A disabling illness, panic disorder is almost always treatable, characterized by repeated, unexpected moments of panic. The moments stem from an evolutionary trait that has served people well through the millennia, as several survival-linked changes occur in instances of perceived danger. To treat panic attacks, individuals and professionals employ several methods, including therapy sessions and controlled breathing.
During panic attacks, vision narrows, breathing and heart rate increase, extra blood flows to the muscles, and digestion shuts down. Together, they lead to the “fight-or-flight” response, which enables the person to deal with a moment of high-intensity danger or stress.
Ordinary occurrences can trigger the fight-or-flight response for those with panic disorder, and the response can become out of proportion to the actual threat. Intense, socially unacceptable sensations that may arise include sweating, nausea, dizziness, and a sense of losing control, as well as an overwhelming need to escape.
Those with conditions such as agoraphobia tend to have a readily identifiable trigger, such as finding themselves in a crowded public space. Some experience attacks that seem to come out of the blue, while others have physiological triggers such as shortness of breath or hot flashes. Misinterpreting these signals, the brain unleashes its survival instincts, with elevated levels of the stress hormone cortisol creating a spiraling sense of fear and anxiety. With episodes often lasting from a few minutes to an hour or longer, the climax may occur several minutes before the attack completely subsides.
Treating panic attacks often involves working with a therapist to understand triggers and symptoms objectively to defuse their effects. Placing them in perspective, the therapist reinforces the idea that the anxiety symptoms are not on their own dangerous but rather part of a natural alarm reaction that the brain employs when the person is in danger. As panic starts to rise, a person learns to challenge such thoughts. If they feel they should run away, they can counter this instinct by applying rational logic, a strong but temporary stress response.
Another pathway to defusing panic attacks is through self-calming techniques, such as controlled breathing. This counters the tendency to hyperventilate or experience rapid, deep breathing that reduces carbon dioxide in the blood and leads to disorienting sensations such as dizziness, lightheadedness, tingling, and numbness. One technique involves aiming for 10 breaths a minute, with a three-second inhale through the nose and a slow three-second exhale through the mouth.
Individuals can also try grounding. This mindfulness-based technique encourages looking around and observing one’s environment. Using a 5-4-3-2-1 principle, individuals pay attention to five things they see, four things they feel, three things they hear, two things they smell, and one thing they taste. Cycling through this list grounds the senses, encouraging relaxation and placing the brakes on often overwhelming negative sensations.
Cognitive behavioral therapy (CBT) may be employed in a psychotherapy setting, with one common technique known as desensitization. This involves the therapist gradually introducing situations that provoke anxiety while providing tools for regaining control of one’s normal faculties. Through graduated, repeat exposure to fear-inducing situations, the patient builds up techniques for managing panic.
One important facet of this equation is resisting an urge to flee and not return. Doing so can create a long-term cycle of fear as one seeks to avoid future attacks and, in the process, loses the ability to function normally in certain environments. By staying in or returning to the place or situation associated with the panic attack, fear lessens, and situational avoidance becomes less of an issue.
Beyond such techniques, many who experience panic attacks also take medications. These include the same types of antidepressants used to combat mood disorders. Most commonly, these are selective serotonin reuptake inhibitors (SSRIs), which target neurotransmitters or the brain’s chemical messengers. In particular, SSRIs help balance the neurotransmitter serotonin, which alleviates mood swings and anxiety and promotes better sleep.
Another pharmacological approach centers on fast-acting sedatives or anti-anxiety medications that help reduce panic symptoms while promoting relaxation. Common medications include benzodiazepines such as Xanax and Valium, though they carry risks of addiction and misuse.
