Characteristics And Treatments For Panic Disorder

According to the DSM-5, between two and three percent of the population in the Western world have had or will have a panic disorder. There are two affected women for each affected man, and the average age is between 20 and 24 years. But what exactly is this disorder? What causes it? Are there treatments for panic disorder?

Let’s shed light on anxiety disorder. It can be inhibiting because a person who has experienced a panic attack is often afraid of getting a new one.

These disorders, along with depression and those associated with substance abuse, are quite common. Giving them visibility can thus increase awareness of their significance and consequences.

Definition and symptoms of panic disorder

Panic disorder is a type of anxiety disorder. The main characteristic, according to the DSM-5 ( Diagnostic and Statistical Manual of Mental Disorders ), is the repeated occurrence of sudden and unexpected panic attacks. A person is often calm and enjoying himself in the moments before a seizure. In the same way as with panic disorders, they fear getting a new one. This is because it disrupts important parts of their lives.

But what exactly is a panic attack? Also referred to as an existential crisis, it consists of the occurrence of sudden and temporary episodes of feelings of anguish, discomfort and intense fear. Although the duration varies, they last about 15 minutes. Also, the peak of maximum intensity is a few minutes after it starts.

The symptoms that can occur during a panic attack are different and include sweating, hyperventilation, tachycardia, tremor, dizziness, vomiting and nausea. In addition, there are other mental symptoms, such as the fear of going crazy, losing control, having a heart attack and dying. There may also be dissociative symptoms such as derealization (feeling that what is happening is not real) or depersonalization (detachment from yourself).

Causes of panic disorder

The causes of panic disorder are not always clear. For example, the first panic attack may appear due to situational factors. Similarly , the fear of it happening again may be due to the generation of negative and aversive interpretations of bodily experiences (not related to anxiety).

Thus, if you interpret certain bodily experiences as anxiety-related, these can intensify and generate more fear and anxiety which in turn can lead to a panic attack.

Genetics may also be related to the etiology of panic disorder. In other words, people with relatives who also experience anxiety disorders are more likely to develop it. Finally, past experiences and exposure to certain behaviors can also affect the onset of a panic disorder.

Treatments for panic disorder: psychotherapy

Some of the effective psychological therapies for panic disorder are cited in Marino Perez’s Guía de Tratamientos Psicológicos Eficaces (in Norwegian: Guide to Effective Psychological Treatments) (2010) and MA Vallejo’s Manual de Terapia de Conducta (In Norwegian: Atferdsterapimanual) (2016).

Multicomponent cognitive behavioral programs

There are two very effective programs in panic disorder:

• Barlow’s Panic Control Treatment (2007).
• Cognitive therapy by Clark and Salkovskis (1996).

Barlow’s therapy includes live exposure to interoseptic experiences as a key element of the intervention. It also includes the following components: psychoeducation, interoseptic exposure, cognitive restructuring and breathing / relaxation training.

Clark and Salkovski’s cognitive therapy aims to identify, test and modify erroneous experiences for more realistic ones. It includes the following components: psychoeducation, cognitive restructuring, behavioral experiments based on the induction of dreaded experiences, and recommendations for abandoning safe behavior.

Treatments for panic disorder: Breathing exercises

This is Chalkley’s (1983) exercise in slow breathing for panic attacks. It really involves learning slow, diaphragmatic breathing. However, there are currently questions about its effectiveness as a stand-alone intervention (ideally, it should include such an exercise).

Used relaxation

Öst’s (1988) applied relaxation is mostly used for panic disorder, and it teaches progressive muscle relaxation so that the patient can use it to meet a future seizure. It is a gradual way of confronting:

• First, the body experiences that release the panic.
• The activities and situations you can avoid.

Live exposure therapy

One of the most effective treatments is exposure therapy by Williams and Falbo (1996). Such treatment involves systematic exposure to the situations they fear and avoid.

Treatments for panic disorder: Vagal innervation

Sartory and Olajide’s (1988) vagal innervation for panic seeks to control the patient’s heart rate by learning some massage techniques on the carotid artery. In particular, it consists of applying pressure to one eye while the person exhales.

Sensory-focused intensive care

The authors of this treatment for panic disorder are Morissette, Spiegel and Heinrichs (2005). It is an eight-day follow-up intervention aimed at eliminating the fear of physical experiences.

To do so, they use massive exposure without grading, and face the most feared experiences from the very beginning. They also strengthen the exposure and induce body impressions through physical exercises.

Acceptance and commitment therapy

Within acceptance and commitment therapy (ACT), there is an increased acceptance of cognitive behavioral therapy for panic, by Levitt and Karekla (2005).

It consists of a standard cognitive behavioral procedure that includes psychoeducation, situational and interoseptic exposure, and cognitive restructuring. It also adds other components to CT, such as attention and discussion of valuable activities in the face of anxiety.

Treatments for panic disorder: Pharmacotherapy

Marino Pérez (2010) and M. Vallejo (2016), explain that pharmacotherapy used and validated for panic disorder includes the use of antidepressants and anti-anxiety drugs. In this connection, SSRIs are usually prescribed as antidepressants and benzodiazepines or sedatives as anxiolytics.

These drugs can help reduce a person’s anxiety. However, it is best for the treatment to combine both psychotherapy and pharmacotherapy. This is because the profound changes in the individual will always be achieved with appropriate psychological support (with therapy). Furthermore, pharmacotherapy can calm an individual and lay the foundation for their recovery. However, psychotherapy is what will allow the individual to change their beliefs and stop avoiding certain situations and experiences.