Panic Attacks :

You may experience panic attacks in a very sudden way; a feeling of intense fear and discomfort starts building up, your heart starts beating very fast and you may feel it difficult to breath. This may make you think that you are “loosing control”, “fainting” or even dying; you might be sitting at home watching a movie, studying at school or being at work. Often it feels like coming “out of the blue”; you go into panic mode in an instant. These episodes may happen to you multiple times and makes you afraid of futre attacks, leading you to a change in your behavior, for example by avoiding driving long distances, taking the bus or going into crowded places.

Panic attacks can also happen late at night when you are sleeping; you suddenly wake up from sleep in a state of panic, feeling intense fear without any obvious trigger such as nightmares, making you think that you’re dying or that something dangerous is happening. This may make you fearfull of sleep and as a result, your behavior may change: like delaying when you go to bed which causes sleep deprivation, increasing the risk of having more nocturnal panic attacks.

Panic attacks can be caused by a variety of different mood disorders or for instance from smoking hashish or taking other drugs. It is important to know that panic attacks are not dangerous.

Panic disorder

If your panic attacks persist for more then 1 month along with changes in your behavior that substantially limits your everyday life, a diagnosis of panic disorder can be established. When it comes to the specific symptoms you experience during a panic attack, they are not always the same for everyone; sometimes, especially after having suffered from panic since a long time, you may no longer be afraid of dying or some other specific terrible thing happening, and you may rather become more and more afraid of the fear itself, which in turn causes a panic attack.

Studies have shown that panic disorder occurs twice as often in women than men. The longer you suffer from panic attacks, the higher the risk is of developing agoraphobia.

Agoraphobia

Agoraphobia is often a consequence of panic disorder; when your avoidance behavior becomes more and more debilitating. In simple terms, Agoraphobia, is when you avoid or endure with so much discomfort a situation that you think is difficult to escape or when help is unavailable if something goes wrong. In those moments you may feel disoriented, and afraid that something bad will happen, like a panic attack. Sometimes the fear is not about getting a panic attack; the fear may also be about other strong physical sensations like nausea or the need to vomit, stomach discomfort or a sudden urge to rush to the bathroom. This may cause you to avoid some places like going to the mall, waiting in line, taking the bus or going to a concert or the cinema, or avoiding crowded places. You may even find it difficult to leave your own home on your own. This restricts your freedom and your daily activities and may ruin your social life. Luckily, there is effective help!

CBT as an effective treatment for panic disorder and agoraphobia

Research shows that cognitive behavioral therapy (CBT) is a very effective treatment for panic disorder and agoraphobia. Your therapist will first give you psychoeducation about the nature of your panic attacks, going through what is physically really happening in your body and helping you observe what you are thinking will happen during a panic attack. The therapist will also help you see how these thoughts and physical sensations are related, and how avoidance behavior may feel like they help in the short run but unfortunately makes the problem worse in the long run (read more about Psychoducation in this article). Your therapist will then create a tailored treatment program with different components and exercises based on your specific needs. One early exercise is often self monitoring (by observing and writing down your own feelings, thoughts and behaviors. With your therapist you will also start using the most powerful techniques of CBT for your panic attacks and agoraphobia, wich are different forms of exposure. More specifically in vivo exposure for your agoraphobia and interoceptive exposure for panic attacks (read more about exposure in this article). Another technique, helping you identifiy the catastrophic thoughts you may have, and evaluate how realistic they are, is called cognitive restructuring.