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National Institute of Mental Health

Getting Treatment for Panic Disorder

GETTING A DIAGNOSIS

Since panic disorder can mimic a variety of medical conditions, such as heart problems and digestive complaints, the first thing you should do is have a full medical evaluation.

Although it is important for you and your doctor to concentrate on your physical symptoms, you should not overlook other aspects of your attacks. You may want to re-read the questions at the beginning of this pamphlet and tell your doctor anything you notice about how your attacks make you feel and when they usually occur.

Information on both the physical and emotional aspects of the attacks can be very useful to the doctor in making a diagnosis. For example, the doctor will want to know if your attacks, or fear of having attacks, keep you from carrying out any of your normal activities.

Many people with panic disorder also suffer from depression—feelings of intense sadness, even hopelessness. Depression is accompanied by an impaired ability to think, concentrate, and enjoy the normal pleasures of life. Be sure to make your doctor aware of these symptoms as well. If you have been drinking or using drugs to try to control your symptoms, let your doctor know about that too.

Once you have been properly diagnosed, your doctor—perhaps in consultation with a mental health specialist—can help you determine which treatment is best for you.

EFFECTIVE TREATMENTS FOR PANIC DISORDER

Treatment for panic disorder can consist of taking a medication to adjust the chemicals in your body—just as you might take medicine to correct a thyroid imbalance.

Or treatment might involve working with a psychotherapist to gain more control over your anxieties—just as some people work with specialists to learn techniques to control migraine headaches or lower their blood pressure.

Research shows that both kinds of treatment can be very effective. For many patients, the combination of medication and psychotherapy appears to be more effective than either treatment alone. Early treatment can help keep panic disorder from progressing.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) teaches you to anticipate and prepare yourself for the situations and bodily sensations that may trigger panic attacks. CBT usually includes the following elements:

A therapist helps you identify the thinking patterns that lead you to misinterpret sensations and assume "the worst" is happening. These patterns of thinking are deeply ingrained, and it will take practice to notice them and then to change them.
A therapist can teach you breathing exercises that calm you and that can prevent the overbreathing, or hyperventilation, that often occurs during a panic attack.
A therapist can help you gradually become less sensitive to the frightening bodily sensations and feelings of terror. This is done by helping you, step-by- step, to safely test yourself in the places and situations you've been avoiding.

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CBT generally requires at least 8 to 12 weeks. Some people may need a longer time in treatment to learn the skills and put them into practice. Most panic disorder patients are successful in controlling or preventing their panic attacks after completing treatment with CBT.

CBT requires a motivated patient and a specially trained therapist. Make sure any therapist you work with has proper training and experience in this method of panic disorder treatment. Indeed, in some parts of the country, you may find limited access to professionals trained and experienced in CBT.

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