Unveiling the Overlapping Symptomatology: Panic Attacks in Geriatric Depression

Herman Lee^*
*Correspondence: Herman Lee, Department of Brain Health, University of British Columbia, Vancouver, Canada, Email:

Keywords

Geriatric depression • Mental health • Panic attacks

Introduction

Brain regions implicated in mood regulation. These findings provide evidence for the involvement of neurotransmitter imbalances in depression. Furthermore, the presentation of depression can differ significantly in older adults compared to younger individuals. For instance, older adults might be less likely to express feelings of sadness and more likely to report physical complaints such as pain, which can mask underlying depressive symptoms. This divergence in symptom expression underscores the necessity of a comprehensive evaluation, especially when considering comorbid conditions like panic attacks. Panic attacks are sudden, intense surges of fear or discomfort that typically reach their peak within minutes. They are often accompanied by physical symptoms such as heart palpitations, shortness of breath, trembling, sweating, and a feeling of impending doom. Panic attacks are not exclusive to any age group; however, in the context of geriatric depression, they can be particularly perplexing to diagnose due to the potential overlap of symptoms and the presence of other medical conditions. The challenge lies in differentiating between panic attacks as a separate entity and panic-like symptoms that could arise as a part of geriatric depression. In some cases, panic attacks might be a symptom of an underlying mood disorder, while in others, they could indicate a distinct anxiety disorder. The distinction is crucial for effective treatment planning.

Literature Review

Changes in brain structure and neurotransmitter functioning that occur with age can influence the onset of both depression and panic attacks. Alterations in the serotonin and norepinephrine systems, for instance, have been implicated in both conditions. Cognitive vulnerabilities, such as negative thought patterns and distorted perceptions, can contribute to the emergence of panic attacks. In the elderly, cognitive changes related to aging might exacerbate these vulnerabilities, potentially leading to panic-like symptoms. Chronic medical conditions that are common in older adults, such as cardiovascular diseases and respiratory disorders, can trigger panic-like symptoms. These symptoms might be misconstrued as panic attacks, necessitating a comprehensive medical assessment to rule out underlying health issues. The use of certain medications in the elderly population can lead to side effects that mimic panic attack symptoms. For example, medications that affect heart rate or blood pressure can induce sensations of palpitations and shortness of breath. Social isolation, bereavement, and loss of support systems are prevalent in older adults and can contribute to the development of both depression and anxiety symptoms, including panic attacks [1-3].

Discussion

A comprehensive assessment that considers medical, psychological and social factors is necessary. This includes detailed medical history, medication review, mental status examination, and screening tools designed for geriatric populations. It's crucial to differentiate panic attacks from other medical conditions, such as cardiac arrhythmias or respiratory disorders, which can manifest with similar symptoms. Collaborative efforts between medical and mental health professionals are essential. Effective management necessitates a holistic approach that addresses both depression and panic attacks. This might involve psychotherapy, pharmacotherapy, and lifestyle modifications. Cognitive-Behavioural Therapy (CBT) can be particularly beneficial in addressing panic-like symptoms and negative thought patterns. Prescription of medications should be approached cautiously in older adults due to potential interactions and side effects. Medications targeting both depression and anxiety should be chosen based on the individual's medical profile and potential benefits. Given the complexity of geriatric depression and the potential for evolving symptoms, regular follow-up appointments are essential to monitor progress and adjust the treatment plan as needed [4-6].

Conclusion

Clinical studies have provided valuable insights into the neurobiological basis of depression. Neurochemical imbalances, structural and functional alterations in specific brain regions, dysregulation of the HPA axis, and genetic and epigenetic factors all contribute to the complex ethology of depression. However, it is essential to recognize that depression is a heterogeneous disorder with significant individual variability. Future research should aim to unravel the intricate interplay between these neurobiological factors and develop personalized treatment approaches that target specific mechanisms underlying depression. Further research is required to unravel the intricate relationship between geriatric depression and panic attacks. Longitudinal studies examining the trajectory of panic attacks in older adults with depression, along with neurobiological investigations, could provide insights into shared mechanisms and potential targets for intervention. Additionally, the development of age-appropriate assessment tools and treatment guidelines specifically tailored to the elderly population would enhance the accuracy of diagnosis and effectiveness of treatment.

Acknowledgement

None.

Conflict of Interest

None.

References

1. Smith, Wade S., Gene Sung, Jeffrey Saver and Ronald Budzik, et al. "Mechanical thrombectomy for acute ischemic stroke: Final results of the Multi MERCI trial." Stroke 39 (2008): 1205-1212.

Google Scholar, Crossref, Indexed at

2. Su, Huanxing, Tak-Ho Chu and Wutian Wu. "Lithium enhances proliferation and neuronal differentiation of neural progenitor cells in vitro and after transplantation into the adult rat spinal cord." Exp Neurol 206 (2007): 296-307.

Google Scholar, Crossref, Indexed at

3. Kessler, Ronald C., Patricia Berglund, Olga Demler and Robert Jin, et al. "Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication." Arch Gen Psychiatry 62 (2005): 593-602.

Google Scholar, Crossref, Indexed at

4. Nierenberg, Andrew A and Lindsay M. DeCecco. "Definitions of antidepressant treatment response, remission, nonresponse, partial response, and other relevant outcomes: A focus on treatment-resistant depression." J Clin Psychiatry 62 (2001): 5-9.

Google Scholar, Indexed at

5. Steffens, David C., Gwenith G. Fisher, Kenneth M. Langa and Guy G. Potter, et al. "Prevalence of depression among older Americans: The aging, demographics and memory study." Int Psychogeriatr 21 (2009): 879-888.

Google Scholar, Crossref, Indexed at

6. Shafer, Alan and Federico Dazzi. "Meta-analysis of the positive and Negative Syndrome Scale (PANSS) factor structure." J Psychiatr Res 115 (2019): 113-120.

Google Scholar, Crossref, Indexed at