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Time2change - Laois CBT


Katie O'Hara - Reg. Psych., M.Sc. CBT

Panic Attack Treatment

How research has shown therapy is better than medications

You can find excellent general information on panic disorder here. High quality research has shown that a 10-12 session therapy can work as well as medications for panic. This approach is more like getting some coaching on anxiety management techniques than "therapy" as you might usually think of it. And it seems to work better than medications if you look at how people are doing 6 months after treatment. For details of this research, click here. (Indeed, a 2007 study recently showed that people on medications need to stay on them in order to maintain the benefits). 

We know these work, for a large number of patients. Let's compare their advantages and disadvantages. 

  • Advantages of medication - Possibly a little faster than therapy.
  • Disadvantaged of medication -Side effects are possible - Panic returns after stopping 80% of the time.
  • Advantages of Cognitive Behavioural Therapy -No risk of side effects and you learn how to deal with anxiety for the long term. 

If you use a medication approach, you are more likely to see your panic return after you stop the pills. You may have to pay more money and invest more time to do the therapy, at first. But if you are one of the large number of people who remain free of panic after treatment -- for years, maybe forever -- then in the long run you could easily pay less and suffer less. Just think how it would feel, to walk around panic-free, knowing that you were the one who did that.  

What are the steps in this therapy? Cognitive Behavioral Therapy (CBT) is a 4-step process:

  1. learning what causes panic attacks
  2. learning to breath differently so as to reduce anxiety and panic
  3. learning how to handle panic thoughts
  4. testing your new abilities in low-anxiety situations, then higher-anxiety situations

This treatment uses your body's natural "anxiety-ending" capacity. The therapy will help you get to "1" as a starting place for these exercises. This process is called "desensitization", because it makes you less "sensitive" to the anxiety-producing situation. You desensitize yourself by leaving yourself "exposed" to the situation. Once you learn how to do this "desensitizing", you can definitely get better on your own. The process is repeated with something that causes you a 5-level anxiety. But wait, now -- don't run away yet, you don't have to take on any 5's, or even 4's, until you have seen this "exposure" method work and are absolutely convinced it will help you. Instead, you can start with the tiniest anxiety level you can find -- something that causes 2-level fear, say.

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I will work with you to make sure you are really learning the process. The goal is not simply to be free of panic attacks - it is to know how to handle panic attacks, so well that you don't really worry about them much. You become a professional at handling your own anxiety. And that's what makes this treatment so valuable: once you know how to do this, you can do it again if your panic ever returns. That's why this therapy "wins" over medications, in the long run.

The key in this CBT approach is that you learn how to handle your symptoms. In an odd way of thinking, you "need" your symptoms now to help you in this learning process. The first few weeks involve some really intense note-taking about the symptoms you experience -- learning exactly the parts of your panic experience, because each part has a treatment angle that you must "match up" to the symptom. It's easy, but it depends on the specific symptoms that you have. Every person's panic experience is a little different.

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