Panic Disorder

Therapies for panic disorders aim to reduce the frequency and severity of panic attacks while addressing the underlying anxiety that fuels them. These therapies often combine psychological, behavioral, and sometimes pharmacological approaches. Below are the most effective therapies for managing panic disorders:

Cognitive Behavioral Therapy (CBT): CBT is the gold standard treatment for panic disorder. It helps individuals identify and challenge distorted thoughts and beliefs that contribute to panic attacks.

• Cognitive Restructuring: Focuses on replacing catastrophic thoughts (e.g., “I’m going to die”) with realistic and calming ones.
• Behavioral Techniques: Encourages gradual exposure to panic-inducing situations or sensations in a controlled way to desensitize the individual.
• Effectiveness: Studies show that CBT significantly reduces panic attack frequency and improves long-term coping skills.

Exposure Therapy: A subtype of CBT, exposure therapy targets the avoidance behaviors and fear of specific triggers associated with panic attacks.

• Interoceptive Exposure: Patients are exposed to physical sensations associated with panic (e.g., increased heart rate or dizziness) to reduce fear responses over time.
• Situational Exposure: Gradual exposure to environments that induce panic, such as crowded places or elevators.
• Goal: To help patients learn that these sensations or situations are not inherently dangerous.

Acceptance and Commitment Therapy (ACT): ACT focuses on mindfulness and acceptance strategies to manage panic symptoms.

• Mindfulness Training: Teaches patients to observe and accept their thoughts and feelings without judgment.
• Values-Based Living: Encourages focusing on life goals and values, even when experiencing anxiety.
• Effectiveness: Useful for individuals who struggle with avoidance behaviors or are resistant to traditional CBT techniques.

Dialectical Behavior Therapy (DBT): Originally designed for borderline personality disorder, DBT has been adapted to help with panic disorders.

• Emotion Regulation: Teaches individuals how to manage intense emotions.
• Distress Tolerance: Builds skills for coping with panic attacks when they occur.
• Mindfulness: Helps patients remain present during moments of acute anxiety.

Eye Movement Desensitization and Reprocessing (EMDR): While traditionally used for trauma, EMDR can benefit those with panic disorders linked to specific events.

• Mechanism: Combines bilateral stimulation (e.g., eye movements) with recalling distressing memories to reduce their emotional impact.
• Application: Effective for panic triggered by past traumatic experiences.

Pharmacology: Medications may be used in conjunction with therapy to manage symptoms:

• Selective Serotonin Reuptake Inhibitors (SSRIs): First-line medications (e.g., sertraline, fluoxetine) that reduce overall anxiety.
• Benzodiazepines: Fast-acting but typically short-term options (e.g., lorazepam, alprazolam) for severe panic symptoms.
• Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Medications like venlafaxine can also be effective.
• Tricyclic Antidepressants: An older class of medications occasionally prescribed if SSRIs are ineffective.