Cognitive behaviour therapy (CBT) has been shown to be very effective in the treatment of Panic Disorder. Cognitive behaviour therapy for Panic Disorder may integrate a range of different interventions aimed at teaching the individual more adaptive strategies for coping with anxiety.
Therapy may include relaxation skills training (such as diaphragmatic breathing and progressive muscle relaxation) to teach people how to manage their anxiety, thought challenging techniques to teach people to identify and challenge their anxiety provoking thoughts, identifying and modifying the positive and negative beliefs that maintain anxiety, behavioural interventions aimed at teaching people to change the behaviours that maintain the anxiety cycle (such as avoidance, checking and reassurance seeking behaviours) and exposure therapy where the individual learns to confront their fears in a safe and controlled manner.
Anti-depressant medications and Benzodiazepine medications (such as Valium and Xanax) have also been shown to be effective in the treatment of Panic Disorder.
Although the exact causes of panic attacks and panic disorder are unclear, the tendency to have panic attacks runs in families. There also appears to be a connection with major life transitions such as graduating from college and entering the workplace, getting married, or having a baby. Severe stress, such as the death of a loved one, divorce, or job loss can also trigger a panic attack.
Panic attacks can also be caused by medical conditions and other physical causes. If you’re suffering from symptoms of panic, it’s important to see a doctor to rule out the following possibilities:
- Mitral valve prolapse, a minor cardiac problem that occurs when one of the heart’s valves doesn’t close correctly
- Hyperthyroidism (overactive thyroid gland)
- Hypoglycaemia (low blood sugar)
- Stimulant use (amphetamines, cocaine, caffeine)
- Medication withdrawal
A panic attack is a period of intense fear or discomfort during which four or more of the following symptoms developed abruptly and reached a peak within 10 minutes:
- Palpitations, pounding heart or accelerated heart rate
- Sweating
- Trembling or shaking
- Sensations of shortness of breathing or smothering
- Feeling of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, lightheaded or faint
- Derealisation (feelings of unreality) or depersonalisation (being detached from oneself)
- Fear of losing control or going crazy
- Fear of dying
- Paresthesias (numbness or tingling sensations)
- Chills or hot flushes
Panic Disorder is an anxiety disorder which is characterised by the presence of recurrent, unexpected panic attacks which is followed by at least 1 month of persistent concern about having another panic attack, or significant behavioural change related to the attack. For example people who experience panic attacks often change their behaviour by not going to the places in which they have had previous attacks in the hopes that they may avoid further attacks (i.e. avoiding public transport, lifts, movie theatres, shopping centres etc).
People who have panic attacks often are not aware that they are experiencing an anxiety attack and can misinterpret the signs of anxiety as signs that they are suffering from a serious medical condition (e.g. misinterpreting their increased heart rate and muscle tension in the chest as a sign that they are having a heart attack, thinking that the hyperventilation they are experiencing is the result of an asthma attack and that they may suffocate/stop breathing, or thinking that the blurred vision they are having is a sign that they may pass out). Consequently, many people who have panic attacks fear that they may die during one of their attacks and may only present for treatment after several trips to the doctors.
Some people with panic attacks may also experience agoraphobia. Agoraphobia is anxiety about being in places or situations from which escape might be difficult or embarrassing (such as a movie theatre, public transport, or staff meetings) or in which help may not be available in the event of having a panic attack (i.e. going out in public alone).