Psychotherapy in the Treatment of Panic Disorder


Do you sometimes feel like you’re losing control? Like there’s something seriously wrong with you and you’re the only one who feels that way? If so, you might be suffering from panic disorder. Panic disorder is a mental health condition characterized by sudden and frequent episodes of intense fear or anxiety.

Left untreated, it can be severely debilitating. However, there is hope. Psychotherapy is an effective treatment for panic disorder, and with the help of a qualified therapist, you can overcome your fears and get your life back on track. So don’t wait any longer – seek out professional help today!

In the treatment of panic disorder, there is a belief that medication is absolutely necessary for the treatment of panic disorder and panic attacks, or that the first intervention is always done with medication, that there is always a physical disease underlying panic attack and panic disorder, or that psychological origins remain in the background is no longer valid in today’s psychiatric treatments.

Underlying panic disorders are the effects of a series of neurochemical changes on the brain and a catastrophic misinterpretation of bodily sensations are currently accepted theories.

Can panic disorder be dangerous?

Yes. Panic disorder can be dangerous if left untreated. People with panic disorder often experience panic attacks, which are periods of intense fear and anxiety. These panic attacks can be so severe that they interfere with a person’s daily life. Untreated panic disorder can also lead to other mental health issues, such as depression and addiction. If you think you may have panic disorder, please see a mental health professional for help.

Although medications alleviate panic symptoms and eliminate anticipatory anxiety and avoidance behaviors, they cannot give the ability to cope with the problem to the patient. This is the main role of cognitive-behavioral therapy in the treatment of panic disorder and panic attacks. In fact, when many patients do not receive psychotherapy or medication, there might be new distortions that the patients cannot deal with.

Psychotherapy is also crucial in patients who are hypersensitive to drug side effects, who are pregnant, who cannot use drugs due to a physical illness or any other reason.

What Is Panic Attack?

A panic attack is a sudden period of intense fear that comes on out of the blue. It lasts anywhere from 5 to 30 minutes, but any individual may have longer or shorter attacks depending on how they experience it. The worst part about panic attacks is that there’s no warning at all. Anyone can be caught completely off guard without any sign whatsoever! Panic disorders are the most common mental illness in America after depression, affecting 6 million adults each year.

The anxious individual sees any situation as a danger or threat to his/her security, due to the perception we call “selective processing of information”.

The individual with panic disorder interprets bodily sensations catastrophically. Heart attack, brain hemorrhage, loss of control, madness, and being unable to breathe can occur during panic attacks as some of the results of catastrophic scenarios.

In the treatment of panic disorder with psychotherapy, we focus on maladaptive behaviors and thoughts and catastrophic beliefs that initiate, sustain or exacerbate panic symptoms.

Explaining the role of rapid breathing, which we call hyperventilation, in panic attacks and discussing with the patient, teaching breathing exercises, redefining bodily sensations, are the basic elements of cognitive-behavioral therapy in the treatment of panic disorder. Throughout the treatment, the focus will be on the relationship between the somatic sensations of the patients and their panic-anxiety responses, and awareness will be increased. This process is provided by cognitive restructuring and familiarization with internal stimuli.

Generally, 12-15 sessions of psychotherapy are required in the treatment of panic disorder and attacks. Cognitive errors related to panic attacks, hyperventilation, conditioned responses to physical sensations, applications for fear, and avoidance behaviors will be covered in detail throughout the therapy. The psychotherapist will actively use methods such as cognitive restructuring, breathing exercises, comparison with internal stimuli, real-life exercises, and homework while providing mental training and information on the physiology and treatment of panic disorder in cognitive-behavioral therapy.

The main interpretation or cognition in anxiety is the perception of physical or psychosocial danger. In addition to negative automatic thoughts, dysfunctional attitudes and rules also play a role here. The main element in the cognitive model of panic is the tendency to interpret bodily situations in a catastrophic way. Misinterpreted bodily sensations will first create normal anxiety responses, gradually catastrophizing will come into play, sensations will be paired with a physical illness, the focus will be on a disease such as a heart attack or a stroke, and the feeling of loss of control will gradually intensify, and the panic attack picture will emerge.

In the cognitive approach to panic disorder and panic attack, the neurobiological and neurochemical processes underlying autonomic symptoms are not denied, but the main goal is to establish the link between the emergence of autonomic symptoms and the misinterpretation of bodily sensations as “catastrophic”. Meanwhile, it tries to show the links between panic symptoms and catastrophic responses to bodily sensations.

The initial symptom of a panic attack is a great guide to psychotherapy. Automatic thoughts here are the greatest help in reaching core belief. Treatment is guided through warm cognitions that are experienced and active at that moment.

In panic attack treatment, the priority is to reduce anxiety and end panic attacks. The psychiatrist should adopt a realistic but hopeful approach and change negative beliefs and distortions about treatment.

The general principle in cognitive therapy is that the patient should be able to define his/her own cognitions, be aware of them, and learn to replace them with alternative thoughts.

Panic attack patients have experienced the same situation over and over again, and although they test that nothing has happened, they again succumb to the feelings of having a heart attack, losing control, and being paralyzed. This is because of constantly fighting against body sensations, over-concentrating the attention we call hypervigilance on all internal and external stimuli, the tendency to scan the body repetitively, and preventing confrontation with negative thoughts.

Cognitive-behavioral treatment of panic disorder consists of structured sessions. Here are the steps of treatment of panic disorder:

Treatment of Panic Disorder

1) The first step in treatment is to reveal negative automatic thoughts.

2) The relationship between thoughts, feelings, and behaviors is shown.

3) What anxiety is, its sources, symptoms, physiology, formation, and consequences of autonomic changes are explained in detail.

4) In situations where automatic thoughts cannot be dealt with, the skills of controlling anxiety symptoms are gained.

5) Verbal challenge is made with automatic thoughts.

6) Voluntary hyperventilation and similar experiences create panic attack-like clinical situations and behavioral experiments are performed.

7) Behavioral experimentation can also be in the form of creating panic attacks through imagination.

8) Situations that cause fear and avoidance behavior such as going out alone and exercising are addressed gradually.

9) Dysfunctional beliefs and assumptions are processed with special techniques to gain insight into the patient.

10) Relaxation exercises, in which the patient sees that they can control their symptoms themselves, are used at every stage of the treatment.

If the skills gained through treatment are not used sufficiently, practice methods are abandoned and reinforcement sessions are neglected, the disorder may recur in many cases. It is important for panic patients to pay particular attention to this situation in terms of the permanence of the treatment. Even if panic symptoms reappear, reminding that the individual is at a different point from their pre-treatment situation and that they now have the knowledge, attitude, and skills about how to deal with the disorder will stop the panic symptoms in a short time.

Presence of depression or a comorbid psychiatric disorder, inadequate cooperation of the patient, use of alcohol or benzodiazepines may reduce the effectiveness of psychotherapy.

With psychotherapy and treatment of panic disorder, which is becoming increasingly important in the world and in our country, you can stop panic attacks and get rid of panic attacks and panic disorder.

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Last Updated on December 17, 2021 by Patric Johnson

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About Author

He is studying psychology in Canada. Lucas also volunteers helping elderly people in nursing homes. Lucas, who is especially interested in hypnotherapy, continues his education and research in this field.

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