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If you suffer from frequent panic attacks, that are not connected to specific situations, you may be suffering from panic disorder especially if your fear of having another panic attack interferes with your day to day functioning.
Counselling and medication are the most common treatments for panic. They demonstrate strong evidence of effectiveness in helping people address and overcome this disorder.
A panic attack can occur suddenly without warning, and for what appears to be no logical reason. Panic attack symptoms can be extremely frightening to those who aren’t aware. Alongside the feelings of anxiety they provoke, a host of other symptoms can accompany a panic attack such as:
Most panic attacks last for around 5 to 20 minutes. In certain situations, the shock of the physical symptoms can make people fear they are having a heart attack. However, it is important to note that the symptoms of a racing heartbeat and shortness of breath during a panic attack will not cause a heart attack.
People with panic disorder tend to experience general feelings of worry and anxiety in their daily life. They experience panic attacks on a regular basis. For some, panic attacks occur as much as two or three times a week, whereas for others an attack may happen once or twice a month.
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Counselling and psychotherapy can help people to address panic in a number of ways including understanding and managing panic symptoms, overcoming panic attacks and reducing panic frequency. In fact, it is not uncommon for people to be free of unexpected panic altogether by the end of a course of treatment. These therapies also help people develop the skills needed to feel confident in coping should a panic attack occur again in the future.
CBT for Panic Attacks
CBT (Cognitive Behavioural Therapy) is considered one of the most effective psychotherapies for dealing with panic disorder and panic attacks. According to this model, people who suffer from panic disorder often have distorted ways of thinking that they are not aware of and these thoughts bring on a cycle of fear. By recognising and reshaping these thought patterns, people can take control over their panic. Relaxation training and exposure might also be used to help an individual overcome the problem, and homework assignments such as journals or breathing exercises are typically part of the programme. Weekly sessions of CBT for panic, over a period of 7 to 14 weeks, are recommended by the UK National Institute for Care and Excellence (NICE).
Panic Attack Psychotherapy
Psychotherapy can help people understand the roots of panic attacks, which do not have an obvious connection with here and now stimuli. By exploring areas in people’s past such as childhood experiences, early personal difficulties or past relationships the underlying causes that contribute to your panic can be uncovered and dealt with. This helps remove the issues that are often out of awareness but powerfully fuel the physiology which gives rise to panic. Blocked feelings such as anger, low self-esteem or shame can also be factors which exacerbate anxiety. Psychotherapy can help you uncover these issues and correct them, so they no longer contribute to fuelling panic.
Exposure Therapy for Panic
This type of therapy exposes people to the physical sensations of a panic attack, in a controlled environment, so that they can learn healthier coping mechanisms. Each exposure can gradually reduce your fear of having a panic attack and help you feel more in control of the situation when panic feelings arise in the future.
There are some medications that can help control the physical symptoms that accompany panic disorder, but medication is rarely used alone to treat the problem.
Selective Serotonin Reuptake Inhibitors (SSRIs) work by increasing the level of serotonin in your brain. These medications might initially make anxiety and panic worse, and it can take two to four weeks for the full effects to kick in. There are a number of potential side effects, including:
Tricyclic antidepressants might be prescribed if SSRIs are not effective after a period of 12 weeks. They work in a similar way to SSRIs, but they are typically not prescribed initially because they have more side effects including:
Benzodiazepines are sometimes used to stop a panic attack in an emergency care setting because they work quickly but they can be habit-forming so they are not widely prescribed for regular, long-term use.
You should never attempt to stop taking antidepressants on your own as this can result in severe withdrawal symptoms.
In certain cases, when panic symptoms are severe or exacerbated by other conditions such as depression, some people find a combination of medication and counselling can be more helpful. Once the severe physiological symptoms have abated and the individual feels more in control, it is possible to move towards reducing or eventually stopping medication. Again you should never reduce or stop taking medication suddenly or without proper medical supervision.
Alongside medication and/or counselling the options listed below can assist people in coping with or reducing panic disorder symptoms.
Ten Tips For Managing Panic Attacks
Panic Attacks: How Can Cognitive Behavioural Therapy Help?
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This page was written by Maggie Morrow (MSc, BSc, Adv Dip, UKCP) and medically reviewed in June 2019.
