Panic Attacks

Panic Disorder is the experience of panic attacks followed by ongoing concern and worry about having another panic attack and/or worry about the possible consequences of a panic attack. There may be avoidant behaviors associated with, and secondary to, the panic attacks. Panic attacks consist of:

1. Heart palpitations or racing heart
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or a smothering sensation
5. Feeling of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, lightheaded or faint
9. Feelings of unreality or being detached from oneself
10. Fear of losing control or going crazy
11. Fear of dying
12. Numbness or tingling sensation
13. Chills or hot flushes (DSM IV-TR-Revised)

One to two percent of the population is likely to have a Panic Disorder at some point in their life. Often associated with a panic attack is a catastrophic misinterpretation of a physical sensation. For example, in response to a rapid heartbeat, a person with panic disorder may think:

• “I’m having a heart attack.”

In response to a feeling of dizziness, a person with Panic Disorder may conclude:

• “I’m having a stroke.”

These catastrophic misinterpretations further create anxiety which exacerbates the physical sensation and strengthens the catastrophic misinterpretation. The thoughts most often associated with panic include:

• “I’m having a heart attack,”
• “I’m having a stroke,”
• “I’m out of control,”
• “I’m going to die.”

In the past panic disorder has been thought of as a condition that was chronic or only treated with psychiatric medication. In the last 20-30 years new, highly effective cbt treatments for panic disorder have been developed, tested, and refined. The newest cbt treatments are not only effective in a relatively brief period of time but research has demonstrated a low relapse rate. Most people with panic disorder get better and stay better after cbt treatment. Panic disorder has the best prognosis of any problem a person can come to a psychologist with and can generally be treated in 12-20 sessions.

Psychotherapy consists of relaxation exercises and patients learning to identify, evaluate and alter the thoughts that are associated with their panic attacks. This is often combined with systematically approaching situations that are being avoided because of fear of having a panic attack.