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Montreal, Qc, H4A 3L6
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What is a panic attack?
A panic attack is a short period of intense anxiety or fear (usually lasting no more than 10 minutes) during which an individual experiences several of the following symptoms:
- shortness of breath
- feeling of choking
- chest pain
- dizzy or faint
- chills or hot flashes
- numbness or tingling
- depersonalization (being detached from oneself)
- fear of losing control or going crazy
- fear of dying
In many cases, symptoms seem to appear without good reason and individuals often describe the panic as emerging from “out of the blue”.
What causes panic attacks?
- Inherited physiological tendency to overreact to threat
Studies have shown that high rates of panic disorder exist among relatives of patients suffering from panic disorder.
- Catastrophic misinterpretation of normal bodily sensations
Panic patients interpret ambiguous bodily sensations as signs of an impending physical or mental disaster (Clark et al., 1997). For example, chest pain might be interpreted as an imminent heart attack or a sudden shortness of breath combined with heart palpitations and hot flashes without justification might be interpreted as going crazy.
- Perceptions of lack of control
Experiencing a lack of control is an important psychological variable for the onset of panic attacks. If one feels overwhelmed or believes that they are not having a significant impact on events in their lives, the likelihood of suffering a panic attack increases.
In many cases, a biological predisposition and psychological factors combine to produce panic attacks.
How can therapy help for panic attacks?
The good news is that CBT (Cognitive Behavioral Therapy) is an effective treatment for panic attacks!! In fact, CBT is as effective as drugs and can be more long-lasting than drug treatment (Barlow et. al., 2000).
Four main therapeutic elements are used to treat panic attacks:
- Psychoeducation – consists of helping clients understand the fight/flight stress reaction and the physiology of the anxiety system. Providing clients with this information promotes a sense of control and can help minimize the tendency to believe that some very bad outcome is looming based on bodily cues which are otherwise difficult to explain.
- Cognitive restructuring – consists of challenging catastrophic misinterpretations of unexpected physical sensations and replacing them with more accurate perceptions (e.g., challenging the inaccurate perception that a sudden chest pain represents the onset of a heart attack).
- Breathing retraining – consists of diaphramic inhaling and exhaling – essentially, relaxed breathing with your stomach rather than breathing from your chest. Breathing retraining can help eliminate panic attacks by (1) increasing a sense of control, and (2) raising awareness of how certain breathing patterns can actually trigger panic attacks.
- Interoceptive exposure – the repeated and systematic exposure to feared bodily sensations (e.g., increasing heart rate by exercise or provoking dizziness by spinning in a chair). Although this type of exposure has been shown to be effective by triggering the feared symptoms without obtaining the feared catastrophic outcome, it can cause a great deal of anxiety for some individuals. Clients will not be forced to participate in interoceptive exposure. Often, a combination of psychoeducation, cognitive restructuring and breathing retraining is enough to eliminate panic attacks or help clients manage their anxiety.
If you have experienced distressing and recurrent panic attacks, or have had a single panic attack and fear having another one, you may benefit from professional advice. In addition, if your behavior has changed as a result of having experienced panic attacks – for example, you no longer drive or leave your home - please consult the professionals at the Montreal Psychology Center.