Psychological Services Center

Panic Disorder

Panic attacks are sudden and intense feelings of fear accompanied by physical symptoms, such as a pounding heart, shortness of breath, tingling sensations, and dizziness or lightheadedness. Each year about one in 10 people experiences a panic attack, but only about one in 50-75 people develops panic disorder. Panic disorder involves a series of unexpected and severe panic attacks that interferes with a person’s emotional life, relationships, and ability to work.

Agoraphobia

Many people who have panic disorder develop agoraphobia, a tendency to avoid the places and situations that trigger panic attacks. Not all people with panic disorder develop agoraphobia. Those who do develop agoraphobia commonly avoid large stores and other crowded places, driving on the highway, and being far from their home.

What types of treatment are available?

Panic disorder tends to be chronic and tends to reaction to stress. Those who do not receive treatment are likely to continue having problems, though the severity of their attacks may wax and wane. Here are the main treatment options usually considered for panic disorder:

  • Medication. Many people who meet criteria for panic disorder can benefit from medications. There are three main groups of medications that are commonly used for panic disorder: tricyclics, benzodiaphines, and serotonin reuptake inhibitors. Different people respond differently to these medications, so deciding which one to try should be done with your physician or psychiatrist. Some medications can have side effects and cannot be used by certain people. Not all people who can take medications benefit from them. People who do benefit typically have a substantial reduction in symptoms, but some experience limited-symptom panic attacks. When medications are ended, there is some risk that the panic attacks will return.
  • Cognitive-behavioral therapy using interoceptive exposure and behavioral experiments. This type of treatment is relatively new. It includes learning about panic attacks and their causes, and correcting the thoughts that cause panic attacks. This treatment has been shown to be highly effective at reducing panic attacks, with approximately 80% of those going through these treatments being panic-free at the end of treatment. This treatment is not for everyone. Usually 10-15 therapy sessions are needed, and the person is expected to participate in difficult and uncomfortable activities, and work outside of sessions to master new skills.
  • Cognitive-behavioral therapy using relaxation training. This type of treatment is has been shown to be effective at reducing panic attacks, with approximately 50% of those going through these treatments being panic-free at the end of treatment. Usually 10-15 therapy sessions are needed, and the person is expected to work outside of sessions to master new skills. Psychological therapies using agoraphobia exposure. For people who have panic disorder with agoraphobia, there are several treatments available that incorporate agoraphobic exposure. Although this type of treatment focuses on reducing avoidance behavior, it has also been shown to be moderately effective at reducing panic attacks, with approximately 50% of those going through these treatments being panic-free at the end of treatment. Usually 10-15 therapy sessions are needed, and the person is expected to participate in difficult and uncomfortable activities, and work outside of sessions to master new skills.
  • Other psychological therapies. There are many different types of psychological therapies. Many of these therapies were not developed specifically for panic disorder, but for other reasons, such as reducing depression, improving relationships, or personal growth. The effectiveness of most of these therapies for panic disorder has not been studied. While these other therapies may be useful for reaching other goals, they are not likely to be useful for reducing panic attacks.