canned soups, cured meats, and processed cheeses, contain high amounts of salt. Excessive salt intake raises blood pressure and increases the workload of the heart, causing the body to release adrenalin into the bloodstream and leading to anxiety. In addition, many cans and plastic containers are lined with bisphenol A (BPA), a chemical that has been linked to changes in mood and blood pressure. While research is still being conducted into the possible dangers of BPA, many experts believe the chemical can seep into food or drink and produce harmful effects.

Food Additives

Food additives, including aspartame, monosodium glutamate (MSG), and some food dyes, have also been linked to anxiety, depression, and mood changes. Aspartame is an artificial sweetener used in many different foods, including sugar-free candies, chewing gum, and soft drinks, and studies have linked it to several health conditions, including anxiety and depression. Regular consumption of MSG, which is used to enhance the taste of many snacks, processed foods, and pre-cooked ready meals, has been linked to fatigue, headaches, depression, and anxiety. Some food dyes used in drinks, candies, cheese, and other processed foods have also been associated with anxiety symptoms.

Caffeine

Caffeine can be found in a range of products, including coffee, tea, energy drinks, chocolate, and some painkillers. Many people can tolerate small amounts of caffeine, but because caffeine stimulates the central nervous system, excessive intake can lead to heart palpitations, shaking, irritability, and insomnia. Caffeine can also inhibit the absorption of some vitamins, including B vitamins, which are needed to aid relaxation and control mood. In addition, some people are more sensitive than others to the effects of caffeine, so even small amounts can cause headaches, shaking, and anxiety.

A balanced diet is essential for controlling anxiety, depression, and long-term mental health conditions. Eliminating or cutting down on foods known to trigger anxiety symptoms is an important step in managing chronic anxiety disorders. In addition, food sensitivities can precipitate a range of unpleasant symptoms that can mimic anxiety, so it's important to talk to your doctor if you suspect specific foods may be causing you distress.

9 Tips for Managing Your Anxiety Right Now

Are you feeling overwhelmed with anxiety? Whether recent life changes have caused it or it's something you've been struggling with for a while, it can be challenging to know how to manage your anxiety. These nine tips can help you get started.

7 Foods You Should Avoid If You Have Depression

You probably already know that diet has a huge impact on your psychological and mental state. Excluding harmful foods from your diet is the first step towards a healthier brain and mind.

How to Use Food to Manage Your Mental Health

Moods are not created in the mind alone, but in partnership with the body. Ask anyone who has eaten ice cream to cheer themselves up, and they'll tell you that's true. What we feed the body can have an enormous impact on how we feel.

Beyond Depression: Recognizing the Signs and Symptoms of Bipolar Disorder

Depression is a complex disorder, a condition triggered by biochemical, environmental, and psychological influences. Although patients diagnosed with bipolar disorder often experience bouts of depression, their condition is far more complex.

Dietary Changes That Can Have Positive Effects on ADHD Symptoms

When parents suspect their child has attention deficit hyperactivity disorder (ADHD) or a diagnosis has already been made, making changes to the child's diet, for example, could have significant positive effects.

Gaslighting: Is Someone Meddling with Your Perception?

Does the way someone communicates with you make you question your reality? Then, perhaps they are gaslighting you. When you understand what gaslighting is, you can identify whether you are its victim and improve your life.

The 4 Worst Foods for Your Anxiety

Roughly 40 million Americans have an anxiety disorder. If you live with chronic stress or anxiety, you might spend much of your daily life managing it with tools like therapy, mindfulness, exercise, and anti-anxiety medication.

But did you know that anxiety may be triggered by certain foods we put in our bodies?

This isn’t to say that these tools and approaches aren’t necessary for tackling anxiety — they’re often healthy options for any person’s lifestyle.

But if anxiety is still impacting your life, it might be worth it to consider what’s on your plate.

Read on for four foods that may trigger your anxiety and suggestions for what to eat instead.

Believe it or not, the beverage often used to quell social anxiety is actually making it worse.

“Although it may seem like it calms your nerves, alcohol can have a negative impact on hydration and sleep, both of which can trigger anxiety symptoms when suppressed,” says Erin Palinski-Wade, RD, CDE, author of “Belly Fat for Dummies. ”

Alcohol changes levels of serotonin and the neurotransmitters in the brain, which makes anxiety worse. And when the alcohol wears off, you may feel even more anxious.

Drinking in moderation — about 1 drink per day for women and 2 drinks per day for men — is typically safe, as long as your doctor gives you the OK.

Try Instead: There’s no real substitute for alcohol. If you like the flavor but don’t need the side effects, consider nonalcoholic beer. Drinks that feel special, like mocktails or sparkling water with fancy bitters, can also be good replacements in social situations.

According to the National Coffee Association, 62 percent of Americans drink coffee on a daily basis, and the average amount per day is slightly over 3 cups per coffee-drinker. But our favorite morning ritual might actually be doing more harm than good when it comes to anxiety.

“High levels of caffeine can not only increase anxiety and nervousness, but also decrease the production of the feel-good chemical serotonin in the body, causing a depressed mood,” explains Palinski-Wade.

Typically, caffeine is safe in low doses. But high doses can cause unpleasant effects, namely anxiety and nervousness. The Food and Drug Administration (FDA) reports that the average adult can generally consume up to 400 milligrams (mg) of caffeine daily without dangerous or negative effects.

A 2015 study found that many adults and adolescents who consumed more than 400 mg of caffeine per day reported anxiety and mood disorders. In Starbucks terms, a large (“grande”) containing medium roast coffee contains about 310 mg of caffeine.

Also keep in mind that many products have caffeine, including tea, chocolate, and certain headache medications, and can contribute to anxious feelings.

Try Instead: Herbal teas, such as peppermint, lavender, or lemon balm tea, are refreshing hot drinks with soothing effects.

There’s no way to avoid sugar 100 percent of the time, as it naturally occurs in many of the foods we love to eat, like fruit.

But added sugar is a contributor to overall anxiety.

“Added sugars cause your blood sugar to go on a rollercoaster ride of spikes and crashes, and with it, your energy also goes up and down,” says Palinski-Wade. “When blood sugar crashes, your mood sours and anxiety levels can spike.”

The body releases insulin to help absorb the excess glucose and stabilize blood sugar levels, but a sugar rush makes the body work too hard to get back to normal, causing the highs and lows.

Consuming large amounts of processed sugar can trigger feelings of worry, irritability, and sadness.

Foods that fall into the added sugar category that you should consider avoiding or minimizing don’t all look like desserts. Condiments like ketchup, certain salad dressings, pasta sauces, and breakfast cereal can all contain high levels of added sugar.

Try Instead: Luckily, you don’t have to deny your sweet tooth if you give up processed sugar. Stevia, erythritol, and Yacon syrup are natural substitutes for sugar. Fill up your plate with fruits and naturally sweet vegetables, like sweet potatoes.

Refined carbohydrates have been associated with increased risk of serious health conditions like diabetes, heart disease, and obesity. Refined carbohydrates are foods that have been stripped of much of their fiber and micronutrients.

It appears that anxiety is being added to the list of health issues that may be associated with consumption of refined carbohydrates.

One 2019 study found that refined grains consumption was related to both anxiety and depression in women. Another study from 2018 found that mice fed a diet high in refined carbs became obese and then developed anxiety and depressive-like behaviors when exposed to stress.

Refined sugars and refined grains are the two main types of refined carbs. Refined grains have been milled to remove the fibrous parts, such as the bran and germ, which also removes many of the nutrients. Three common examples of refined carbs are:

white flour
white rice
white bread

Refined sugars come from plants such as sugar cane, sugar beets, and the agave succulent. They’ve been processed to extract their sugar. These refined sugars are different from the natural sugars that are found in fruit and dairy products. Common refined sugars include:

sucrose (table sugar)
high fructose corn syrup
agave syrup

Refined carbs are found in many modern foods, including:

white bread
white rice
pastries
sodas
pasta
breakfast cereals
processed snacks and meals

Try Instead: Try cereals and breads made of whole or sprouted wheat. Even some whole high-carb grains can be very healthy. If you’re living gluten-free, try breads or pasta made of brown rice, oats, or quinoa.

Between 5 and 8 percent of children and 3 and 4 percent of adults in the United States have food allergies.

Young people with food allergies and sensitivities are at much higher risk for developing anxiety disorders. In one study of young people between 10 and 16 years old, those with food allergies were more likely to have symptoms of separation anxiety, generalized anxiety, and anorexia.

This may be especially true in families in underserved communities. In one study of children from such communities, those with food allergies had increased symptoms of both social anxiety and anxiety overall.

The lead researcher of the study pointed out that food allergies can be expensive, involving food shopping, meal preparation, and the cost of epinephrine auto-injectors, which expire annually. They suggested that these demands might cause anxiety for those with few financial resources.

Adults can be affected, too. One study showed that parents of children with food allergies reported significantly higher levels of stress, anxiety, and depression, compared to parents of children with no food allergy.

Anxiety can result from long-term exposure to a perceived threat. If you have food allergies, you may face the very real threat of severe reactions to food every time you eat.

Minor worry may help keep you alert: You read labels, check ingredients when eating out, and always carry your epinephrine. But continual worry over food allergies can get out of control. If it does, anxiety can be managed with the right supports, including:

education
nutritional guidance
counseling
support groups
medication

If you or your child needs help, don’t hesitate to contact a medical professional for testing and diagnosis. They’ll make sure you get help in developing menu plans that consider any related fears.

The Anxiety and Depression Association of America is a good place to start for resources or to find a therapist.

Anxiety disorders in patients with diabetes mellitus uMEDp

Anxiety disorders are common in patients with diabetes mellitus (DM), especially in patients with type 2 diabetes. Anxiety disorders significantly worsen the compensation of the disease. Consequently, the risk of developing diabetic complications increases, and the quality of life of patients decreases. In this regard, timely detection of anxiety disorders in this group of patients is necessary.
The treatment of anxiety disorders in patients with DM is a difficult task due to numerous comorbid somatic diseases. Tofisopam (Grandaxin®) is an effective and safe treatment for anxiety disorders in these patients. nine0004

Table. Efficacy of Grandaxin and Atarax in the treatment of TR in patients with DM, M ± m

Diabetes mellitus (DM) is a chronic disease characterized by metabolic disorders and persistent pathological hyperglycemia. It ranks fifth among diseases in terms of prevalence and sixth among the causes of death among the elderly.

The chronic course of DM, the nature of complications, the need for frequent self-monitoring of glycemia using an invasive method cause an increased risk of developing mental disorders, especially anxiety and depressive states. It should be noted that in patients with DM, anxiety disorders (AD) are often combined with depression. And if much attention is currently paid to the study of the development of depression in this group of patients, the relationship between TR and DM remains poorly understood. However, TR in patients with DM occurs no less frequently than depression. Thus, the results of a study conducted by E.G. Starostina et al. showed that in patients with DM, the frequency of TR is comparable to the frequency of depression - 39.5 vs. 40.0% [1].

The incidence of TR in patients with DM is higher than that in patients with other chronic somatic diseases. Particularly significant are such types of AD as phobias, panic disorder, generalized anxiety disorder (GAD), organic anxiety disorder (GAD).

Traditionally, pathological anxiety is considered as a patient's reaction to the presence of DM. The role of TR in the development of DM has not yet been studied.

According to the existing theory, the biochemical and pathogenetic relationship between TR and DM is explained by dysfunction of the hypothalamic-pituitary-adrenal axis in response to chronic stress. One of the neuroendocrine manifestations of psycho-emotional stress is the secretion of corticoliberin by the hypothalamus, followed by activation of the adrenal glands and an increase in their production of glucocorticosteroids. nine0004

Chronic stress can lead not only to adrenal exhaustion, but also to disruption of the negative feedback mechanisms of cortisol secretion. The latter is often observed in endocrine pathologies: obesity, impaired glucose tolerance, as well as in some mental disorders - depression, TR. Chronic hypercortisolism contributes to an increase in visceral fat, a violation of carbohydrate and lipid metabolism. The relationship between chronic anxiety and cortisol hypersecretion was revealed using the dexamethasone test [2]. nine0004

The association of TR with DM and obesity has been demonstrated in a number of studies. So, in the screening study of A.N. Niles et al. when examining 42,249 patients, it was found that TRs significantly increase the risk of developing diabetes (relative risk (RR) 1.3) and obesity (RR 1.2) [3]. In a large population study, I.C. Chien et al. the frequency of DM in patients with TR was significantly higher than in the general population - 11.89 vs. 5.92%, respectively. The prevalence of DM in the group of patients with TR was also higher than in the group of patients without TR - 2.25 vs. 1.11%, respectively [4]. nine0004

Epidemiology of anxiety disorders

Symptoms of pathological anxiety in patients with DM, according to the literature, are observed in 40.0% of cases. At the same time, GAD - in 14.0% of cases, subsyndromal anxiety - in 27.0%, which is six to seven times more than in the population.

For patients with type 2 diabetes, permanent forms of anxiety are more typical - GAD, OTR and subsyndromal, for patients with type 1 diabetes - paroxysmal anxiety in the form of a phobia of hypoglycemia and injections [5]. nine0004

GAD is associated with increased nonspecific inflammatory response, obesity, and arterial hypertension, factors that make a significant contribution to the development of DM. In addition, GAD can cause an unhealthy lifestyle - insufficient physical activity, overeating, smoking, which also contributes to the development of type 2 diabetes.

Research by S.S. Deschenes et al. demonstrated that GAD occurs in 60% of patients with type 1 diabetes. Diabetes increases the risk of developing GAD or exacerbates the symptoms of an anxiety disorder. When GAD is combined with depression, the risk of developing type 2 diabetes is doubled (RR 1.99 at 95% confidence interval (CI) (1.22–3.25), p = 0.006). The relationship between isolated GAD and DM has not been identified. These results were obtained by statistical analysis, taking into account socio-demographic factors, as well as factors related to the state of health (smoking, alcohol consumption, body mass index (BMI)) [6].

E.G. Starostina et al. when examining 228 patients with type 1 and type 2 diabetes, TR was detected in 39.5% of cases, 15.0% of them were GAD. Anxiety disorders were more common among patients with type 2 diabetes (60.0 vs. 35.0%). Patients with type 2 diabetes were more likely than patients with type 1 diabetes to have persistent anxiety disorders: generalized (22. 4 versus 9.3%) and organic (18.0 vs. 0%). However, pathological phobias of hypoglycemia and insulin injections were recorded eight times more often in patients with type 1 diabetes - 14.8 vs. 1.7%. It is important to note that in this study, the diagnosis of "anxiety disorder" was made based on the results of not only psychometric scales, but also consultations with a psychiatrist [2]. In another study by the same author, during which 200 people (48 men and 152 women) with DM were examined (type 1 DM - 61 patients, type 2 DM - 139patients), "pure" TRs were studied in patients with DM. The impact of TP on the course of DM was assessed by comparing data from 87 patients with DM and TP and data from 46 patients with DM but without TP. Anxiety disorders were identified in 44% of participants. At the same time, in patients with type 1 diabetes, they were recorded less frequently than in patients with type 2 diabetes - 26.2 and 51.2% of cases, respectively [5].

In the screening study L. T. Wu et al. anxiety disorders were found in 14% of patients with type 2 diabetes. In persons without DM, their frequency was 7.5%. Using logistic regression analysis, it has been demonstrated that the presence of type 2 diabetes increases the likelihood of developing TR, as well as other mental disorders [7]. nine0004

The relationship between TR and DM differs between men and women. So, R. Demmer et al. found that the cumulative incidence of DM over 17 years of follow-up was 11.0% in men and 8.0% in women (p

In another screening study, N. Sun et al. the prevalence of TR among patients with type 2 diabetes was 43.6%. At the same time, it was higher among women than among men [9].

The relationship between TR and SD was also evaluated in a longitudinal study by S. Hasan et al. The observation period is 27 years. Number of participants - 3489. The authors showed that DM increases the risk of only post-traumatic stress disorder throughout life. Women with DM had a longer duration of TR compared with women without DM [10].

Influence of anxiety disorders on the course of diabetes mellitus and the development of complications

Anxiety disorders in patients with DM primarily lead to poor compliance with treatment and adherence to dietary recommendations. So, L. Gentil et al. found that TR in combination with depression is accompanied by a significant deterioration in compliance with oral antidiabetic drugs [11]. If a patient has an insulin phobia, he stubbornly refuses such therapy. With a phobia of hypoglycemia, the patient tries to maintain a higher level of glucose in the blood. E.G. Starostina et al. showed that in patients with a phobia of hypoglycemia, the average level of glycated hemoglobin (HbA1c) is 1.3% higher than in patients without a phobia. This difference is clinically significant in relation to the risk of developing complications of DM [2]. nine0004

Anxiety disorders are associated with overeating. In patients with DM and TP, BMI values are significantly higher than in patients with DM but without TP [6, 8].

Patients with TR are also more prone to smoking and other bad habits.

In a study by N. Sun et al. it has been noted that the combination of TR with depression leads to poor glycemic control in patients with diabetes [9].

TRs are an independent risk factor for the development of cardiovascular diseases and their adverse outcomes. In particular, in the work of M. Tsai et al. with participation 40 896 patients with DM demonstrated an association of TR with an increased risk of stroke [12].

The results of the study by E.G. Starostina et al. indicate that in patients with DM and TR, the level of HbA1c is higher than in patients with DM without TR. For patients with type 1 diabetes, the difference was 0.9%, for patients with type 2 diabetes, it was 0.5% [2]. In the presence of DM and TP, higher values of both systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded, the incidence of arterial hypertension was 85.0 vs. 46. 0% of cases, respectively (p nine0004

In addition to the negative impact on the course of diabetes, TRs significantly worsen the quality of life of patients.

Diagnostics

Timely detection of TR is a difficult task, since there are a number of somatic symptoms that are similar to those of diabetic autonomic and distal neuropathy, micro- and macroangiopathies. It is possible to identify TR in patients with DM using psychometric scales - the Hospital Anxiety and Depression Scale (HADS), the Spielberg-Khanin scale. These diagnostic methods are available to both endocrinologists and primary health care professionals. nine0004

The International GAD Guideline Group invites general practitioners to ask two questions in order to screen for a disease:

have you felt restless, tense or anxious most of the time in the last four weeks;
Do you often have a feeling of tension, irritability and sleep disturbance?

If at least one of the questions received an affirmative answer, it is necessary to ask additional questions to identify TR [13]. nine0004

The risk groups for developing TR are patients with severe diabetes. TR should be suspected in patients with labile diabetes, difficult-to-control glycemia, poor adherence to treatment, and non-compliance with lifestyle recommendations. Patients with chronic pain due to diabetic neuropathy are a special risk group. Patients who have a pronounced increase in body weight should also be examined for the presence of TR.

Symptoms of TR can be constant and paroxysmal.

Anxiety can be associated with situations that do not pose a real danger. It is characterized by anxiety of expectation, fears, a tendency to negative forecasts. Often there is unreasonable anxiety.

Patients appear tense, restless, fussy. They tend to constantly adjust their clothes or hair. Patients are not able to completely relax, muscle tone is increased. Patients with TR often replay past and expected events in their heads, which may lead to sleep disorders, difficulty concentrating, and memory impairment. Such patients are characterized by general weakness and increased fatigue. nine0004

However, general weakness in patients with diabetes can be associated with both the presence of TR and long-term decompensation of diabetes. The latter condition can be ruled out by laboratory testing.

Autonomic symptoms of anxiety include palpitations, fluctuations in blood pressure, headaches, nausea, diarrhea, increased urination, pallor or redness of the skin.

The autonomic symptoms of TR need to be differentiated from complications of DM, such as autonomic diabetic neuropathy. Diabetic complications can be identified with special diagnostic tests. nine0004

Paroxysmal anxiety proceeds as a panic attack - attacks of pronounced anxiety or fear with various vegetative manifestations (palpitations, sweating, feeling of suffocation, nausea). Often there is a fear of death, a fear of going crazy. Paroxysmal anxiety (panic disorders) should be differentiated from hypoglycemia. The only reliable confirmation of the latter is the level of glucose in the blood below 3.3 mmol / l, determined using a glucometer. nine0004

If the patient suffers from cardiovascular diseases, panic attacks should also be differentiated from angina attacks, cardiac arrhythmias.

Treatment

With TR, both medication and psychotherapy (mainly cognitive-behavioral and relaxation techniques) are indicated.

Unfortunately, today high-quality psychotherapeutic care is not available to the majority of the population, so pharmacotherapy is of particular importance. nine0004

Among patients with DM and TR (n = 90), examined by E.G. Starostina et al., most of them took anti-anxiety drugs prescribed by therapists, neurologists or on their own. At the same time, their doses were insufficient, the courses of treatment were short or, on the contrary, very long. The drugs turned out to be ineffective (herbal remedies) or had a high dependence potential and other side effects (phenobarbital as part of Corvalol and analogues, benzodiazepines) [2]. In another study, E.G. Starostina et al. of 87 patients with TR and DM, only 8.0% had previously consulted a psychiatrist and neurologist. Psychotropic drugs previously taken 59.8% of patients with TR, and in 82.7% of cases on their own, without consulting a psychiatrist or neurologist. In the vast majority of cases, these were drugs containing phenobarbital and benzodiazepines [5].

Today, antidepressants, antipsychotics, and anxiolytics are used for TR. From the first group of drugs, selective serotonin reuptake inhibitors (SSRIs) and tricyclics (TCs) can be used. It is necessary to prescribe TC to patients with DM with caution due to the risk of weight gain and deterioration of the glycemic profile during such therapy. In addition, these drugs have pronounced cholinergic and adrenergic side effects, which limits their use in patients with concomitant somatic diseases. A relative disadvantage of SSRIs is an increase in the early stages of treatment of individual symptoms of TR and a delayed anti-anxiety effect. Among the adverse reactions of SSRIs are nausea, increased appetite, sexual dysfunction. The use of antipsychotics in patients with DM also has a number of limitations: the risk of weight gain, dizziness, excessive sedation. nine0004

Traditional benzodiazepines (phenazepam, alprazolam, clonazepam), related to anxiolytics, are not recommended for long-term use, since pharmacological dependence develops after 14 days from the start of treatment.

Grandaxin

Therapy for TR requires long-term use of anti-anxiety medications. Of the benzodiazepines, only tofisopam (Grandaxin, Hungary) is allowed for use for three months. nine0004

Grandaxin has anti-anxiety and vegetostabilizing effects, while there are no sedative and muscle relaxant effects, which is extremely important for elderly and senile patients [14]. In addition, Grandaxin does not have cardiotoxicity, which is important for patients with diabetes and concomitant diseases of the cardiovascular system [15].

Convenient dosing regimen and low cost are additional advantages of Grandaxin. nine0004

The effectiveness of TR therapy with tofisopam (Grandaxin) and hydroxyzine (Atarax) in patients with DM was studied by E.G. Starostina et al. in an open, comparative, randomized prospective study. Participants - 60 patients with DM and TR. The duration of treatment is three months. The follow-up period after discontinuation of drugs is one month. The condition of patients before the start of treatment, after three months of treatment, and one month after its completion was assessed using the Spielberg-Khanin scale, the Giessen Psychosomatic Complaints Questionnaire (GOSP). Tofisopam was prescribed at an average therapeutic dose of 50 mg three times a day. nine0004

Anti-anxiety therapy was accompanied by a reduction in the psychological symptoms of TR. A good effect was observed in about 30.0% of patients, satisfactory - in 60.0%, no effect - in 9.0% of patients. The results of comparing the effectiveness of Atarax and Grandaxin are presented in the table.

In patients treated with Grandaxin, an improvement in carbohydrate metabolism was observed - a decrease in the level of HbA1c. In those taking Atarax, the dynamics of HbA1c did not reach statistical significance. In addition, treatment with Grandaxin, in contrast to treatment with Atarax, was accompanied by a significant decrease in heart rate, SBP and DBP. nine0004

At the end of the course of treatment, Grandaxin was canceled immediately; no signs of withdrawal syndrome were recorded in patients. Tolerability of Grandaxin was characterized as good. A month after treatment, there was no recurrence of TR [16].

The positive effect of Grandaxin on the cardiovascular system in patients with coronary heart disease (CHD) was also demonstrated in a study by K.Yu. Skvortsova et al. It was shown that the addition of Grandaxin to complex antianginal therapy in patients with IHD was accompanied not only by a decrease in the severity of anxiety and depressive disorder, but also by a more pronounced decrease in the total duration of ischemia (by 53. 0% compared with patients who did not receive Grandaxin) [17]. nine0004

In the work of E.V. Kuleshova drug Grandaxin was used in 23 patients with coronary artery disease and various types of pain syndrome. During therapy, a decrease in psychoemotional disorders was observed in 19 (82.0%) cases. In eight out of 12 patients with atypical pain syndrome, its decrease was recorded. In none of the patients, the frequency and intensity of typical exertional angina attacks changed significantly [15].

Thus, Grandaxin can be considered as an effective and safe drug for the treatment of TR in patients with DM. nine0004

Panic attacks: self-help

A panic attack is a feeling of sudden and intense anxiety.

Panic attacks can cause you to experience the horror of losing control of yourself or death, a feeling of loss of consciousness, disorientation. Panic attacks can also have physical symptoms such as tremors, nausea, rapid and irregular heartbeat, dry mouth, shortness of breath, sweating, and dizziness.

Panic attacks cause severe discomfort to a person's life, but are not life-threatening if the algorithm of actions is correct. Most panic attacks last from five minutes to half an hour. nine0004

How to deal with a panic attack

Medicover Medical Center doctors advise that it is important not to let the fear of panic attacks control your emotions.

- Panic attacks are always self-limiting and all the symptoms that may accompany an attack are not life threatening;

- Tell yourself that the symptoms you feel are caused by anxiety;

- Don't look for distractions, but try to avoid being attacked. Try to keep doing the things you were doing before the anxiety started; nine0004

- Try to face your fear. If you don't walk away from it, you give yourself a chance to know that nothing bad will happen;

- When the anxiety starts to subside, start focusing on your surroundings and keep doing what you were doing before the panic attack;

- If you have a short-term sudden panic attack, it is important to have someone near you to reassure you that it will pass and there is no reason to worry.

Breathing exercises to relieve symptoms of panic attacks

If you experience shortness of breath and lack of air during a panic attack, breathing exercises can relieve your symptoms:

- inhale deeply and gently through your nose as slowly as possible;

- exhale slowly, deeply and gently through your mouth;

- some people may also be helped by counting out loud or mentally from one to five on each inhalation and each exhalation; nine0004

- close your eyes and focus on your breathing.

You should feel better in a few minutes. After that, you may feel tired.

How to prevent panic attacks?

- You should try to find out what factor is causing stress and may worsen your symptoms;

- It is important not to restrict your daily activities and movement;

- Daily breathing exercises will prevent panic attacks and alleviate them when they do occur; nine0004

- Regular exercise, especially aerobic exercise, can help control stress levels, relieve tension, improve mood and increase self-confidence;

- Eat sensibly, do not skip main meals and snacks to stabilize blood sugar levels;

- Avoid caffeine, alcohol and smoking - these can make panic attacks worse.

Learn more