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Panic Disorder Treatment

14 Minutes

Edited & medically reviewed by THE BALANCE Team
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Panic disorder is defined by the occurrence of recurrent, unpredictable panic attacks. When you experience rapid, overpowering apprehension for no apparent reason, you could be experiencing a panic attack. Physical symptoms including a rapid heartbeat, breathing difficulty, and perspiration may also be present.

A panic attack is characterized by a sudden burst of severe fear or anxiety that lasts only a few minutes. Panic disorder is considered as a continuous dread of panic attacks (or associated symptoms) recurring for at least one month. Panic disorder symptoms commonly occur in young people between the ages of 19 and 23. If you have had 4 or more panic attacks, or if you’re scared of having another following one, you might have panic disorder.

  • Anxiety disorders, like panic disorder, are by far the most frequent mental health issues in the US, with 40 million individuals suffering from them.
  • Only around 36 percent of individuals with anxiety problems receive the care they require.
  • Anxiety patients are 6 times more likely to be hospitalized or visit a doctor for a psychiatric issue.
  • In the previous year, a projected 2.7 percent of adults in the United States (aged 18 and older) suffered from panic disorder. Panic disorders afflict over 6 million adults every year, according to another report.
  • Females had a higher occurrence of panic disorder (3.8 percent) than males (1.6 percent) in the previous year.
  • Approximate 4.7 percent of adults in the United States suffer from panic disorder at some point in their lives.
  • Panic disorder affects 2.3 percent of adolescents (ages 13 to 18), with 2.3 percent having a severe impairment. The criteria for determining impairment were based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition.
  • Females (2.6 percent) had a greater prevalence of panic disorder than males (2.0 percent ).
  • A total of 44.8 percent were severely impaired, 29.5 percent were moderately impaired, and 25.7 percent were mildly impaired.

What factors influence the onset of panic disorder? The patient’s avoidance behavior is assumed to be driven by a phobia of inner sensations. Some researchers proposed a cognitive framework for this condition, in which individuals learn to misunderstand emotions and thoughts as physical symptoms, in addition to genetic and neurochemical explanations. For instance, a woman who is terrified to be alone whenever her husband goes to work may feel anxious (– for example, symptoms like sweating, shortness of breath), which leaves her feeling even more apprehensive (“What is happening to me?”), intensifying the cycle and contributing to more symptoms. 

Luxury Inpatient Anxiety Retreat in the UK

Another notion is that patients’ panic attacks are triggered by otherwise harmless physical sensations (the behavioral model). For instance, a man whose pulse rate rises when he is upset may exaggerate the sensation and the worry that follows into chest discomfort that is mistaken for a “heart attack.” The patient’s fear of interior sensations can be seen in both of these situations.

Not everyone who experiences panic episodes is suffering from panic disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) issued by the American Psychiatric Association provides the following criteria for the diagnosis of panic disorder:

  • You have a great number of panic attacks that strike you from nowhere.
  • At least one of the panic attacks was accompanied by a month or more of continuing worry about getting a further attack; sustained fear of the repercussions of an attack, like loss of control, cardiac events, or “going insane”; or substantial behavioral changes, like avoiding things that you think might provoke a panic attack.
  • Your panic attacks are not the result of alcohol and substance abuse, a physical ailment, or a mental health problem like obsessive-compulsive disorder or social phobia.
  • You could still respond to treatment if you suffer panic episodes but don’t have a recognized panic disorder. If panic attacks are not addressed, they might progress to phobias or panic disorder.

The question of whether panic disorder should be treated with cognitive therapy, cognitive-behavioral therapy, medication, or a combination of approaches is still being debated. Although the effect sizes of acute treatment options may differ, clinicians and patients should consider various aspects other than acute treatment outcomes when choosing treatment. These considerations involve assessing the benefits and drawbacks of each potential treatment, as well as how well they match the patient’s symptoms, financial and personal resources, and preferences. Even though treatment guidelines differ, some recommendations can be made.

In terms of pharmacological therapy, an evidence-based approach advises that SSRIs should be the first line of treatment. Although tricyclic antidepressants have similar acute therapeutic rates of success as SSRIs, they have a higher side-effect load. If immediate relief is required, a high-potency benzodiazepine taken at the minimal therapeutic dose may be a beneficial complement to antidepressant medication. To reduce the danger of discontinuation challenges associated with benzodiazepines, the treatment regimen should involve quitting the benzodiazepine drugs when the antidepressant’s maximum effects are expected (for example, 4 to 6 weeks). While benzodiazepines are a suitable choice after tricyclic antidepressants and SSRIs have failed, they must not be taken if the patient has a background of or is currently abusing other substances, or if the patient has concomitant depression. When concurrent depression or social anxiety is present, MAOIs should be considered, but they should always be a last resort due to the hazards they represent.

In individuals with mild to moderate panic disorder or disorder with contextual avoidance, cognitive-behavioral therapy is an effective first-line treatment option. Even though benzodiazepines can be used in conjunction with cognitive-behavioral therapy to provide immediate relief from acute symptoms, they have been shown to impede the effects of it, thus their use as an adjunct should be limited. In cases where severe agoraphobia prevents involvement in cognitive-behavioral therapy, a combination of a tricyclic antidepressant or SSRI medication and cognitive-behavioral therapy should be considered. Patients who do not react to medication have found cognitive-behavioral therapy to be useful, and it can be used in this situation as well.

When medicine for panic disorder is stopped, the acute rebound is common. Because recent studies have demonstrated that cognitive-behavioral therapy can significantly reduce the cessation and relapsing difficulties related to medication discontinuation, it should be explored as an adjuvant treatment with any pharmacotherapy to potentially lessen the risk. Other factors to consider when choosing a first-line treatment are the patient’s choice for a medication-assisted approach vs. one without and the accessibility of cognitive-behavioral therapy in the region.

Patients must be monitored regularly once a treatment has been chosen. Irrespective of the treatment technique employed, individuals should be progressively encouraged to resume formerly avoided situations once stabilized. Alternatives should be sought if the specific outcome is unsatisfactory after about 8 weeks of therapy.

Finally, people with panic disorder frequently require delicate clinical care. Most of these individuals have been sick for a long time and have had several different, inadequate, and unsuccessful treatments. Creating a therapeutic relationship with patients is a crucial part of any therapy plan.

Apart from the luxury amenities and services provided at a luxury inpatient rehab for Panic disorder, a genuine therapeutic alliance with a wholesome relationship between patient and therapist is a significant factor in uplifting the treatment outcomes. This includes: 

  • Developing a therapeutic alliance by paying attention to the patient’s concerns, providing genuine reassurance and optimism, and being willing to be present in the event of unanticipated challenges.
  • Giving the person some information regarding panic disorder (for instance, it is not life-threatening, it is common, it is treatable).
  • Examine the many aspects of panic disorder (predictive anxiety, panic attacks, and aversion) and how therapy focuses on each.
  • Examine and discuss the patient’s medication problems.
  • Explaining the various therapy choices and their benefits and drawbacks.

If you’re suffering from panic attacks or depression, medications can help you manage your symptoms. Several medications have been demonstrated to be beneficial in treating panic attack symptoms, including:

Selective serotonin reuptake inhibitors (SSRIs). SSRIs are drugs that block the reuptake of serotonin. SSRI antidepressants are frequently advised as the first line of treatment for panic attacks since they are generally safe and have a low risk of major adverse effects. Paroxetine, sertraline, and Fluoxetine are SSRIs that have been approved by the Food and Drug Administration (FDA) for the management of the panic disorder.

Serotonin and norepinephrine reuptake inhibitors (SNRIs). These drugs belong to a different family of antidepressants. Venlafaxine, an SNRI, has been licensed by the FDA for the management of panic disorder.

Benzodiazepines. These sedatives are suppressors of the central nervous system. Clonazepam and Alprazolam are two benzodiazepines that have been authorized by the FDA for the management of panic disorder. Since benzodiazepines can be habit-forming and develop physical or mental reliance, they are usually only administered for a brief time. If you have a history of drug or alcohol abuse, these drugs are not for you. These can also react with other prescription drugs, resulting in potentially serious side effects.

If one medicine isn’t working for you, your doctor may suggest changing to another or a combination of medications to improve efficacy. Bear in mind that noticing a symptomatic improvement can take many weeks after starting a drug.

Side effects are a possibility with all medications, and some are not suggested in specific situations, like pregnancy. Discuss any potential risks and side effects with your clinician. Keeping in view the safety and convenience of psychological therapies, lifestyle modifications, and alternative treatments, a Premium luxury rehab center that has such a feasible, comprehensive approach is the best place to begin treatment.

Luxury Panic Disorder Facilities

Traditional panic disorder treatment clinics may not have as many 5-star resort-like amenities as luxury panic disorder treatment programs. Such facilities are frequently found in quiet regions where patients can dwell without fear of someone intruding on their privacy. Additional therapies, like holistic therapy programs and recreational therapies, may be available in luxury programs. More sophisticated treatment methods or strategies may be provided in premium rehab centers that are not generally available in public or normal panic disorder institutions.

Programs for Executives with Panic Disorder

Many upscale and private panic disorder treatment centers provide patients with exclusive treatment plans. Acupuncture, traditional Western and Eastern treatments, Massage therapy, personal attendants, and other services may be available.

Since women are twice as likely as males to develop panic disorder, several Upscale panic disorder treatment centers cater exclusively to women. You can contact locate a private panic disorder treatment center that specializes in treating ladies with this problem.

Programs for Panic Rehab and Treatment in the Outpatient Setting

Based on the individual’s treatment success, an outpatient panic disorder rehab and treatment program can take up to 4 months to finish. A person visits an outpatient center and receives therapy over several hours, as opposed to an inpatient environment. If the patient simply has panic disorder, an outpatient panic disorder treatment center is indicated.

Individuals with panic disorder are hesitant to accept that their condition is not life-threatening, and they frequently visit the emergency room. Furthermore, individuals with panic disorder are usually unwilling to cooperate due to a fear of loss of control due to medication and an unwillingness to use drugs. Mental health professionals must not only evaluate and identify possible hurdles to treatment adherence but also collaborate with patients to minimize or eliminate these obstacles.

Individuals with panic disorder are also four times more likely to experience negative drug side effects, which can lead to noncompliance and temporary anxiety. Mental health professionals should urge patients to talk about their worries and set realistic expectations for them at various stages of their therapy.

Any sort of treatment will not produce immediate results, so be diligent and patient in your efforts to recover. Any therapy you choose will necessitate your active participation.

The majority of antidepressant drugs take 3 to 4 weeks to produce benefits. If you don’t observe any improvement after 6 weeks of treatment, it’s time to talk to your health professional about other possibilities.

CBT frequently results in gradual rather than immediate improvement. Giving the therapy a chance is critical. Treatment usually consists of eight to twelve 60-90 minute sessions. Unless you have experienced any change after 6 to 8 sessions, you may have to take alternative therapies, just as you would with medicine.

CBT requires you to be an active part of your treatment. If you’ve followed the methods and completed homework in sessions and still aren’t feeling better, a switch in treatment may be necessary. Long-term outcomes research shows that psychological behavioral interventions offer long-term effects that endure after therapy is completed.

Stay optimistic, and if you believe the rehab center or the therapist you’ve picked isn’t the best fit for you, get independent advice or switch therapists altogether. It is critical to completely engage in treatment and to be aggressive when it comes to treatment plans and choices. You should collaborate with your therapist rather than merely follow his or her orders.

The anxiety of experiencing another panic attack might cause significant disruption in your life. It may force you to flee certain social situations, as well as separate yourself from others. Your education or job life may be impacted. Inform your family, friends, and colleagues so that they can better assist you when you require assistance.

While you’re being treated at an upscale rehab center, you can help yourself. Changes will aid in the control of problems and can lead to panic episodes. Follow these steps:

  • Develop a healthy lifestyle.
  • Get a decent rest.
  • Every day, set aside some time for yourself
  • Start exercising regularly.
  • Cultivate Healthy Behaviors

Some habits may exacerbate your panic disorder symptoms. Keep the following in mind and keep them to a minimum:

  • Caffeine is a stimulant present in tea, coffee, soft drinks, chocolate, and other beverages.
  • Restrict alcohol consumption to one drink per day for women and 2 drinks per day for men. Consult your doctor if you’re having trouble limiting your alcohol use.
  • Nicotine accelerates your pulse and respiration when you smoke. If you smoke, your therapist can assist you in quitting.
  • Illegal drugs—Talk to your therapist about obtaining help if you have a substance abuse problem.
  • Medications on prescription— Any medication you’re taking should be discussed with your physician. If it’s causing issues, let them know.

Various natural methods may be prescribed by your doctor as complementary and alternative treatments to therapy or prescription medication.

Sugary, sweet prepared foods, refined carbs, and meals containing chemicals and additives should be avoided. Reduce your caffeine intake gradually to avoid headaches and other symptoms of withdrawal. Consuming chamomile (skullcap, lemon balm, or passionflower) tea rather than caffeinated drinks can help you relax without producing sleepiness or addiction.

Vitamin B complex, Magnesium, and Calcium all help to keep the nervous system healthy and functioning properly. They also aid in the creation of neurotransmitters, which are molecules that assist nerve cells to communicate.

Non-drug treatments for anxiety disorders include regular exercise and relaxation practices like yoga, meditation, tai chi, and progressive muscle relaxation. Cardiovascular activity, which eliminates lactic acid, releases mood-enhancing compounds (endorphins), and allows the body to utilize oxygen more effectively, should be part of your daily routine.

Regulated breathing exercises might help you calm down if you’re having a panic attack. Whenever an attack comes, try the following breathing technique: inhale gently to a count of five, wait for five counts, exhale gently to a count of five, pause five counts, then redo till the attack passes.

If you have a severe medical issue or are taking any medicines, visit your physician before utilizing any health therapy, such as herbal supplements and natural therapies. This information is provided solely for educational reasons and is not intended to be a replacement for medical advice.

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