Anxiety And Panic Attacks
Explains anxiety and panic attacks, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.
Mae’r dudalen hon hefyd ar gael yn Gymraeg. This link will take you to a Welsh translation of this page.
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We hope that you can still find information here that helps. You can visit our coronavirus information hub to find lots of information on coping during the pandemic.
Treating Panic Attacks With Neurofeedback
For over 35 years, the Drake Institute of Neurophysical Medicine has utilized both therapeutic technologies to successfully treat patients suffering from stress and anxiety related disorders. Unlike other treatment plans that rely heavily on medication to subdue the symptoms of stress-related disorders, our treatment plans focus on treating the origin of the disorder to the fullest extent.
Because we are essentially teaching the brain/mind-body to acquire a new skill, the positive results that are formed through the Drake Institutes Panic Attack treatment program are typically sustainable long after treatment has concluded, as this skill eventually becomes hard-wired into the individual. This is in direct contrast to treatments involving medication since this type of treatment requires the patient to continually ingest an external chemical compound in order to experience relief.
Its important to emphasize, that during the neurofeedback and biofeedback treatment, nothing invasive is being done to the patient: the entire process only requires that the patient wears sensors on their head, or sensors over the forehead muscles and a thermometer on the finger monitoring hand temperature so that the real-time analysis can be displayed visually on a computer monitor and through auditory feedback. No medications. Our patients through learning self-regulation are able to reestablish a healthy homeostasis or psychophysiologic balance which reduces or resolves symptoms.
How K Health Can Help
Want mental health support? Get connected to care in minutes. K Therapy offers free smart chats, which are dynamic, pre-written conversations designed by experts that cover a number of common mental health topics such as depression, anxiety, stress, relationships, and more. Access them for free by downloading the K Therapy app.
K Health also offers anxiety medication for the right candidates.
Online therapists are also available in select states for individualized care. Connect with a licensed mental health therapist for unlimited asynchronous text-based therapy. Therapists respond Monday through Friday between 9 am-5 pm, within 24 hours.
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What To Do During A Panic Attack
If a person senses the onset of a panic attack, it is best to resist the urge to fight it. It may help to remember that the feeling will pass, is not dangerous or life threatening, and will not harm them physically.
Finding a peaceful spot may help if possible, as sights and sounds can intensify a panic attack. A person can also try some relaxation techniques, such as:
- taking long, slow, deep breaths
- smelling a soothing scent, such as lavender
- focusing on a physical object in the environment to help them feel more grounded
- repeating a mantra, which is a word, phrase, or sound that may help shift their focus away from fear
What Questions Should I Ask My Doctor
If you have panic attacks, you may want to ask your healthcare provider:
- Why am I having panic attacks?
- What is the best treatment for panic attacks?
- How long will I need therapy?
- How long do I need to take medications?
- Should I look out for medication side effects?
A note from Cleveland Clinic
Panic attacks can be extremely uncomfortable. Although theyre not physically harmful, they can take a toll on your mental health and stop you from doing the things you love. Dont be embarrassed to tell your healthcare provider that you have panic attacks. Your provider can help you overcome fears and anxieties that trigger attacks. You can get better with treatments like psychotherapy and medications.
Last reviewed by a Cleveland Clinic medical professional on 08/12/2020.
References
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Lifestyle Changes And Home Remedies For Panic Attacks
Psychotherapy and medication can help to treat anxiety and panic attacks, but there are also certain lifestyle changes that can have a positive effect on anxiety. Lifestyle changes that can help to reduce feelings of anxiety and the occurrence of panic attacks include:
- Stress management: Mindfulness, meditation, yoga, physical activity, muscle relaxation techniques, and other stress management exercises can help to keep your central nervous system calm and reduce feelings of anxiety and panic.
- Getting enough sleep: Prioritizing getting regular quality sleep can help to improve your mental and physical health.
- Support groups: Engaging in a support group can help to provide an additional outlet for sharing anxieties, concerns, and achievements with others.
Main Symptoms Of A Panic Attack
If you have panic attacks, you may feel sudden intense fear along with physical symptoms like shaking, sweating, chest tightness, and rapid heartbeat. You may feel like you are having a heart attack or even dying.
The severity of the condition varies from person to person. Your panic attacks may range from mild to severe. You can have multiple panic attacks in a day or week and then go weeks or months without one.
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Other Drugs For Panic Disorder
Tricyclic antidepressants may also be effective in treating panic disorder.
Some TCAs your healthcare provider may prescribe include:
Plus, you can feel like you have the flu with symptoms like tiredness, chills, and muscle aches.
This is why you shouldnt abruptly stop taking your medication without first discussing it with your healthcare provider.
When youre ready to stop taking your medication, youll slowly decrease your dose over time. Even this gradual process can still produce adverse effects.
Discontinuation syndrome can be very challenging, so be sure to ask your provider about this risk and how to prevent or minimize its effects.
Lastly, the decision to take medication, and which medication to take, should be a thoughtful, collaborative process between you and your healthcare provider.
Be your own advocate and bring up any concerns you have.
Though psychotherapy and medication are considered first-line treatments for panic disorder, there are several things you can try on your own to help you feel better.
Some People May Develop Panic Disorders
For many people, the feelings of panic occur only occasionally during periods of stress or illness. A person who experiences recurring panic attacks is said to have panic disorder, which is a type of anxiety disorder. They generally have recurring and unexpected panic attacks and persistent fears of repeated attacks.
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Cognitive Behavioral Therapy Is 70 To 90 Percent Effective As A Treatment For Panic Disorder
Panic disorder is one of the most treatable anxiety disorders. The prevailing treatment is cognitive behavioral therapy . A new offshoot of CBT, known as Acceptance and Commitment Therapy , has also been found effective in treating panic disorder. Psychologist Steven Hayes developed ACT in part as a way to treat his own panic disorder. This form of therapy uses acceptance and mindfulness techniques to change how you relate to your physical sensations of anxiety and anxiety itself.
CBT is an incredibly effective treatment for panic disorder. Seventy to ninety percent of people who undergo CBT will get better, says Gruner.
A key part of CBT in treating panic is a method called interoceptive exposure, in which the person deliberately confronts the unpleasant physical sensations that are causing anxiety. People become more sensitive to these sensations because they fear and avoid them, so facing the sensations and learning that they are not dangerous can lower anxiety sensitivity.
CBT sessions are usually conducted on a weekly basis and last for around 12 to 16 sessions. The treatment tends to show long-lasting results, and relapse is uncommon.
Selective serotonin reuptake inhibitors are also often used to treat depression and anxiety disorders, with or without CBT. These drugs can be effective, but CBT has been found to be a longer-lasting treatment than SSRIs.
How Do I Access Treatment
To get treatment on the NHS, the first step is normally to visit your GP. They will do an assessment, which might include asking you to fill in a questionnaire about how often you feel worried, anxious and nervous.
They should then explain your treatment options to you, and you can decide together what might suit you best.
See our pages on seeking help for a mental health problem for more information on how to prepare for an appointment and have your say in treatment.
Unfortunately NHS waiting lists for talking treatments can be very long. If you’re finding it hard to access talking therapies you could consider:
- Charities and specialist organisations. See useful contacts for a list of organisations that may offer therapy or be able to put you in touch with local services. Mind’s Infoline could also help you find services near you.
- Private therapy. Finding a private therapist is another option some people choose to explore, but it’s not suitable for everyone because it can be expensive. See our page on private therapy for more information.
What if my anxiety stops me from seeking help?
It can be especially hard to get treatment if making or attending an appointment with your doctor involves doing something that causes lots of anxiety for you. For example, you might not feel able to talk on the phone or leave the house.
Here are some things you could try:
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Preventing A Further Attack
It may help to:
- read a self-help book for anxiety based on the principles of cognitive behavioural therapy ask your GP to recommend one
- try complementary therapies such as massage and aromatherapy, or activities like yoga and pilates, to help you relax
- learn breathing techniques to help ease symptoms
- do regular physical exercise to reduce stress and tension
- avoid sugary food and drinks, caffeine and alcohol, and stop smoking, as all they can all make attacks worse
For more help, read how to deal with panic attacks.
Treatments For Panic Attacks
While panic attacks do not pose any specific threats to your physical health, they are difficult to live with. Persistent panic attacks may lead to substance abuse or the development of additional disorders like agoraphobia, or the fear of being in crowded places. The best treatment option for your panic attacks will be different than someone elses.
Counseling
Just as self-awareness is the key to diagnosis, it can also help you manage your attacks. A specialized counselor can help you with tools to help you ground yourself during attacks and recover more quickly.
A counselor can help you learn coping techniques to use when you have a panic attack. While they cannot be completely avoided, knowing what to do during a panic attack may help you overcome the episode and recover.
Medication
If your doctor suspects a chemical imbalance is triggering your attacks, medication, or other supplements can help to prevent attacks. Antidepressants are often prescribed because research shows they can reduce the number of attacks.
In addition to these, you may need to make lifestyle changes to improve the disorder. A healthy diet and exercise has a positive effect on your body and mind and can help you to feel more in control of your life.
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What Triggers A Panic Attack
Regardless of who they happen to or how they manifest, panic attacks do not happen in a vacuum. Although panic attacks are often unpredictable and seem spontaneous, there are nevertheless risk factors that act as potential panic attack triggers.
Negative mood is a situational factor that contributes to the increased likelihood of experiencing a panic attack. In contrast, an individualâs general level of anxiety is a less specific factor that can work in the background and increase the likelihood of panic attacks regardless of situational factors.
In other words, it can be useful to think of anything that causes negative mood as a trigger , while general levels of anxiety can be thought as a magnifying lens that turn seemingly innocuous events into potential triggers.
These general triggers are useful for understanding the psychological origin of a panic attack. However, they may miss some of the spontaneity and confusion of how panic attacks manifest in day-to-day life, where triggers may be harder to identify and the timeline of a panic attack does not necessarily follow a neat beginning, middle, and end.
An individual interviewed by Woodgate, Tennent, Barriage, and Legras described the onset of their panic attack:
âI was just walking down the street and then these guys walked past me and theyâre like âWhatâs up?â and I started panicking.â
How Are Panic Attacks Treated
Panic attacks are one of the characteristic symptoms of panic disorder, which is a type of anxiety disorder. To treat panic disorder, you may be recommended to try therapy for panic attacks, as well as medications as part of a treatment plan. You might also receive treatment for anxiety if youre struggling with other anxiety symptoms.
Depending on the severity of your attacks, tried and tested treatment for panic attacks may include:
Cognitive behavioural therapy – CBT aims to address any dysfunctional thought patterns that may be contributing to your panic attacks, in order to re-evaluate these thoughts in a healthier way
Medication certain antidepressant medication, such as selective serotonin reuptake inhibitors , or other medications, can be used alongside CBT to further support in the management of panic attacks
Alongside these treatments, you may also be recommended to practice different mindfulness activities as well as breathing techniques, which can help you during a panic attack.
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How Is Panic Disorder Diagnosed
Medical or mental health providers can diagnose panic disorder. Your provider may diagnose panic disorder when you have repeated panic attacks and you:
- Persistently worry about having more panic attacks or their consequences.
- Obsess about losing control during a panic attack.
- Change your behaviors to avoid situations that may trigger a panic attack.
Key Points About Panic Disorder
- Panic disorder is an overreaction of fear and anxiety to daily life stressors.
- The reaction causes a hyperphysical response, followed by intense worry that another attack will happen soon. This can upset the ability to function normally.
- It is a common disorder and can often lead to depression.
- Panic disorders can be disabling because you become so afraid of when the next panic attack may happen that you can’t cope with regular tasks.
- Treatment involves use of anti-anxiety medicines and antidepressants along with cognitive behavioral therapy.
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Other Forms Of Psychotherapy For Panic Disorder
CBT may not work for everyone, but other effective options are available.
Panic-focused psychodynamic psychotherapy and panic-focused psychodynamic psychotherapy extended range appear to be effective for panic disorder and other anxiety disorders, though theyre less researched than CBT.
PFPP-XR consists of 24 sessions, two times a week. Its divided into three phases. The content of these phases varies by person.
In the first phase, you explore the origins of your anxiety and discover the meaning of your symptoms. Having a deeper understanding of your anxiety, and knowing the source, can reduce anxiety and panic attacks.
In the second phase, you further identify the unconscious feelings and underlying conflicts of your anxiety symptoms.
In the third phase, you explore any conflicts or fears around ending therapy.
Other treatments for panic disorder include acceptance and commitment therapy and mindfulness-based stress reduction . Although more research is needed for MBSR and ACT, the results so far are promising.
One 2011 study of 68 people concluded that MBSR was effective at treating anxiety disorders, including panic disorder, though the researchers admitted that the study had limitations.
One 2016 study of 152 people observed that both guided and unguided online ACT treatment through a smartphone app helped reduce panic symptoms.
The researchers concluded that getting help through an app may at least partially compensate for being unable to see a therapist.
Engage In Light Exercise
Research shows that regular exercise can not only keep the body healthy but boost mental well-being, too.
Experts have found that exercising at 60 to 90 percent of your maximum heart rate for 20 minutes three times per week can help reduce anxiety.
If you are not used to exercising, talk with your doctor before starting. There is some evidence that starting aerobic exercise anew can trigger additional anxiety in people with an anxiety disorder. Building up gradually can help your body adjust and avoid breathing problems. Aerobic exercise includes activities such as running on a treadmill.
If you feel stressed or youre hyperventilating or struggling to breathe, stop and take a rest or choose a more moderate option, such as walking, swimming, or yoga.
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What If Speaking With A Therapist Is Not An Option
If you have health insurance, Medicare, or Medicaid, call your insurance provider to learn more about mental health coverage and to get a list of providers in your network.
If you dont have insurance or are concerned about the costs of psychotherapy, affordable options are available.
Some therapists and clinics offer sliding scale or free services for people with no insurance or low incomes.
Asking your primary healthcare provider for their recommendations can be a good first step. You can also ask about any therapy apps or local support groups they recommend.
- reduce their frequency and severity