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Conditions & Diseases: Psychological & Mental Health

Panic Disorder

See Also:
Panic Disorder : Introduction & Overview
Panic Disorder : Symptoms & Types of Panic Attacks
Panic Disorder : Causes & Risk Factors
Panic Disorder : Treatment Options

Panic Disorder Treatment

Panic disorder patients have several treatment options available. These treatment options can be classified in two major categories: 1) psychotherapy approaches and 2) medication. Clinical experience has shown that a combination of both these two treatment methods is the most effective.

Psychotherapy, as a treatment approach, includes two options: (1) cognitive-behavioral therapy, and (2) cognitive therapy.

Cognitive-behavioral therapy is a psychotherapy approach which considers that our thoughts and not the external situations, people or events, trigger the behavior and feelings. The benefit of this perspective is that a person can change the way he or she thinks and further the way he or she feels and acts when the situations, other people or events do not change. This form of therapy combines methods from behavioral and cognitive therapies for a better outcome such as: applied relaxation, exposure in vivo (reality) and through imagery, panic management, breathing retraining, and cognitive restructuring.  

Cognitive-behavioral therapy for panic disorder focuses on re-training the way the person thinks. This is possible by following some essential steps:

1. Education: During this step, the person learns what causes the panic attacks.

2. Physical control strategies: During this step, the person learns to breath differently and relax in order to reduce the anxiety and panic.

3. Psychological control strategies: During this step, the person learns how to handle the panic thoughts by realistically evaluating and modifying thinking patterns that trigger and maintain the panic.

4. Behavioral strategies: During this step, the person is encouraged to face those situations that trigger panic attacks by testing the new coping skills.

Cognitive therapy is a form of psychotherapy that focuses on changing peoples' unproductive and inaccurate beliefs which are the source of the panic attacks. Numerous controlled trials conducted in the United States, Germany, England, Netherlands, and Sweden have shown that cognitive therapy is an effective treatment for panic disorder.

Cognitive therapy is based on the cognitive model of panic disorder, which considers that panic attacks in those that suffer from panic disorder are being caused by a misinterpretation of the body and mental sensations. These sensations are usually perceived more dangerously than they really are, and are seen as sign of an imminent catastrophe.

Cognitive therapy for panic disorder is usually a brief treatment that includes between 8 and 15 sessions which follow several steps:

1. Education: When the patient receives information about panic disorder, and the common myths about the danger of panic attacks are explained. During this step, each symptoms is identified and the panic itself is defined.

2. Cognitive restructuring: During this step, the person learns to identifies how cognition provokes panic, explores and evaluates the accuracy of his or her thoughts, and identifies distortions.

3. Decatastrophize step: When the person learns to think in more adaptive ways

Medication: Those that suffer from panic disorder can benefit from medication to treat panic attacks. There are two types of medication prescribed for those that suffer from panic disorder anti-anxiety medication and antidepressants. In some cases, when necessary, heart medication may also be prescribed.

Tranquilizers: Benzodiazepines are an anti-anxiety medication used for people that suffer from panic disorder for their sedation or tranquilizer effect. They decrease the physical symptoms of a panic attack (such as pounding heart, chest pain, dizziness, trembling, muscle tension, or nervousness) leaving the person calm and relaxed, and reduce the frequencey of panic attacks.

Unfortunately, the use of benzodiazepines is associated with adverse side-effects during use and after stopping the treatment. One of the most predictable side effects when used over the long-term is physical dependence. Used in combination with other central nervous depressants (opiates) or alcohol, benzodiazepines increase the risk of an overdose and death due to collapse of the central nervous system, as well as respiratory and cardiovascular system depression. Benzodiazepines can impair the ability to drive and operate machinery (impairment that can worsen in association with alcohol) or cause behavioral disturbances and cognitive impairment and deficits.

Antidepressants: Antidepressants can be prescribed for those that suffer from chronic panic disorder or panic disorder associated with depression. Studies show that antidepressants reduce the panic severity, control anxiety, and eliminate the attacks. The two most common types of antidepressants prescribed for panic disorder patients are tricyclic antidepressants (which correct the imbalance of norepinephrine and serotonin) and selective serotonin reuptake inhibitors (which corrects the serotonin imbalance).

Heart medication: In some cases, heart medication (such as beta blockers) is prescribed for panic disorder patients because of its benefic effects over physical symptoms of anxiety (shaking and heart palpitations).

See Also:
Panic Disorder : Introduction & Overview
Panic Disorder : Symptoms & Types of Panic Attacks
Panic Disorder : Causes & Risk Factors
Panic Disorder : Treatment Options

Article by Alina Morrow,
MS Psychology
Medical Writer
OmniMedicalSearch.com

Sources:

Anxiety Disorders Association of America, Panic Disorder, Unknown Date
WebMD, Anxiety and Panic Disorder Guide, Mental Health: Panic Disorder, March 2007
WebMD, Anxiety and Panic Disorders Health Center, Panic Attacks and Panic Disorder - Causes, November 2006
Mental Health: A Report of the Surgeon General, Anxiety disorders, Date Unknown
US Department of Health and Human Services, National Institutes of Health, Emotion-Regulating Protein Lacking in Panic Disorder, January 2004
American Psychological Association, Anxiety, Answers to Your Questions About Panic Disorder, Unknown Date
Medline Plus, Panic disorder, July 2006
National Institute of Mental Health, Panic Disorder, January 2008
Psycheducation.org, Panic Attack Treatment, November 2007
American Academy of Family Physicians, Treatment of Panic Disorder, February 2005
HealthyPlace.com, Cognitive Therapy for Panic Disorder, 2006
Academy of Cognitive Therapy, Panic Disorder and Agoraphobia, Unknown date
Cleveland Clinic Health System, Medication for the Treatment of Panic Disorder, January 2004
Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, Panic disorder, May 2003

 

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Page Last Modified:
05/04/2009