Managing Panic Attacks with Cognitive-Behavioral Therapy

By Danny Gonzalez

Panic attacks afflict as many as six million adults in the United States according to statistics published by the National Institute of Mental Health (NIMH). More than 40 million Americans – or about one out of every six – suffer from some form of clinical anxiety disorder; overall, these figures represent a reasonably conservative estimate of the prevalence of panic attacks across the United States. In addition, millions suffer in silence from persistent, uncontrollable episodes of overwhelming anxiety.

Symptoms of Panic Attacks: A Clinical Definition

The Diagnostic and Statistical Manual of Mental Disorders IV-TR defines Panic Disorder as a distinct period of abnormally intense fear which reaches a peak within about 10 minutes. Sudden, unpredictable onset is another important feature of the clinical definition of a panic attack. In addition to a brief – yet absolutely horrifying – duration, at least four of the following symptoms must present themselves during the initial onset of terror: rapid heart rate, dizziness, involuntary trembling, sensation of smothering, nausea and sweating. Other subjective symptoms may include a fear of losing control, or a fear of death. Occasionally, these frightening symptoms can even spawn feelings of depersonalization (i.e. being outside of yourself) or derealization (i.e. the feeling of experiencing unreality).

Severe episodes of anxiety could indicate other concurrent mental illnesses too according to the NIMH. Acute panic attacks may manifest as the result of Post-Traumatic Stress Disorder or Social Anxiety Disorder. Mood disorders such as Major Depression and Bipolar Disorder can also exist alongside Panic Disorder, so if you believe you suffer from panic attacks, the best course of action would be to seek a full evaluation from a mental health professional.

Treatment of Panic Attacks: Cognitive-Behavioral Therapy at a Glance

Fortunately, several psychological interventions have proven efficacy in the treatment of panic attacks. Psychiatrists may prescribe any number of anti-anxiety medications (e.g. Lorazepam, Citalopram, Fluoxetine, etc.) which can alleviate the severity of acute panic attacks. Anti-depressant medications have proven useful in the long-term maintenance of anxiety disorders, but non-medical clinical interventions such as Cognitive-Behavioral Therapy are equally – if not more – beneficial. Indeed, millions of Americans choose to combine both psychotherapy and medication in order to treat persistent panic attacks most effectively.

Cognitive-Behavioral Therapy (CBT) focuses on the reciprocal relationship between cognition (i.e. thoughts) and behavior. Pioneered by researcher Aaron Beck in the mid-20th century, CBT instructs patients to recognize the link between maladaptive thoughts and disturbing emotions. CBT also emphasizes the concept that changes in outward behaviors can negatively reinforce “faulty” cognition. For example, vehemently avoiding social situations may reinforce the expectation of fear, thus feeding back into a negative loop.

CBT implores patients to break this negative feedback loop. One CBT-inspired therapy aims to teach patients to decatastrophize their thoughts in order to catch, control and correct anxiety beforehand. The idea is to cultivate awareness of anxiety's “triggers” – both internal and external – which could explode into a full-blown panic attack. Deep breathing is another common technique among therapist who adhere to the CBT model.

If you suffer from panic attacks, fear no longer. You – like millions of others afflicted with anxiety – are not alone. Millions can relate to your affliction; seek professional assistance; embrace CBT and understand that anyone can learn to catch, control and correct anxiety.