As you spend more time discussing goals and challenges with your Talkspace therapist, you may have questions or are interested in learning more about specific mental health topics and conditions. The Talkspace Bookshelf offers up-to-date mental health information directly from our behavioral health team to provide a better understanding of condition origins, diagnoses, various forms a condition may take, and different treatment options. Feel free to use this resource as a starting point to open up a dialogue and pose questions for your Talkspace therapist.
Panic is an emotional experience characterized by intense and extreme moments of terror, worry, or fear. Panic attacks are the words we most often use to describe those intense moments of overwhelming fear. It is estimated that about 2.7% of the US population lives with Panic Disorder in a given year.
Commonly thought of as an expected part of anxiety disorders, this is not always the case. While panic and anxiety belong to the same family of conditions, panic (or panic attacks) can accompany any mental health condition. That is, those with anxiety disorders may or may not experience panic attacks. In addition, Panic Disorder is classified as its own, stand-alone condition. Panic attacks can be experienced in addition to other mental health conditions such as Posttraumatic Stress Disorder, depressive disorders, and substance use disorders.
What does a panic attack feel or sound like? People who have experienced panic attacks often cite symptoms such as:
- Heart racing or heart palpitations
- Shortness of breath
- Dizziness
- Chest pain
- Trembling or shaking
- Sensations of choking
- Numbness
- Fainting
Panic attacks can be experienced by anyone and do not necessarily indicate a mental health disorder. Panic Disorder, by contrast, is an ongoing condition that is characterized by periodic panic attacks, which are defined in the Diagnostic and Statistical Manual of Mental Health Disorders 5 (DSM 5) as an, “abrupt surge of intense fear or intense discomfort that reaches its peak within minutes.” In addition to the symptoms listed above, those experiencing panic attacks may also experience nausea or abdominal distress, feeling of being detached from their bodies or reality, fear of completely losing control, and even a fear of dying. Having a panic attack is a very frightening experience.
Panic Disorder can be particularly debilitating to those living with the condition as it also leads to other disruptions in a person’s life in addition to the panic attacks themselves. Those living with Panic Disorder also often experience ongoing or periodic worry about having another panic attack in the future, which can greatly limit daily functioning.
In an effort to ward off further attacks, those living with Panic Disorder often find themselves engaging in avoidant behaviors, particularly in environments in which they may have experienced prior panic attacks. This can include avoidance of both the specific environments themselves (such as a restaurant where they recently had an attack) as well as the people around them at the time of the attack. This can lead to further isolation and lack of exposure to new or exciting situations.
A note about Agoraphobia
Those affected by Panic Disorder may also experience a condition called agoraphobia, which is experienced by most as an intense fear of public or open spaces. Those living with Panic Disorder may or may not experience agoraphobia and its accompanying symptoms. If you find yourself fearing open spaces, public environments, or public transportation, then you may also be experiencing symptoms of agoraphobia. Speak to a therapist about your experiences and they will be armed with the information necessary to best help you to move past your symptoms.
Treatment for Panic Disorder
There are a range of treatments available to those who live with Panic Disorder. As it is primarily thought of as part of the anxiety conditions continuum, many of the most often recommended treatments are similar to those of the suggestions for other anxiety-based conditions.
Medication or Pharmacotherapy
As the research suggests, most mental conditions are best served by combination of both talk therapy and medication. For those living with Panic Disorder, there are a few classes of medications that may be a helpful adjunct to talk therapy. Contrary to their name, antidepressants can be quite helpful in alleviating the symptoms of Panic Disorder. Medications like Paxil, Prozac, and Zoloft (and their generic equivalents) are sometimes prescribed by doctors or psychiatrists.
In addition, short acting medications, from the benzodiazepine class may be particularly strong allies in the fight against debilitating panic attacks. Sample medications such as Ativan, Valium, or Xanax may be used at the onset of an attack to help quickly alleviate symptoms. Benzodiazepines, while very effective, have been demonstrated to be at greater risk for misuse and dependency due to their effectiveness and potency. As such, doctors and therapists may closely monitor the use of this class of medications in an effort to prevent misuse, and to prevent a substance use disorder from developing.
Cognitive Therapy
Cognitive therapy is one of the most effective and recommended treatments for anxiety disorders, including Panic Disorder. A therapist may help a client work through thought patterns that are negatively contributing to the experiences of panic or exacerbating panic events.
Therapy may focus on cognitive distortions, or those often automatic thought patterns that worsen anxiety and panic. One example of an automatic thought pattern is catastrophizing, which is the almost immediate belief that the current situation will result in intense and extreme negative consequences. For those who experience panic attacks, this may mean moments in which they believe that are about to die. In many situations where panic is experienced by those with Panic Disorders, death may not be likely at all or so remote that the possibility of even immediate physical harm is highly unlikely.
In addition to addressing cognitive distortions, cognitive therapy may also include an exploration of common panic triggers in public, home and work environments. By thoughtfully identifying these triggers in therapy, you may be better able to work with your therapist to craft a panic attack plan in the environments that you find yourself most affected. A plan may include a variety of cognitive, behavioral, and mindfulness strategies. This plan may serve to limit onset of panic attacks as well as identify ways to respond with healthier thought patterns.
For example, for some people who experience panic attacks, they may be able to use others around them as allies in the run up to panic events. If prepared and incorporated into a part of the panic plan, coworkers, partners, friends, or other loved ones may be very helpful in limiting the negative impact on the individual’s suffering.
Behavioral Therapy
In many instances, a therapist or psychologist may blend the principles of both cognitive and behavioral therapy for effective and powerful treatment outcomes. Of course, this also depends on the client’s specific needs and preferences.
Behavioral interventions may often include strategies to limit or moderate the impact of anxiety and panic. For many this may include things like changing the immediate environment, grounding exercises, and engaging in an established panic plan.
Additionally, clients may be introduced to techniques that are rooted in mindfulness, which include mindful breathing, meditation, progressive muscle relaxation, and more.
Stress Management
In addition to the therapies listed above, therapists may also encourage clients living with Panic Disorder (or those who experience panic attacks) to regularly engage in stress management techniques. This may include a variety of lifestyle changes including, but not limited to, decreasing caffeine use, assertiveness training, and schedule and routine management.
Therapeutic Note
Remember your therapist is here to help you figure out the best way to address your concerns. Therapy works best when it is a collaboration between you and your therapist. It is important to be open, honest, and an active participant in this process. Talk to your therapist about your goals for therapy so that together you can come up with the best plan to achieve them.
Questions You Might Have For Your Talkspace Therapist
- Can you die from having a panic attack?
- How did I develop this problem of having panic disorder?
- Do panic attacks run in the family?
Sources
American Psychiatric Association. "Panic Disorder." Desk Reference to the Diagnostic Criteria From DSM-5®. Washington: American Psychiatric Publishing, 2014. 119-121.
National Institute of Mental Health. Panic Disorder Among Adults. (n.d.). Retrieved May 17, 2017
WebMD. Panic Attacks and Panic Disorder - Medications. (n.d.). Retrieved May 17, 2017