Panic Disorder

What is Panic Disorder?

Panic attacks are sudden and intense feelings of fear accompanied by physical symptoms, such as a pounding heart, shortness of breath, tingling sensations, and dizziness or lightheadedness. They are part of the body's "alarm system" and are normal responses to extreme danger. Each year about one in 10 people experiences a panic attack, but only about one in 75 people has panic disorder. Panic disorder involves a series of unexpected, "false alarm" panic attacks. These unexpected panic attacks can interfere with a person's emotional life, relationships, and ability to work.

What is Agoraphobia?

Many people who have panic disorder also develop agoraphobia. Agoraphobia involves a tendency to avoid the places and situations that trigger panic attacks. Not all people with panic disorder develop agoraphobia. Those who do develop agoraphobia commonly avoid large stores and other crowded places, driving on the highway, and being far from their home.

What Types of Treatment Are Available?

Panic disorder is usually chronic and tends to be a reaction to stress. Those who do not receive treatment are likely to continue having problems, though the severity of their attacks may wax and wane. Here are the main treatment options usually considered for panic disorder:

Medication. Many people who have panic disorder can benefit from medications. There are several types of medications that are commonly used for panic disorder. Different people respond differently to these medications, so deciding which one to try should be done with a physician or psychiatrist. Some medications can have side effects and cannot be used by certain people, and not all people who can take medications benefit from them. People who do benefit typically have a substantial reduction in symptoms, but some continue to experience mild panic attacks. When medications are ended, there is some risk that the panic attacks will return.

Cognitive-behavioral therapy using the "false-alarm" model. This type of treatment is relatively new. It includes learning about panic attacks and their causes, and correcting the thoughts that cause panic attacks. This treatment has been shown to be highly effective at reducing panic attacks, with approximately 80 percent of those going through these treatments being panic-free at the end of treatment. This treatment is not for everyone. Usually 10 to 15 therapy sessions are needed, and the person is expected to participate in difficult and uncomfortable activities. Work outside of the therapy sessions is required to master new skills.

Cognitive-behavioral therapy using relaxation training. This type of treatment has been shown to be effective at reducing panic attacks, with approximately 50 percent of those going through these treatments being panic-free at the end of treatment. Usually 10 to 15 therapy sessions are needed, and the person is expected to work outside of sessions to master new skills.

Psychological therapies using agoraphobia exposure. For people who have panic disorder with agoraphobia, there are several treatments available that focus on returning to the places and situations that have beena avoided. Although this type of treatment focuses on reducing avoidance behavior, it has also been shown to be moderately effective at reducing panic attacks, with approximately 50 percent of those going through these treatments being panic-free at the end of treatment. Usually 10 to 15 therapy sessions are needed. The person is expected to participate in difficult and uncomfortable activities and work outside of sessions to master new skills.

Other psychological therapies. There are many different types of psychological therapies. Many of these therapies were not developed specifically for panic disorder, but for other reasons, such as reducing depression, improving relationships, or for personal growth. The effectiveness of most of these therapies for panic disorder has not been studied. While these other therapies may be useful for reaching other goals, they are less likely to be as useful for reducing panic attacks.

Many people who have panic disorder have other problems, including depression, alcohol and substance use, and relationship difficulties. The decision to try a specific treatment depends upon several factors, including the types of other problems that are present and individual preferences. Treatment often includes coordination of several services, including medication, individual therapy, and/or group therapy. These decisions should be made after consultation with a qualified professional who has thoroughly evaluated the situation and can describe the best treatment options.

Evaluation and Treatment in the Anxiety Disorders Service. The Anxiety Disorders Service recognizes that our treatment programs are not for everyone. We begin with a two-session evaluation that helps us come to a better understanding of the problem. The evaluation sessions are provided at no cost to the client. At the end of the evaluation process, we summarize our findings and the treatment options that are likely to be helpful. These options often involve services available in our clinic, from other mental health professionals in the community, or some combination of services.

Return to the Anxiety Disorders Service main page, to the Psychological Services Center, or to the Department of Psychology
.