Panic Disorder
Panic Disorder is one of many different types of anxiety disorders. It is characterized by episodic anxiety that is experienced differently in different individuals. There are often many physical expressions of anxiety, including a sensation of shortness of breath, heart racing, tingling and/or numbness in arms and legs, weakness in legs, difficulty concentrating, trembling, chest pain, nausea, and lightheadedness.
People with panic disorder have inadvertently taught themselves to be hypersensitive to “normal” levels of anxiety. It is normal to experience a certain degree of anxiety. It is anxiety which helps us to be alert, “on the look out”, aware of potential danger in our environments (e.g. looking both ways before crossing the street). The person with panic experiences this normal anxiety and misperceives it as a sign of “something terrible about to happen”, the thought of which then intensifies the anxiety. Anxiety then gets expressed throughout the nervous system, such as by increasing heart rate, breathing rate, gastrointestinal motility (may lead to diarrhea), tremulousness, etc. This entire experience becomes a vicious circle where the individual is inadvertently intensifying his/her own anxiety by misperceiving the physical sensations.
In addition, in the midst of a panic attack, people usually start breathing more quickly and much less deeply. The shallow breaths then lead to higher levels of carbon dioxide in the blood which affect the brain in such a way as to increase anxiety. This is such a powerful effect that usually simply helping someone in a panic attack to focus on and regulate one’s breathing brings about a significant decrease in anxiety.
Ideally, cognitive-behavioral psychotherapy should always be combined with medicine (or may even be given in place of medicine). This type of therapy helps the individual to learn how his/her own thoughts are actually triggering and maintaining the panic attack. This usually comes as quite a surprise to the individual and may even be difficult to believe. However, as time goes on, one becomes convinced as he/she learns how this then enables the person to completely regulate one’s anxiety and prevent a panic attack!
Psychodynamic psychotherapy has also been found to be very effective for the treatment of panic disorder. Often, the individual with panic is experiencing deeper psychological conflicts involving separation or loss or difficulty expressing anger or other distressing feelings. By helping the individual explore these underlying feelings and learn healthy ways of expressing them, the panic usually resolves. This type of treatment takes more time than medicine but is often experienced as being much more meaningful and effective with regard to improving interpersonal relationships overall in addition to resolving symptoms.