Panic Disorder – Symptoms and Treatment

In order to fully describe Panic Disorder, it is first necessary to define panic attacks. A panic attack is defined in the Diagnostic and Statistical Manual (DSM-IV) published by the American Psychiatric Association as “a discrete period of intense fear or discomfort”, including four or more of the following symptoms:

• sweating
• trembling or shaking
• shortness of breath
• a sensation of choking
• chest pain
• heart palpitations or pounding heart or rapid heartbeat

• nausea or abdominal pain
• dizziness or feeling faint
• fear of losing control
• fear of dying
• numbness/tingling sensation
• feelings of being detached from reality
• feelings of being detached from oneself

The primary feature of Panic Disorder is a history of panic attacks, as defined above, followed by one or more of the following symptoms:

• persistent anxiety about having further panic attacks
• excessive concern about the implications and/or consequences of the panic attacks
• substantial modification of daily activities in an effort to avoid situations and/or places in which one fears the possibility of experiencing a panic attack (i.e., driving, flying, trains, subways, movie theatres, concert halls, stadiums, class rooms, restaurants, malls, grocery stores)

While some may not consider Panic Disorder to be a true OC Spectrum Disorder, these three symptoms indicate that the condition has obsessive-compulsive qualities that are quite similar to OCD. In fact, recent studies indicate that approximately 6% of those with OCD also have Panic Disorder. Both Panic Disorder and OCD are categorized as anxiety disorders in the DSM-IV, and both involve intense, irrational fears. Furthermore, an individual with Panic Disorder can be extremely obsessive about having more panic attacks, as well as compulsively avoidant of situations in which he or she fears a panic attack may occur. In extreme cases, this avoidant behavior may evolve into Agoraphobia, in which the individual markedly restricts daily activities in an effort to prevent exposure to situations that he or she fears may result in the onset of a panic attack. Agoraphobia may become so severe that the individual never leaves his or her home.

As these symptoms demonstrate, Panic Disorder, like OCD, can cause significant emotional distress.Both conditions may greatly impair academic and professional functioning, and can have a profoundly negative impact on interpersonal relationships. Perhaps the most significant similarity linking Panic Disorder and OCD is the cyclical process by which the symptoms of both increase. In this process, called the Obsessive-Compulsive Cycle, the compulsive and avoidant behaviors that individuals employ in an effort to reduce their anxiety actually reinforce and worsen their obsessions.To learn more about this process, click here.

Treatment of Panic Disorder

Because of these many similarities, some of the Cognitive-Behavioral Therapy (CBT) methods that are so effective in treating OCD are also employed in the treatment of Panic Disorder. The initial treatment for Panic Disorder includes a type of Cognitive Therapy called “Cognitive Restructuring”, and a type of Behavioral Therapy called “Interoceptive Exposure”. After the client has attained some gains with this approach, he or she graduates to “In-Vivo Exposure Therapy”, a variant of the Exposure and Response Prevention (ERP) techniques used in treating OCD.

Additionally, a variant of ERP has been developed that has also been found to be extremely effective for the treatment of Panic Disorder. This method, called imaginal exposure, involves writing short stories based on the client’s obsessional fears. These stories are then used as exposure therapy tools, allowing the client to experience exposure to feared situations that he/she imagines (e.g., having a panic attack in a restaurant, while driving on a freeway, or while on a plane). When combined with standard exposure therapy and other CBT techniques such as Cognitive Restructuring, imaginal exposure can help to greatly reduce the frequency and magnitude of obsessions about having a panic attack, as well as the individual’s sensitivity to the thoughts and mental images experienced in Panic Disorder.

One of the most effective CBT developments for the treatment of Panic Disorder is Mindfulness-Based Cognitive-Behavioral Therapy. The primary goal of Mindfulness-Based CBT is to learn to non-judgmentally accept uncomfortable psychological experiences. From a mindfulness perspective, much of our psychological distress is the result of trying to control and eliminate the discomfort of unwanted thoughts, feelings, sensations, and urges. In other words, our discomfort is not the problem – our attempt to control and eliminate our discomfort is the problem. For an individual with Panic Disorder, the ultimate goal of mindfulness is to develop the ability to more willingly experience their uncomfortable thoughts, feelings, sensations, and urges, without responding with compulsions, avoidance behaviors, reassurance seeking, and/or mental rituals.  To learn more about Mindfulness Based CBT for the treatment of Panic Disorder, click here.

Using these CBT tools, clients learn to challenge their fear of having a panic attack, as well as the compulsive and avoidant behaviors they use to cope with their excessive fear. If you would like to learn more about Cognitive-Behavioral Therapy for the treatment of Panic Disorder, click here.

Individual Therapy for the Treatment of Panic Disorder

The OCD Center of Los Angeles offers individual therapy for the treatment of adults, children, and adolescents with Panic Disorder, with a strong emphasis on Cognitive Behavioral Therapy (CBT). As part of our treatment program, we also offer the option of home visits for our clients with Panic Disorder who have difficulty leaving their residence. We also provide clients the opportunity to have therapy sessions in the field to address panic-related fear of driving or flying, or the fear of public places, such as markets, stores, malls, movie theaters, and stadium events.

We have 14 therapists on staff, and are open six days a week, including evenings and Saturdays.  If you would like to discuss treatment options at the OCD Center of Los Angeles, please call one of our client coordinators at (310) 824-5200 (ext. 4), or click here to email us.

Group Therapy for the Treatment of Panic Disorder

In addition to individual therapy, the OCD Center of Los Angeles also offers six weekly, low-fee, therapy / support groups for adults with OCD, Panic Disorder, and related conditions. These groups are led by our staff therapists, and use the same treatment protocol as our individual Cognitive-Behavioral Therapy program. To learn more about our weekly groups for adults with OCD, Panic Disorder, and related conditions, click here.

Telephone and Online Therapy for the Treatment of Panic Disorder

The OCD Center of Los Angeles also offers webcam based online therapy and telephone therapy to clients around the world suffering with Panic Disorder. Telephone and online therapy are cost-effective options for clients who have physical and/or psychological limitations that restrict their ability to come to our office, and for those in remote areas who cannot find specialized Panic Disorder treatment close to their home. Telephone and internet therapy have repeatedly been found to be safe and effective in numerous research studies, and have been legal in California since 1997. If you would like to learn more about our telephone and online therapy program for Panic Disorder, please click here.

Intensive Treatment for Panic Disorder

We also offer intensive Panic Disorder treatment for adults, adolescents, and children. This program is designed to meet the needs of those for whom standard outpatient Panic Disorder treatment is either unavailable or insufficient. Our intensive outpatient program is ideal for clients from other states or countries who cannot find effective treatment near to their homes, and for those whose symptoms require a more rigorous treatment protocol. To learn more about our intensive outpatient treatment for Panic Disorder, click here.

About the OCD Center of Los Angeles

The OCD Center of Los Angeles is a private outpatient treatment center specializing in Cognitive Behavioral Therapy (CBT) for the treatment of OCD and related anxiety-based conditions, including Panic Disorder. We have 13 therapists on staff, all of whom are either licensed or registered, and all of whom specialize in CBT.  We treat adults, adolescents, and children, and offer services six days a week, including evenings and Saturdays.

Our Southern California office is located in Brentwood.

If you are experiencing any of the above Panic Disorder symptoms, and would like to discuss treatment options at the OCD Center of Los Angeles, please call one of our client coordinators at (310) 824-5200 (ext. 4), or click here to email us.

Please note that the above is not meant to replace a complete and thorough evaluation by a licensed Cognitive-Behavioral therapist or other qualified mental health professional. As with OCD, some individuals with Panic Disorder may benefit from medication, and may therefore require a psychiatric evaluation. Likewise, a psychiatric assessment may be necessary to differentiate between Panic Disorder and other psychological conditions. If a psychiatric evaluation is indicated, the OCD Center of Los Angeles can refer you to a qualified psychiatrist in our area. Furthermore, it is imperative to make the distinction between Panic Disorder and other medical conditions. For this reason, a medical examination may be a necessary part of Panic Disorder treatment.