Panic Attacks and Panic Disorder

A Report On Your Treatment Options

Written by:

Michael H. Karowski

Though anxiety disorders were only recognized in 1980, they have been around for years. There are
many famous people throughout history who (based on accounts of their lives) seem to have had an
anxiety disorder. Their strange character was often blamed on nerves or the stress that came from the
position or role they had to carry.

Doctors and medicine men at the time tried to find ways to alleviate the problem by designing
treatments they believed would help. Ranging from hydrotherapy (the application of extreme
temperatures to the body) to blood letting through leaches, many of the treatments failed. This is
probably because the problem itself was not fully understood. (There were some treatments, like herbal
treatments, that did provide a measure of relief.)

It wasn't until the birth of psychology and psychological treatment methods did those who suffered
from anxiety disorders truly get the attention and care they needed for their ailment. Since then, and
since the formal recognition of anxiety disorders in the medical world, scientists and researchers have
been striving to find better and more effective treatment methods for these patients.

This report focuses on panic attacks and panic disorder, which is a psychological disorder that falls
under the category of anxiety disorders. Panic disorder is a serious problem which can debilitate and
halt a person's life. One of the goals of this free report is to raise awareness among people, as well as to
be a source of knowledge and understanding to those who may be dealing with the ailment itself.
Specifically, the report will discuss:

• What is a panic attack?

• What is panic disorder?
• What causes panic attacks or panic disorder?
• Can panic disorder be cured, and what are a person's options for treatment?
• How are each of these treatment methods explained and supported by both medical professionals
and panic disorder patients?
• Can panic disorder be prevented?
• What tips do doctors give to patients suffering from panic disorder?

By the end of this report, a person should have a good overview and understanding of panic attacks and
panic disorder. They should have awareness of their treatment options, and basic knowledge of what
each option entails.

For more detailed information on panic attacks, panic disorder, and the various treatment options, click
on http://www.PanicDisorderAttacks.com.

What is a Panic Attack?

A panic attack is an period of time in which a person is gripped by intense feelings of apprehension,
anxiety, worry, and fear or terror. The attack causes physical reactions such as:

− a rapid heart beat and/or chest pains

− sweat
− chills
− dizziness and/or nausea
− stomach pain
− hyperventilation or staggered breathing, sometimes to the point of choking
− tingling or numbness in the extremities (hands and feet)
− shaking or trembling
− de-realization or de-personification (feeling detached from reality or from oneself)
− feeling weak
− fear of dying

These feelings and symptoms take over the body during the episode, usually leaving the person unable
to continue with what they were doing. They literally “stop a person in his/her tracks.”

The attack usually peaks within 10 minutes, and the symptoms begin to fade. Some symptoms fade
slowly, however, lingering for up to two hours after the initial attack. This leads many panic attack
sufferers to believe that attacks last much longer, though during an attack, most patients do lose track of
a sense of time and feel like it lasts very long.

Sometimes, lingering symptoms worry the patient to the point of having another panic attack, which
reinforces their belief that they have lost control. Often, successive or multiple panic attacks are more
the result of lingering symptoms than of “new” anxious feelings.

Panic attacks are different for each patient. They can come without warning or provocation or they can
come due to a trigger or cue (a phobia, for example.) Some patients experience successive or multiple
panic attacks everyday or every few days, while others experience panic attacks every few months.
Recurring panic attacks combined with the fear of having another attack, and allowing this fear to take
over one's life are the factors which lead people to develop panic disorder.
What is Panic Disorder?

Panic disorder is an anxiety disorder characterized by recurring unexpected panic attacks. There are
two types of panic disorder. These are panic disorder with agoraphobia and panic disorder without
agoraphobia. The characteristics of these two types are as follows:

Panic disorder without agoraphobia

This type of panic disorder is characterized by recurring unexpected panic attacks which are not caused
by a general medical condition or substance abuse. The patient also does not have agoraphobia, or the
fear of not being able to escape a situation or not being able to escape a situation without
embarrassment. Also, for one month or more after at least one panic attack, the patient has had one or
more of the following:

− worry about the importance of the attack or its consequences

− constant concern that another attack will come
− change in behavior (ex. avoidance)

Panic disorder with agoraphobia

This type of panic disorder is characterized by recurring unexpected panic attacks which are not caused
by a general medical condition or substance abuse. For one month or more after at least one panic
attack, the patient has had one or more of the following:

− worry about the importance of the attack or its consequences

− constant concern that another attack will come
− change in behavior (ex. avoidance)
− agoraphobia

In both types of panic disorder, the panic attacks should not be better explained by another anxiety
disorder or another psychological disorder. However, the disorder itself can often be accompanied by
other mental health conditions such as depression and/or alcoholism.

The change in behavior, specifically avoidance, is very characteristic of panic disorder because patients
tend to avoid the place or situation in which the attack occurred or which (in their mind) “triggers”
attacks. This often leads to the development of phobias.

What Causes Panic Attacks or Panic Disorder?

Panic Attacks

Everyone feels anxious every now and then. It is a natural feeling for humans. We can feel anxious
about an upcoming exam, about getting a job, about having a child, and so on. However, when the
anxiety becomes extreme or excessive, a panic attack can occur.

One theory about the causes of panic attacks is that the extreme anxiety felt prior to a panic attack
possibly triggers a human's fight or flight response. When this is triggered, the person's system goes
into over-drive. Even without the presence of a threat, the body's nervous system prepares for either
fight or flight, and the manifestation of the body's reaction are the known symptoms of panic attacks.

This is why some believe that panic attacks are caused by an inherited over-reaction of the fight or
flight response, perhaps due to a disturbance in the brain pathways which regulate emotion. The
feelings felt during a panic attack, such as the want to escape or a feeling of aggression is also
attributed to the fight or flight response.

Another theory suggests that panic attacks are caused by life events which have built up anxiety in a
person. For example, a person who got lost in a crowded room as a child may forever have a fear of
large crowds of people and one day this manifests itself in the form of a panic attack. Perhaps a person
who has always been rejected by women he asked out has a panic attack when he finds out his job
interviewer is a woman. Maybe someone who has had a very hard year in terms of work has a panic
attack at the first sign of trouble during the new year.

Though both theories for what causes a panic attack are plausible, scientists cannot attribute the
occurrence of the attacks to one or the other. Maybe its both, maybe it's either/or. The one thing that
they do know is that if a person has a family history of anxiety or panic attacks, then they are more
likely to have panic attacks or panic disorder. This genetic correlation seems to swing in favor of the
biological theory.

It is important to make note of the fact that just because a person has a panic attack, does not mean they
will develop panic disorder. Though having a panic attack once will increase a person's probabilities of
having another.

Panic Disorder

As you learned from the previous section, panic disorder develops after recurrent panic attacks which
are accompanied by specific behavioral symptoms or feelings. What causes panic disorder is still
unknown. Since people can have panic attacks and not develop panic disorder, scientists have theorized
that there may be something different about the people who develop panic disorder.

Theories include learned behavior (ex. a series of panic attacks leaves a person so frightened of having
more that they develop panic disorder with or without fearful avoidance of a certain situation) or
temporal lobe dysfunction. Other possible biological causes for panic disorder include a problem with
the limbic system, hypoglycemia, mitral valve prolapse, pheochromocytoma, labyrinthitis, and
hyperthyroidism. There are other medical illnesses that have also been correlated with panic disorder
and panic attacks, which is why most patients should seek complete medical tests.

Whats statistics have revealed, however, is that the most common age for the onset of panic disorder is
between a person's mid-teens and early adulthood. Usually between the ages of 15 and 19. Tests have
also shown that stimulants, such as coffee and/or drugs (uppers) can induce the symptoms of panic
disorder.

Can Panic Disorder Be Cured?

Most people who have panic disorder see their plight as a hopeless situation. Contrary to what they
may believe, however, panic disorder can be successfully treated. It is difficult to call the treatment a
“cure” in the sense that it can never occur again. Similar to a person who has had one panic attack is
statistically more likely to have another, panic disorder is the type of ailment that may require
maintenance. Even after years of having never had a panic attack or feelings associated with panic
disorder, a person still needs to be vigilant and wary about their body's reactions and their feelings.

What are a Person's Options for Treatment?

Currently, there are many options for the treatment of panic attacks and panic disorder. These range
from treatments backed by psychological studies, to alternative natural treatments, to herbal treatments.
Each one has its own technique for addressing panic attacks and panic disorder.

Cognitive Behavioral Therapy

Perhaps the most popular treatment for panic attacks and panic disorder is cognitive behavioral therapy,
known as CBT. With a success rate 80% to 85% of patients becoming free of panic symptoms, on an
average of 8 treatment sessions, most doctors attempt this form of therapy before anything else.

When undergoing CBT, a patient is asked to do two things. The first is to identify which specific
thoughts cause their anxiety. Throughout the sessions, patients are asked to “think this through” and
change the way they think or address these particular thoughts. The second task is for the patient to
expose themselves to the object or situation (if applicable) of anxiety. This will help “de-sensitize”
them and show them that there is nothing to fear.

Interoceptive Therapy

Another approach (which is some consider a part of or a subhead of CBT) is interoceptive therapy. This
form of therapy seems to focus more on the behavioral aspect of the problem and helping patients think
things through as the situation occurs. It's success rate is also quite high, with 87% of patients
succeeding in freeing themselves from panic attacks.
During interoceptive therapy, the doctor stimulates the symptoms of a panic attack so that the patient
can experience the symptom in a controlled environment. For example, the doctor may ask a patient to
run on a treadmill so that their heart begins to beat faster. The patient can then feel their heart race the
way it would during an attack. They are then asked to think through the situation, associating it with
something other than a panic attack and the feelings of panic, thereby changing their thoughts on the
matter.

In this manner, the patient is “de-sensitized” from the symptom of a panic attack, making it less likely
for the patient to believe that this one symptom always has to lead to an attack. As the doctor goes
through the various symptoms (usually starting with the most frightening symptoms first), the patients
thoughts on the symptoms and panic attacks changes, and they are able to manage the various
symptoms in real world settings, without having it lead to an attack.

Panic-Focused Psychodynamic Psychotherapy

This form of therapy tries to address panic disorder possibly caused by traumatic experiences or
biochemical vulnerability. It addresses the problem of people with panic disorder being overly
dependent on others for their sense of security, which can lead to separation anxiety. The therapy
identifies the causes of panic attacks and then tries to find the underlying conflict causing the attacks
and panic disorder. Once identified, the therapist can begin addressing the underlying issues
themselves.

Pharmacotherapy

The use of pharmacotherapeutic drugs is usually seen as a last resort for the treatment of panic disorder.
If the patient does not respond to other forms of therapy, then this form of therapy may be employed.
There are several options when it comes to pharmacotherapy with SSRIs (selective serotonin reuptake
inhibitors) being the most common. Other options include benzodiazepines, buspirone (Buspar),
monamine oxidase inhibitors (MAOIs), propanolol (Inderal), and tricyclic antidepressants (TCAs.)

Usually, the drugs are taken alongside the therapy that has shown the most promise in helping a patient.
A common combination is CBT and SSRIs. The most common SSRI is Paxil.

Deep Breathing and Meditation

One of the most natural ways to help calm oneself is relax, breathe deeply, and meditate. Patients are
asked to lie flat on their back and to put a hand on their stomach. Then they are asked to breath deeply
(counting as they breathe in) and let the air expand their stomachs. Then they are asked to exhale
slowly (also counting) and let the air out. During the exercise, patients should try to relax themselves as
much as possible and not think of anything that may make them anxious. They should focus on their
breathing and their counting.

Initially, patients should do the exercise once a day, but as they get better, they can begin to do it more
often, even while sitting or standing. The exercise attempts to relax the body, ease tension and anxiety,
and allow the mind to re-organize its thoughts subconsciously while the person focuses on their
breathing and counting. When a patient feels any of the symptoms of a panic attack, they are asked to
close their eyes and continue the breathing exercises right away.

It is important to note that this method does not work for everyone. Some people do not benefit from
deep breaths because it may induce a second attack.

Mindfulness

This method for treating panic attacks and panic disorders involves being aware of the present. It is a
meditative process which involves practicing having increased awareness and control over one's body
and the things happening around oneself. In the beginning, patients are asked to sit alone and to start
deep breathing. First they are asked to be aware of each part of their body. Next, the patient is asked to
focus back on their breathing pattern.

Unlike deep breathing and meditation, if a thought occurs to the patient, they are asked to think through
this thought whilst maintaining their breathing pattern and level of relaxation. With practice, the patient
becomes very aware of their body and their thoughts. When a panic attack occurs, the patient is able to
take control of the moment and stop the attack themselves.

Biofeedback

Also used on tinnitus patients, biofeedback involves connecting the patient to electronic equipment
which monitors skin temperature, heart rate, muscle tension, and brain activity. The patient is shown
the results of these machines as they come out, giving them an idea of what their body is like when at
rest or not “panicked.”

Next, the doctor tries to induce a moment of panic (similar to interoceptive therapy) and show the
patient the difference in that particular aspect of their body. For example, the patient may be shown
how their heartbeat changes. The patient is then asked to try and control the biological response their
body gives when faced with an anxious thought or situation.

The purpose of the method is to help a patient take control of the bodily reactions that can lead to a full
blown panic attack. By helping a patient recognize the first steps that lead to the attack, and showing
them how to reverse the steps or control it, they are better able to manage possible panic attacks in real
life situations.

Herbal Remedies

Herbal remedies have been popular for many years. They have been used to address a variety of health
problems, including panic attacks and panic disorder. These are often prepared as teas or tinctures, but
some companies now make herbal supplements that can easily be taken along with a person's vitamins.

There are a good number of herbs which have soothing qualities. They are able to relax a person,
calming their nerves and lessening the chances of the occurrence of an attack. Some herbs that are
commonly used are St.John's wort (actually has been used in Germany for decades), lemon balm,
passion flower, and valerian.

Aromatherapy

Much like taking the herbal remedies, aromatherapy has been around for quite a while. Exposure to
calming scents seem to help stop the coming of a panic attack. This is because the aroma can induce a
relaxed state. Patients are often asked to find a scent that they know will calm them, usually these are
aromas from childhood.

If a patient is not sure where to begin, lavender (which is known for its calming properties) has been
known to work effectively. Baby powder, also, has been found to work for almost everyone. Other
scents tat may calm a person are the scent of the sea, cut grass, freshly baked cookies, and so on.

There are many other alternative treatments designed to address panic disorder such as:

− exercise therapy
− diversion therapy
− food therapy
− homeopathy
− hypnotherapy
− and laughter

Each one can be quite effective and helpful in relieving and addressing the problems. Discussing each
one in detail cannot be done in this report. However, to get more information on alternative treatments,
click on [link to sales page here]
Professional and Patient Opinions on Treatment Methods

Given that there are so many different options for treatment, patients may sometimes become confused
as to which treatment will be the best for them. When it comes to panic attacks and panic disorder,
many professionals seem to agree that the best treatment method is the one that works best for the
patient, whether it be psychotherapy or alternative treatments.

Grainne Holman from the Health Promotion Department of the Canadian Mental Health Association's
Vancouver-Burnaby branch says "We encourage people with mental illnesses to explore both traditional
and alternative forms of treatment," Though she doesn't go into specifics, Holman claims that
alternatives can be quite effective at restoring a person's peace of mind, which can be very helpful
when trying to seek help. "People need to be aware that these alternatives exist, they also need to know
how to evaluate existing information about how effective they are, and about whether there are any
adverse effects when alternative treatments are taken together with traditional treatments...We tell
people to trust themselves and trust their own physical and emotional reactions to different treatments,
no matter how helpless they have been made to feel. We want them to find the combination of
alternatives that works for them.""

Patients with panic disorder are asked to be careful when taking alternative treatments along side
traditional treatments. They must make sure their alternative treatment (an herbal remedy for example)
will not cause any harmful effects when mixed with their other treatments. Most patients are advised to
see a naturopath before embarking on alternative treatments. This is so that they can assess the
treatments better, and get a good idea of the formulations of various supplements used for alternative
treatments.

It is important to note that Holman discussed alternative treatments “together” with traditional
treatments. This is because no one alternative treatment is seen as a complete cure for mental illnesses,
especially very serious ones. However, according to many patients with panic disorder, a combination
of alternative treatments can be quite effective.

Chosen method of treatment aside, both professionals and patients agree and believe that support is one
of the most important factors for successful treatment of panic disorder. The support of family, friends,
and people who understand is very important at helping people pursue treatment and free themselves
from panic attacks. Patients are always recommended to try and discuss their feelings, while families
are asked to be more supportive.

Can Panic Disorder be Prevented?

Because the main cause of panic attacks and panic disorder cannot be identified, there is no way to
prevent the disorder either. Some patients who may have been pre-disposed to the disorder (for
example, their family has a history of panic disorder or other anxiety disorders) may try taking extra
care not to get overly anxious, to practice calming exercises, and to maintain their emotional health by
voicing out their feelings, laughter, or through other techniques.

There are no studies, clinical or otherwise, that support these practices as a method of prevention.
However, if it does make the patient feel better, then it won't hurt. If the practices are being done
because they are anxious about not getting a disorder, then perhaps the exercise is futile.

Tips for Patients

It is difficult for doctors to give tips to patients with panic disorder. Unlike other illnesses, each patient
with panic disorder is different from the next. The thoughts and feelings they are anxious about may
put a different spin on the problem, and so specific tips are hard to give out. But in general, patients are
asked to do the following:

1. Seek Treatment
2. Get the Support of Your Family
3. Quit Smoking
4. Do not do Drugs
5. Stop Drinking Alcohol
6. Maintain a Healthy Diet

If all of these are done, and if an effective solution to the first tip is found, then a patient is well on their
way to becoming free of panic attacks and panic disorder!

***

Panic disorder is something that must be taken seriously. If you feel you may have panic disorder or if
you are suffering from panic attacks, seek professional help. You can also do research on your
condition in order to give yourself better understanding of what is happening to your body. It is not life
threatening and you have nothing to fear.

For more details on the information given here, as well as the tips to follow, check out the book,
‘Perfectly Panic Free’ and get your life back today!
Disclaimer:

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information in this electronic publication is provided “as is,” and is being provided as
information only. It is not to be used as decision making information or taken as health
advice in any circumstance.

The authors, publisher and associated company make no claims expressly or implied and no
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