Panic disorder :Treatment

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• Panic disorder: Outcome studies
• Panic disorder: Treatment protocols
• Panic disorder: Treatment considerations
• Panic disorder: Evidenced based treatment
• Panic disorder: Theory based treatment
• Panic disorder: Team working considerations
• Panic disorder: Followup

Panic disorder is real and potentially disabling, but it can be controlled with specific treatments. Because of the disturbing symptoms that accompany panic disorder, it may be mistaken for heart disease or some other life-threatening medical illness. This misconception often aggravates or triggers future attacks in the uninformed. People frequently go to hospital emergency rooms when they are having a panic attack, and extensive medical tests may be performed to rule out these other conditions.

CBT

Treatment for panic disorder includes medications and a type of psychotherapy known as cognitive-behavioral therapy, which teaches people about the nature of panic attacks, the cycles of negative thoughts, and demonstrated ways to interrupt the panic process.

Psychoanalytic treatment

Fredric N. Busch has been involved in research on panic focused psychodynamic psychotherapy, including the first study to demonstrate efficacy of psychodynamic treatment of panic disorder, published in the American Journal of Psychiatry.

Medication

Medications can be used to break the psychological connection between a specific phobia and panic attacks, reducing future panic attacks. Medications can include antidepressants (SSRI's, MAOI's, etc.) taken every day, or anti-anxiety drugs (benzodiazepines, e.g. -- Valium, Ativan, Xanax, etc.) during or in anticipation of panic attacks. Exposure to the phobia trigger multiple times without a resulting panic attack (due to medication) can often break the phobia-panic pattern, allowing people to function around their phobia without the help of medications. However, for minor phobias that develop as a result of the panic attack, with early detection these can be eliminated without medication through monitored cognitive-behavioral therapy or simply by reinserting oneself into the phobic activity. The decision to participate in this therapy personally or through a registered practitioner should always be left to a medical professional.

Often, a combination of psychotherapy and medications produces good results. Some improvement may be noticed in a fairly short period of time--about 6 to 8 weeks. Thus appropriate treatment by an experienced professional can prevent panic attacks or at least substantially reduce their severity and frequency--bringing significant relief to 70 to 90 percent of people with panic disorder. Relapses may occur, but they can often be effectively treated just like the initial episode.

In addition, people with panic disorder may need treatment for other emotional problems. Clinical depression has often been associated with panic disorder, as have alcoholism and drug addiction. About 30% of people with panic disorder use alcohol and 17% use drugs such as cocaine or marijuana to alleviate the anguish and distress caused by their condition. Research has also suggested that suicide attempts are more frequent in people with panic disorder, although this research remains controversial.

As with many disorders, having a support structure of family and friends who understand the condition can help increase the rate of recovery. During an attack, it is not uncommon for the sufferer to develop irrational, immediate fear, which can often be dispelled by a supporter who is familiar with the condition. For more serious or active treatment, there are support groups for anxiety sufferers which can help people understand and deal with the disorder.

Other forms of treatment include journalling, in which a patient records their day-to-day activities and emotions in a log to find and deal with their personal stresses, and breathing exercises, such as diaphragmatic breathing. In some cases, a therapist may use a procedure called interoceptive exposure, in which the symptoms of a panic attack (such as hyperventilation) are induced in order to promote coping skills and show the patient that no harm can come from a panic attack. Stress-relieving activities such as tai-chi, yoga, and physical exercise can also help ameliorate the causes of panic disorder. Many physicians will recommend stress-management, time-management, and emotion-balancing classes and seminars to help patients avoid anxiety in the future.