PANIC DISORDER

A person with panic disorder has experienced one or more panic attack and has high levels of worry about experiencing future panic attacks. This worry often leads to avoidance behaviors. About half of people with panic disorder also have agoraphobia. 

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A panic attack involves four or more symptoms such as rapid heart rate, numbness, dizziness, sweating, trembling, and nausea.

 

Agoraphobia is a fear of places or situation where escape would be difficult or impossible.

Treatment for panic disorder involves a combination of Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Exposure Therapy. In CBT and ACT, we examine the thought patterns that maintain panic, particularly fears about the meaning and consequences of panic symptoms. Common fears include losing control, having a medical emergency, “going crazy,” or being unable to escape. We work on noticing these thoughts and learning to respond to them differently by challenging unhelpful interpretations. 

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Panic attacks can bring on really intense physical symptoms like racing heart, sweating, dizziness, feelings of dying, muscle tension, and nausea. But we also know panic symptoms subside.  An essential part of treatment is learning to tolerate bodily sensations and emotional discomfort associated with panic.  Rather than trying to prevent or eliminate panic symptoms, the focus is on building trust in your ability to experience these sensations safely and allow them to rise and fall on their own.

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Exposure is a key component of treatment for panic disorder. This includes both interoceptive exposure (intentionally bringing on feared physical sensations such as dizziness, shortness of breath, or a racing heart) and situational exposure to places or activities you may have been avoiding. Exposures are guided by your values and designed to help you reconnect with your life. If you have been avoiding driving or being in crowded places due to fear of panic, exposures may involve gradually returning to those situations. Over time, repeated exposure helps disconfirm catastrophic fears about panic and reduces avoidance. By facing panic sensations and situations directly, without safety behaviors or reassurance, you can retrain your brain’s response to fear and regain a sense of freedom and confidence.

Anxiety Disorder Association for America: ADAA is a national association that focuses on the the research and treatment of all anxiety disorders.  It also has excellent general information about various anxiety disorders and research.  

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Bio-behavioral Institute: A research based clinic that focuses on OCD and other anxiety disorders in New York.

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