What is Panic Disorder? Panic disorder is an anxiety disorder characterized by unexpected and repeated panic attacks in which the person experiences a sudden rush of intense fear or discomfort. The person becomes terrified of having more panic attacks and fear that something bad will happen because of the panic attack, such as going crazy, losing control, or dying. Panic attack symptoms can include the following:
rapid heart beat
sweating
shaking or trembling
shortness of breath
feelings of choking
chest pain or discomfort
nausea or upset stomach
dizziness or lightheadedness
numbness or tingling sensation
a sense of things being unreal or feeling detached from oneself
chills or hot flashes
Safety/Unhealthy Coping Behaviors People suffering panic attacks will often change their behavior to feel safer or to prevent future panic attacks. For example, they might carry items such as medication, water, or a cell phone, having someone (e.g., family member or friend) accompany them to places, avoid physical activities (e.g., exercise, sex) that might trigger panic-like feelings, or sitting near exits or bathrooms. Individuals with panic disorder may also experience agoraphobia; they may avoid situations that might trigger a panic attack or where escape might be difficult.
Panic Disorder in Children Children suffering from panic experience similar symptoms as adults. However, they may also exhibit more irritability, crying, temper tantrums, and clinginess to others with whom they feel comfortable. In the case of agoraphobia, they may have difficulty expressing their fear and may say that they do not want to go somewhere (e.g., school, baseball practice) or do something (e.g., see a movie with their friends) for a seemingly arbitrary reason.
Adverse use of Benzodiazepines Some individuals use benzodiazepines (e.g., Valium, Librium, Ativan, Klonopin, Xanax) to relieve their anxiety symptoms. However, while these medications can produce short-term relief of anxiety, they do not help to resolve anxiety disorders in the long run, with posttreatment relapse rates reported as high as 63%. Use of benzodiazepines long-term can essentially maintain the anxiety disorder. Long-term use is also associated with addiction, memory and learning impairment, and interference with CBT. Read this excellent summary of the adverse effects of long-term use of benzodiazepines to alleviate anxiety.
How We Can Help Our therapists will use cognitive behavior therapy (CBT) to help the individual learn distress tolerance skills and effective self-talk. For children with panic disorder, our therapists will guide parents to effectively implement an incentive plan and decrease accommodating behaviors in order to motivate their child to use their coping skills. Most importantly, individuals learn to overcome fears of panic attacks via interoceptive exposure practices. Real lifeexposures and other interventions are also used to help the individual gradually practice confronting situations (e.g., grocery stores, driving, movie theaters) without avoidance or employing unhelpful safety behaviors as described above. Exposure practice and elimination of safety behaviors serve to help the individual change his/her beliefs about his/her ability to cope with uncomfortable physical sensations and uncertainty and return to living a functional life.