Brief Answer: Claustrophobia Detailed Answer: Dear XXXXXXX Thanks for contacting Ayurveda with your health concern and following points are worth mentioning prior to Ayurveda management 1. It is typically classified as an anxiety disorder and often results in panic attack, [breath going to stop] and can be the result of many situations or stimuli,[clothing in your case] PS. any history of childhood trauma? 2. fear of restriction [fear comes in mind] and fear of suffocation [suffocation while wearing clothes] are two key symptoms and both are defined in your case history. 3. apart from clothes: . Is anxiety attacks related with some threat? . is anxiety manifested due to some illness? . is anxiety a symptom of some withdrawal? 4. any excess use of caffeine and sugar [major diet source of causing anxiety and thereby causing panic attacks] 5. are your symptoms associated with three said problems is excessive or persistent or debilitating.?? PS. In more than 90 percent of cases, gestational diabetes [medical history] goes away after you give birth, but you may still experience emotional "ups and downs" as your hormones get back to normal, talk to your obstetrician [ If you have gestational diabetes, a type of diabetes that develops for the first time during your pregnancy, your risk of postpartum depression [fear, anxiety, exhaustion] may be significantly higher, according to a recent study published in the Journal of the American Medical Association. 6. before I rush to prescribe herbal medicine or any Alternative system of Medicine, do let me know about any of these possibilities to know more about the evaluation and management of your problem, in the mean time start incorporating following guidelines in your daily routine: - Avoid: excess physical –mental exertion, sun exposure, corrylium, smoking, errhine therapy, betel leaves, gruel, soup, day time sleeping, garlic, ginger, onion, spicy-heavy- junk food, mustard oil, pickles. - Take: mint, coriander, tomato, cumin, plenty of water, vitamins and mineral supplements, XXXXXXX banana,grapes,dates - You can practice: bhujangasana,halasana, paschimottasana, sarvangasana, shalabhasana, shavasana and vakrasana and pranayamas like bhastrika and kapalbhati. - Lemon juice mixed with sugar in a glass of water helps release stress removing hormones from the body and bring mind at peace/rest. - Mix 4-5 dates in half glass of water and drink 2 times daily for a month. - XXXXXXX almond, banana, broccoli, cantaloupe, melon, carrot, cashew nut, corn, cauliflower, grapes, guava, lemon, mango, orange, pineapple, soybean, spinach have anti oxidant properties so take them in plenty. PS. Amygdala [portion of brain]: is needed for the conditioning of fear, or the creation of a fight-or-flight response.In anxious states this translates as panicking or overreacting to a situation in which the person finds themselves physically confined.A study done by Fumi Hayano found that the right amygdala was smaller in patients who suffered from panic disorders [please check with your attending Physician for suitable investigation[ MRI] and examination [scale method and questionnaire] if necessary 7. Management: 1. frequent re-exposure to same stimuli PS. Because panic attacks are repeatable which means you feel endangered and unable to escape which means there is ‘fear of fear’ i.e. vicious anxiety- panic attack- anxiety cycle, thus before taking panic attacks to be due to anxiety or depression make sure you have ruled out following medical conditions like overactive thyroid, low blood glucose, use of excess caffeine, cocaine, amphetamines or heart problem. PS. practice relaxation techniques like yoga, meditation but also Pranayam [anulom vilom] which will strengthen the relaxation response of body as opposite to stress response during panic attacks, [i.e. hyperventilation], don’t try to flee away from the situation which will reinforce the perception that your panic attacks are unbearable [remember they are uncomfortable but not life threatening], allow the symptoms to pass and you will gain ability to cope with them 2. Since drug therapy is generally only a palliative treatment, we have to look at cognitive and behavior strategies and especially nutritional strategies. I do recommend behavioral practice, whether it’s yoga, or meditation. Please revert back with above questionnaire for further line of treatment Dr. Munish Sood Consultant & Physician Naimittika Clinic.

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