Panic Disorder and Agoraphobia
Panic
Panic disorder is characterised by recurrent and for some people frequent
panic "attacks" that seem to "come out of the blue"
and seem "uncontrollable." Here I will refer to such experiences
as simply panic. Panic is a discrete periods of intense fear or discomfort
that typically involve some of the following symptoms: shortness of
breath, heart palpitations, dizziness or unsteadiness, chest pain,
trembling or shaking, sweating, feelings of unreality or detachment,
tingling sensations, thoughts about dying, going crazy/mad or of losing
control. It is common for people who suffer from panic attacks to assume
that they have a medical or severe physical problems e.g. heart attack. As
a consequence of such experiences people can begin to associate symptoms
with specific situations e.g. crowds, exercise and they become fearful of
situations that they associate with having panic or situations from which
they might have difficulty leaving if they had a panic.
Agoraphobia
Agoraphobia is the persistent avoidance of situations or places from
which escape might be difficult or help might be unavailable if a panic
were to occur. Other situations that are commonly avoided are driving,
public transport, shops, restaurants, theatres, cinemas, queues, lifts,
enclosed spaces and being far away from home.
Treatment
Panic disorder and agoraphobia are both treatable problems.
Cognitive-behaviour therapy has been shown to be highly effective in the
treatment of these symptoms. Cognitive-behaviour therapy typically
includes education about the nature of panic and anxiety. The more you
know about the problem the less likely you are to respond by
misinterpreting symptoms as signs of physical illness or other
"catastrophe" e.g. losing control or going mad. If you
understand the problem you are also much more likely to be able to utilise
cognitive-behavioural strategies to break the cycle of catastrophic
thinking, increased anxiety and avoidance. Recording of panic attacks and
anxiety symptoms. Learning about your own panic reactions, behaviourally,
physically and cognitively, will help you to start taking control of your
panic reactions. Learning to recognise the first signs of panic, how to
not misinterpret symptoms, learning coping statements and helpful
self-talk to better handle the automatic anxiety-provoking thoughts you
have them is an highly effective strategy. For some people who are prone
to hyperventilation (shallow rapid breathing) in stressful situations then
abdominal breathing helps the body to begin the process of calming the
body down whenever you feel panic or high anxiety. Another important part
of treatment is to practice graded, prolonged and frequent exposure to
feared situations and deliberately bringing on in a controlled way the
sensations of panic in order to learn that they not dangerous. Exposure is
usually done using an "exposure hierarchy" to gradually expose
yourself to situations you have been avoiding in a way that gives a sense
of control. The result is learning that you can effectively cope with
anxiety and no longer need to avoid.
How long does treatment take?
These cognitive-behavioural treatment methods have been shown to be
highly effective in treating panic disorder in a relatively short period
of time usually between 8-12 sessions (2-3 months).
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