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How Are Panic Attacks Treated?

January 13, 2020

 

How Are Panic Attacks Treated?

Treatment for panic attacks and panic disorder consists of medication and/or psychotherapy. A type of psychotherapy called Cognitive behavioral therapy can be very effective in treating panic attacks.

 

Medication helps take the edge off the physical symptoms of anxiety and CBT helps to challenge irrational thinking and beliefs that lead to the panic attacks.

 

Diagnosis

The first step in diagnosing and treating panic attacks is to get a medical evaluation.

 

In fact many people experiencing a panic attack will seek treatment at a hospital emergency room since the symptoms are often confused with a heart attack.

 

Since panic attacks can mimic other medical conditions and certain medical conditions can be linked to anxiety, it is important to see your primary care physician to assess for any medical issues.

 

If your panic attacks are directly linked with a medical condition, then treating it will help treat the symptoms of panic.

 

If your doctor concludes that you don’t have any medical conditions, then you know the symptoms are due to the psychological aspects of anxiety and it will alleviate your worry over internal or physical danger since you do not have any medical issues.

 

Medical conditions linked to anxiety include:

Hyperthyroidism is a condition in which the thyroid gland is overactive and makes excessive amounts of thyroid hormone. Located in the front of your neck, the thyroid releases hormones that control your metabolism, breathing, heart rate, nervous system, weight, and body temperature.

 

People can also experience nervousness, anxiety, hand tremor, excessive sweating, weight loss, and sleep problems.

 

Diabetes associated hypoglycemia and/or low blood sugar can cause symptoms that could be mistaken as anxiety such; as heart palpitations, shaking, sweating, paleness, cold/clammy skin, nausea, seeing flashes of light, dilated pupils, and irritability.

 

Dysautonomia is a collection of several different medical conditions that affect the Autonomic Nervous System. The autonomic nervous system controls the body functions that we do not consciously control, such as heart rate, blood pressure, digestion, dilation and constriction of the pupils of the eye, kidney function, and temperature control.

 

People who may have various forms of dysautonomia will experience difficulty regulating these systems, which can cause light-headedness, fainting, unstable blood pressure, and abnormal heart rates.

 

Heart disease can cause symptoms similar to panic such as irregular heart rhythms, Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back, nausea, shortness of breath, cold sweat, and lightheadedness or sudden dizziness.

 

Respiratory illnesses such as COPD and asthma can cause breathing issues that lead to shortness of breath and feeling dizzy.

 

Drug abuse or withdrawal from drugs or alcohol also cause physical symptoms that could trigger panic attacks.

 

Even if properly treated, having a medical condition or serious illness can cause increased stress and anxiety from worries about your condition and your future.

 

DSM-5 Diagnostic Criteria for Panic Disorder

The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) defines Panic Disorder as recurrent and unexpected panic attacks that can be diagnosed if one or more of the following symptoms occur:

  • Pounding heart

  • Sweating

  • Trembling

  • Shortness of breath

  • Feelings of choking

  • Chest pain

  • Nausea

  • Feeling dizzy

  • Faintness

  • Feelings of unreality (Derealization) or feeling detached from your body (Depersonalization)

  • Fear of losing control or going crazy

  • Fear of dying

  • Numbness or tingling

  • Chills or hot flashes

 

Treatment for Panic Attacks

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is a well-researched and highly effective form of talk therapy that focuses on learning more helpful ways of thinking and behaving.

 

Cognitive Behavioral Therapy (CBT) has been found to be more effective in comparison to a placebo pill or a psychological control condition (Hofmann et al. 2008). Research has also shown that CBT effects to be sustained over time, with little decrease in treatment gains at 6 to 12 month follow-up assessments (Haby et al. 2006). You learn different ways of responding to the symptoms of a panic attack.

 

CBT helps challenge and change unhelpful beliefs that cause anxiety by restructuring your automatic thinking. CBT sessions also provide education on the symptoms of panic disorder.

 

Cognitive Restructuring

Cognitive restructuring is used to identify and dispute unhelpful, automatic, and irrational thinking so that you can create highly effective thoughts with the power to alter your emotions and behavior.

 

An example of an irrational thought is “What if I can’t escape from that place. I’ll have a panic attack and lose control.” We develop beliefs about ourselves, other people, and the world. These beliefs influence how we think.

 

If you believe that the world is basically a dangerous place, then your thoughts will follow.

 

If you believe that you are defective and not a capable person, then your thoughts will reflect those beliefs.

 

It is not the public place that causes the anxiety, it’s your thinking and beliefs that cause the fear and anxiety.

 

Exposure Therapy

Exposure therapy, also known as prolonged exposure, is a form of CBT.

 

As with most anxiety disorders, in order to learn how to overcome the symptoms of panic disorder, you need to have the experience of successfully managing the symptoms.

 

This often means exposing yourself to the thoughts, images, and the public places that trigger the panic attacks, and then applying the coping strategies until the thoughts, images, and public places no longer produce the same level of fear.

 

Medication

Please consult with your primary care physician or a psychiatrist regarding the use of any medication.

 

Medication can help reduce the symptoms of anxiety that occur in public situations that you have been avoiding such as school, work, and any other necessary public location.

 

Commonly prescribed medications include benzodiazepines, anti-depressants, and beta blockers.

 

Benzodiazepines are quick acting sedatives that are generally safe and effective for short term use. However, the long term use of benzodiazepines is associated with the risk of developing tolerance, dependence, and possible other adverse effects.

 

Commonly prescribed benzodiazepines are:

  • Alprazolam (Xanax)

  • Lorazepam (Ativan)

  • Diazepam (Valium)

  • Clonazepam (Klonopin)

 

Anti-depressant medications are also effective at reducing symptoms of anxiety on a daily basis. This helps dampen the physical and emotional effects of anxiety and increases a person’s capacity to cope with stressful situations.

 

Commonly prescribed anti-depressants are:

  • Citalopram (Celexa)

  • Escitalopram (Lexapro)

  • Sertraline (Zoloft)

  • Paroxetine (Paxil)

  • Fluoxetine (Prozac)

 

Beta Blockers are used to treat high blood pressure, heart arrhythmias, and migraines. They are also prescribed for off-label use by physicians to help reduce the physical symptoms of anxiety. Beta blockers have the ability to control rapid heartbeat, shaking, trembling, and blushing in response to a panic attack.Beta blockers do not interfere with cognitive performance and are by far my favorite for removing the jitters before a speech.

 

Commonly prescribed Beta Blockers:

  • Propranolol (Inderal)

  • Atenolol (Tenormin)

  • Acebutolol (Sectral)

  • Bisoprolol (Zebeta)

  • Metoprolol (Lopressor, Toprol-XL)

  • Nadolol (Corgard)

  • Nebivolol (Bystolic)

 

For more information:

 

Please purchase my book Attacking Panic:  The Power to Be Calm” for more in depth information on how to stop panic attacks quickly and how to treat the root cause (Amygdala/Sympathetic Nervous System). 

 

The book shows you how to go beyond just giving up control and allowing yourself to experience a panic attack.  

 

The book has more powerful strategies that will short-circuit your fight or flight system, stop a panic attack very quickly, and even prevent a panic attack from occurring.

 

How to stop panic attacks: 

How to Stop A Panic Attack: 7 Steps 

What To Do In A Panic Attack: 4 Great Ways to Cope 

Panic Attacks In Children - How To Help Your Child

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Attacking Panic System

I want to help you. Please feel free to contact me confidentially by email below with any questions or if you need some advice about the content posted on The Fear Blog.

Dr Hunter's Qualifications

My name is Dr. Russell A Hunter, PsyD and I am a Licensed Clinical Psychologist recognized by the National Register of Health Service Psychologists as meeting the National Register’s stringent requirements for education and experience as a healthcare professional.

 

I specialize in the field of Clinical Psychology and I am an expert in the treatment of Panic Disorder, Anxiety Disorders,  ADHD, and Neurocognitive Disorders. I provide CBT and psychological testing at Northern Virginia Psychiatric Associates within the Prince William Medical Center.

I published a book titled, "Attacking Panic: The Power to Be Calm" and it is available on Amazon and Barnes & Noble. 

Attacking Panic: The Power To Be Calm. Copyright © 2017 Russell A. Hunter, Psy.D. All rights reserved. Attacking Panic is available in paperback and Kindle edition at Amazon and in paperback at Barnes & Noble and other online retailers.

How to Stop A Panic Attack Quickly.

Russell A. Hunter, Psy.D. Psychology Today Profile

National Register of Health Service Psychologists

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