Published on Oct 20, 2016 and last reviewed on Feb 20, 2023 - 3 min read
In this article, I have discussed a case of panic disorder treated with CBT. Cognitive behavior therapy is based on altering your negative thoughts, emotions, and behaviors to positive ones.
What Is Panic Disorder?
Panic disorder is a condition characterized by extreme anxiety attacks which mimic heart attack symptoms such as rapid heartbeat, palpitation, heavy breathing, sweating, choking, etc. But, this is not due to any medical problem. It is completely a psychological issue and can be treated through psychological treatment. Cognitive behavior therapy (CBT) is found to be the best treatment for panic disorder.
Considering the incidents of terrorism, snatching, robberies, accidents and mishaps, we see many people with anxiety and panic disorder. People often consult the doctor at a very advanced stage in which they cannot even move out of their home. A similar case was handled by me recently.
A Case Study
A female aged 46 years from a higher socioeconomic class approached a psychology clinic with the presenting problems of panic attacks, extreme anxiety, and social phobia symptoms. She was unable to move even from her room and her fears of getting panic attacks made her bedridden. She feared to travel in a plane because of previous incidents of tragedy during plane travel. Her uncle died of a heart attack during a plane journey. This and other incidents of deaths among her relatives developed the fear of death in her. She was unable to carry out daily functioning and her psychological state was quite disturbed due to physical symptoms of vomiting, trembling, rapid heartbeat, difficulty in breathing, choking, sweating, and thoughts of having a heart attack. Her medical tests declared normal results and she was referred for psychotherapy.
I planned to conduct a case study on this patient since her psychological assessment findings suggested a good prognosis. She signed a consent form to participate in the study and she was assessed through standardized questionnaires which revealed her severe level of panic attacks and severe symptoms of agoraphobic avoidance. According to recent research findings, cognitive behavior therapy was suggested as the best treatment for her. She was an educated lady who had fair insight regarding her condition. Further insight was developed through psychoeducation since she had a belief that she might be suffering from any heart problem due to clear physical symptoms. Her medications were not producing any satisfactory result because her anxiety was increasing day by day.
She was challenged by the results of her medical reports. Further, she learned relaxation training which produced very positive effects in her anxious state. She was also educated about the mind and body connection, which she clearly observed during times of her panic and through the change in the symptoms after relaxation exercise. Moreover, systematic desensitization was taught to her in which she made a list of feared objects and situations ranging from most feared situations to the least fearful situations.
She was mostly scared of traveling by plane, then driving a car and then traveling in a car with her driver. She was scared of going to crowded places, shopping malls or enclosed places where she might experience panic attacks. This hierarchy was used to lessen her fear while imagining these scenarios in a relaxed position. This exercise was demonstrated during the psychotherapy session and then she was given an assignment to gradually face these circumstances in real life.
She started going out with a driver accompanying a family member, then she started going out shopping with her daughter. She gradually started to drive her car and go shopping alone. Finally, she traveled on a plane to attend a wedding ceremony of her relative living abroad. Then, she went on a tour with her husband. At this stage of psychotherapy, she was able to manage many of her home chores, which she had quit due to her panic disorder.
Another technique which fairly helped her was the de-catastrophizing continuum. Through this strategy, she started observing her misinterpretations regarding her minor bodily symptoms such as heavy breathing, which she assumed to be a heart attack symptom. She had a clear understanding that her thoughts were producing these feelings and sensations in her body. When she understood this, she started controlling her thoughts and feelings.
This way, she was able to manage her panic symptoms and removed agoraphobic avoidance. At the end of therapy, she stated that she was very confident in her ability to control her panic symptoms. She reported that she will be able to manage life without the help of a therapist as she became her own therapist.
After checking her post-therapy evaluations, she was bilaterally terminated because her panic and agoraphobic avoidance lied at zero level.
Similarly, those who observe any depressive symptoms or find any kind of psychological disturbance are recommended to get a consultation as soon as they observe the signs. The earlier they get tested by a psychologist, sooner they can be cured of their psychological problem.
For further information about CBT and panic disorder, consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist
- Psychotherapy- Cognitive behavioral therapy (CBT), a research-supported kind of psychotherapy, is typically utilized to manage the panic disorder. Cognitive behavioral therapy guides the patient in various forms of thought, acting, and responding to the emotions that occur at the time or before the panic attack. The attacks can evolve slightly more frequently once the patient understands to respond differently to the physical senses of anxiety and fear at the time of a panic attack.
- Medications - Certain medications like antidepressants, beta-blocker, and anti-anxiety drugs
Panic disorder is an entirely treatable condition with various known treatments. These therapies are incredibly efficacious, and most patients who have achieved therapy can resume experiencing anxiety, and additional therapy might be required in those patients. Once the therapy is done, the panic disorder does not direct to any permanent difficulties.
- Selective Serotonin Reuptake Inhibitors (SSRIs)- Typically secure with a reduced risk of severe side effects, SSRI antidepressants are commonly suggested as the foremost option of medicines to manage panic attacks.
- Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)- These drugs are another category of antidepressants.
There is a hereditary predisposition to anxiety conditions. Stress is the foremost reason for panic attacks. Certain medications like birth control and flu can trigger panic attacks. Panic disorder can be induced by traumatic circumstances, usage of large amounts of caffeine, and misusage or withdrawal of drugs or liquor.
Panic disorder belongs to anxiety disorder. Different anxiety disorder induces persistent anxiety of impending collapse. A panic attack is an immediate attack of intense fright. Panic attacks can happen at any time. Certain symptoms are similar to mental illness and minor physical conditions.
Complications that panic attacks may cause
- Evolution of characteristic phobias.
- Periodic medical consideration for health matters.
- Avoidance of social statuses.
- Issues at work.
- Depression, anxiety disorders.
- Raised chance of suicidal thoughts.
- Expected Panic Attacks- Predicted attacks are envisioned when a person is subjected to clear cues or panic triggers.
- Unexpected Panic Attacks- Unexpected panic attacks happen unexpectedly without any evident reason or manifestation. When an unexpected panic attack happens, an individual can totally relax prior to the form of the manifestation.
Panic disorder occurs double as standard in females as in males. Manifestation frequently occurs at the age of fewer than 25 years old, but it can also occur at the age of 30 too. Kids can also have panic disorder, but it is frequently not analyzed until they are more aged.
- A thorough physical examination.
- Blood examinations review thyroid and other probable diseases and tests on the heart, like an electrocardiogram.
- A psychological examination to discuss the manifestations, worries or problems, and family history.
Panic disorder does not commonly worsen with age. But the individuals affected by anxiety vary across their lifespans. Anxiety becomes more familiar with more age and is considered among middle-aged grown-ups. This may be because of several elements involving differences in the brain and nervous system due to age and having experienced stressful life circumstances that can activate anxiety.
Numerous individuals have one or two panic attacks in their life, and the issue goes away, and a stressful condition ceases. But if a person has recurrent, unpredictable panic attacks and has extended duration in persistent anxiety of additional attacks. Then they may have a situation known as panic disorder.
Panic disorder is distinguished by unpredictable and repetitive episodes of extreme fear happening together with physical manifestations that may involve chest aches and discomfort, palpitations, shortness of breath, dizziness, or abdominal despair.
Last reviewed at:
20 Feb 2023 - 3 min read
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