CBT for panic disorder
What is a panic attack?
A panic attack has three important features:
1. It is accompanied by intense fear and anxiety
2. It usually comes on fairly suddenly
3. The most intense feelings last a relatively brief time (although it may seem like a very long time when you are in the middle of an attack, and it may leave you feeling uncomfortable for some time after the peak has passed).
Panic is usually accompanied by a sense that something awful is about to happen. You may think that you will die, or go mad, lose control, or make a complete fool of yourself, or something else, there are many different fears. Panic often appears to come “out of the blue” the panic attack is completely unexpected and does not appear to be triggered by anything. Other times, people can recognise particular situations which are likely to trigger an attack.
Panic attacks are very common, but they are not a sign of serious mental illness. ‘We know that as many as one in ten of the general public may have at least one panic attack in their life time (that’s just around half a million people in Ireland!). Many people have panic attackss for a while, but then the panics go away. For others, they may cause problems for a long time. A lot of people presenting for treatment report that they no longer have panic attacks, but they live in fear of having another one. Unfortunately, perhaps because of the prejudices about psychological problems which still exist, many people wait years before they tell anyone or seek professional help, and some people never seek help at all. Which is unfortunate, given the success rate in treating panic disorder using CBT is over 90%.
The symptoms of panic
Panic affects your body, your thoughts and your actions. Below are some of the most common symptoms.
What happens to your body in panic?
During an attack, people usually have very unpleasant bodily sensations. You will probably have noticed certain sensations in your own attacks. Some of the common ones are:
You heart beating very fast, skipping beats or having ‘palpitations’
Breathing very fast (sometimes called overbreathing or hyperventilation).
Feeling short of breath, as if you cannot get enough air.
Chest pains, headaches, or pains in other parts of your body.
Tightness in your throat, choking sensations
Feeling as if you have to go to the toilet
Feeling faint, dizzy or unsteady on your feet
Numbness or tingling, especially in the fingers, toes or lips
Trembling or shaking
Sweating or hot flushes
Feelings of unreality, as if you are not really there, or as if you are separated from everything around you
These are the commonest sensations, but one of the confusing things about panic is that is can cause a very wide range of sensations. Even though your own symptoms may not be on this particular list, you still may be having panic attacks.
Your thoughts/fears in panic
Some of the common fears that people report when having a panic attack:
I am going to have a heart attack
I will collapse or faint
I will not be able to breathe, I will suffocate
I will lose control of my bladder and / or bowels
I will choke
I will be sick
I am going to lose all control, go ‘crazy’, get taken to a mental hospital
I am going to make a complete fool of myself in front of everyone
My panic will never end
In the middle of a panic attack these thoughts are very frightening.
Your action or behaviour in panic
When something as frightening as a panic attack happens, you will obviously do something to try and prevent the harm that seems to threaten you. Most, commonly, people believe that they will be safer if they leave the situation they are in, escape as soon as possible to what seems a safer place. For many, this means going home or finding someone with whom they feel safe.