Panic and Agoraphobia Program

What Is a Panic Attack?

A panic attack is an alarm reaction during which a person has a sudden feeling of fear or dread along with myriad symptoms such as shortness of breath, dizziness, feeling faint, racing or pounding heart, trembling or shaking, sweating, choking sensations, nausea, abdominal distress, numbness or tingling sensations, hot flashes or cold chills, chest pain, fears of losing control, dying, or going crazy, and feelings of being detached or of things seeming unreal. Panic attacks occur and peak in a very short amount of time (usually one to ten minutes) and last an average of five to ten minutes. Individuals report a strong urge to escape and reach safety in situations in which panic may occur.

Many people with panic attacks become afraid of panic symptoms, begin to dread future attacks and avoid situations where they may be triggered. Common situations may include but are not limited to shopping malls, bridges, elevators, and being home alone. People may also be afraid to experience activities such as exercise, sex, or experience emotions such as pleasure or anger given that they may trigger physical symptoms similar to panic.

Panic attacks may first begin right after a stressful life event. Work by Dr. McGinn and others shows that certain physical and psychological vulnerabilities can increase a person’s chance of having a panic attack. Physical vulnerabilities refer to aspects of body functioning that either create symptoms of panic attacks or make it more likely to pay attention to or notice symptoms. Psychological vulnerabilities include beliefs that the physical symptoms experienced are harmful and cannot be controlled. These thoughts usually exacerbate the worry that is involved in panic attacks.

The Treatment of Panic Disorder

Cognitive-behavioral therapy has been shown highly effective in treating panic disorder and agoraphobia. For example, research studies in the United States and England have shown that CBT has an 85-90% success rate over the course of 20-25 sessions. Furthermore, individuals included in these studies maintained their improvement one-year after treatment had ended. Based on Dr. McGinn’s work, we offer comprehensive CBT treatment plans for panic that combine evidence-based CBT treatments such as Barlow and Craske’s Panic Control Treatment, and David Clark’s Cognitive Therapy.

Given that panic attacks may be a symptom of other disorders, a careful evaluation is necessary to confirm a diagnosis of panic disorder and to rule out other causes of panic attacks. A comprehensive evaluation is also necessary because panic disorder, even if present, commonly occurs with other conditions. Based on a comprehensive evaluation, CBC clinicians will design an individualized treatment plan that may combine treatment strategies for panic and other conditions.

CBT for panic disorder usually includes several components.

• Education of panic attacks, and the physical symptoms of anxiety and fear that are experienced.
• Modification of the believability of irrational thoughts and beliefs to circumvent the fight-flight response.
• Physiological techniques to reduce physical tension and increase the threshold for panic,
• Repeated exposure to feared and avoided situations and physical sensations to help overcome fear of panic attacks and situations.