The goal of panic disorder treatment is to increase a person’s understanding of their panic attacks, change their minds about the attacks and reduce the frequency and intensity of the attacks. While immediate elimination of symptoms is unlikely, proper treatment can reduce the intensity of panic attacks.
Therapy Options for Panic Disorder
In the early stages of developing a panic disorder, talk therapies are thought to be the best treatment option. Therapy can be used to reduce the anxieties that ultimately lead to panic attacks. Intervening before there is an excess of locations and other stimuli associated with panic attacks may also prevent reactionary panic attacks.
For people with a mild panic disorder, the best panic disorder therapy may be psychoeducation paired with processing the panic attacks. Understanding how and why panic attacks occur and that panic attacks do not indicate a health problem can reduce the intensity of future panic attacks and anticipatory anxiety.
Cognitive Behavioral Theory
The cognitive behavioral approach works to increase the patient’s understanding of how their thoughts, feelings and actions intertwine. Cognitive behavioral therapy (CBT) often includes challenging negative or faulty thinking patterns. The goal of CBT in treating panic disorder is to change catastrophic beliefs about panic attacks. Using CBT for panic disorder can help a person feel safe when they experience a panic attack. This approach is also particularly useful in treating the anticipatory anxiety.
Medications Used for Treating Panic Disorder
Medication may be prescribed for panic disorder to lower an individual’s overall level of anxiety or to relieve acute anxiety occurring during a panic attack. In some cases, multiple medications may be prescribed to treat both acute and chronic anxiety. There are two main categories for medications used to treat panic disorders: anti-depressants and anti-anxieties.
Before selective serotonin reuptake inhibitors (SSRIs), the best medication for panic disorder was Tofranil, a tricyclic antidepressant. However, as pharmaceutical companies developed new medications, SSRIs became the choice treatment. SSRIs work by increasing the level of serotonin, the chemical that manages happiness, in the brain. A person’s physical makeup may affect how each person tolerates the medication, so it may take several trials before finding which of the panic disorder drugs works best for someone. Lexapro is effective for most people, while others have more success with Celexa, Prozac or Zoloft.
Utilizing anti-anxiety medications, often called benzodiazepines, is less common due to the risk of creating physical dependence. The best use of these medications is in the first several weeks of using anti-depressants. Anti-anxiety medications often provide results within a few hours while anti-depressants may take weeks to be fully effective.
Treating Panic Disorder and Other Co-Occurring Conditions
Panic Disorder and Anxiety
In many cases, there may be a few symptoms that differentiate panic disorder and generalized anxiety disorder. Differentiating panic disorder vs. generalized anxiety disorder ultimately comes down to a history of panic attacks. The anticipatory anxiety of panic disorder presents the same as generalized anxiety. Anxiety and panic disorder go together, and clinicians should treat them in the same way.
Approximately 20 percent of people with an anxiety disorder have a co-occurring substance use disorder. In more severe cases, substance use is more prominent than panic disorder. This magnified substance use disorder is due to the attempts to self-medicate panic attacks using drugs or alcohol.
Panic Disorder and Agoraphobia
Approximately half of the people who have a panic disorder also experience agoraphobia. When a person develops a panic disorder with agoraphobia, they may believe they are no longer safe at certain locations. For example, a person may have a panic attack at the bank and stop going into banks. They may have another at the pharmacy and stop going in pharmacies. Over time this person is likely to feel that stepping outside of their home is too risky and stop leaving at all to avoid experiencing potential panic attacks. If a person with agoraphobia does go places they believe are unsafe, they may attempt to prevent a panic attack by using alcohol or other drugs. This self-medication to prevent panic attacks often leads to a co-occurring substance use disorder developing.
Sleep Panic Attacks
Panic attacks that occur while a person sleeps signify a sleep panic disorder. Nocturnal panic attacks may wake the person with a feeling of impending doom along with physical symptoms such as cold sweats and a rapid heart rate. Treatment for this form of panic disorder follows the same course as other forms of panic disorder treatment. Substance use is common with this form of panic disorder as a person may believe that using alcohol or other drugs will help them sleep undisturbed.
Panic Disorder and Substance Abuse
Substance use disorders and panic disorders commonly occur. People who experience panic attacks can find that certain drugs calm their anxiety. So, they abuse the drug for its calming effects, leading to compulsive use and then addiction. It is important to provide treatment for the substance use disorder along with treatment for panic disorder. The Recovery Village offers treatment to patients who are living with a substance use disorder and are experiencing a panic disorder as a co-occurring disorder. Call The Recovery Village today to learn about how treatment can improve your life.