Panic disorder manifests as repeated panic attacks when the person does not expect to be anxious at all. During the attack, a person fears a catastrophe, like a heart attack or loss of control, according to the National Institute of Mental Health. Between panic attacks, the individual experiences significant, extended worry about another panic attack occurring.
Panic attack symptoms include rapid heart rate, chest pressure, hyperventilation and gastrointestinal symptoms. Several treatments can offer relief from these symptoms, including therapy and medications.
Exposure Therapies
Exposure therapy is a specific type of behavioral therapy designed to treat certain anxiety disorders. During a typical session, the individual is exposed to the feared situation and is not allowed to leave until the fear response diminishes significantly. Individuals with panic disorder fear their own bodily responses during a panic attack, according to the American Psychiatric Association, and therefore therapy sessions focus on exposure to these bodily symptoms. Clinicians may create elaborate scenarios to mimic the symptoms of a panic attack. A patient may spin in a chair to create dizziness or hold her breath to create breathlessness, according to Montenegro and colleagues in a 2001 British Journal of Psychiatry. The clinician monitors the panic response and helps the patient tolerate it until it inevitably diminishes.
If a person with panic disorder has also developed agoraphobia, a fear of losing control in public spaces, the clinician may accompany the client to a typically feared public space and help her tolerate the panic response. A person with panic disorder can also conduct some self-exposure without the aid of a clinician.
Cognitive-Behavioral Therapy
Individuals with panic disorder experience specific types of thoughts about their panic attacks that misinterpret the severity of the situation. These catastrophic interpretations are the focus of cognitive-behavior therapy, which helps patients identify the inaccurate thought, correct it, and reinterpret the feared situation, according to the Anxiety Network website. An example is the patient who thinks, "I'm having a heart attack!" and rushes to the emergency room. Through education about physiological responses and training in modification of the thought, a person learns to manage their thought-emotion reaction to the panic attack symptoms.
Medications
Medicines cannot cure or eliminate panic attacks but can alleviate the symptoms. The Food and Drug Administration has approved several selective serotonin reuptake inhibitors (SSRIs), originally intended to treat depression, for the treatment of panic disorder. These include paroxetine (Paxil) and sertraline (Zoloft). A similar drug, venlafaxine (Effexor), is also FDA-approved to treat panic disorder. These drugs require several weeks of use before full efficacy takes place, according to the Mayo Clinic.
Other medications include the family of benzodiazepines, used only for short-term relief of symptoms due to their habit-forming properties. These medications include the popular drugs clonazepam (Klonipin), diazepam (Valium) and alprazolam (Xanax).
References
- "Diagnostic and Statistical Manual of Mental Disorders"; American Psychiatric Association; 2000.
- National Institute of Mental Health: When Fear Overwhelms -- Panic Disorder
- Mayo Clinic: Panic Disorder and Panic Attacks -- Treatments and Drugs
- Anxiety Network: Cognitive-Behavioral Therapy
- "British Journal of Psychiatry"; Self-Exposure Therapy for Panic Disorder with Agoraphobia; L. Montenegro and colleagues; vol 178, issue 4, 2001
