Anxiety and Panic Disorders
The ten billion or more brain and nerve cells we have arrange themselves into groups in order to form "maps" that respond to our experience.
A panic attack is a good example of how the brain works. A particular situation or trigger (heights, social situations, open spaces, and so on) produces a particularly strong physical response (sweaty palms, fast breathing, panic, etc). The brain learns quickly and thereafter, every time the person is presented with the same stimulus, their body knows to have the same response. The amazing thing is that people with panic attacks NEVER forget to have this response.
What this means in simple terms is that our brain is nothing short of the most advanced and sophisticated computer in the world. Like computers, which operate through programs such as word processing or spreadsheets and emailing, we have internal programs running in our brain in a similar fashion.
In our case, once we learn something like driving a car for instance it is stored as a set of programs in our brain and the next time we need to go through a similar process it fires off. For instance when you are driving a car now you are not so conscious about the whole processes of driving, as you were when you first started learning it has become second nature to you now. Even the small things we take for granted such as brushing our teeth, getting dressed, speaking, walking and just about every activity we don't have to think about consciously, are a set of programs running in our subconscious mind.
Luckily for us, we have these programs running in the background. Imagine the chaos our lives would be in if every time we approached a door we had to stop, think and work out how to open the door. Can you see how everyone's lives would be utterly chaotic if for a small task like opening a door we had to think about the process every time?
Just imagine the confusion we would experience in the other areas of our life, if we didn't have these programs running in the background! But, here's the problem just as we have programs running that benefit us in some way like driving a car for instance, we have programs running in the background that are not so good for us, like those that cause anxiety, phobias, panic attacks, just about every limiting condition that exists can be traced back to a self limiting set of programs.
So we can use simple methods to replace the bad limiting programmes with more productive and beneficial programmes.
Most people I work with suffer from some of the panic attack symptoms below; they can be overcome:
Heart Palpitations with or without panic attacks
Lack of motivation
Panic attacks or generalized anxiety
Shortness of breath or Hyperventilation
Insomnia or tiredness
Dizziness or feeling faint with or without panic attacks
Treating panic disorder
The main aim of treatment for panic disorder is to reduce the number of panic attacks that you have, and to help ease the severity of your symptoms.
The two main types of treatment for panic disorder are:
- psychological therapy
Depending on your individual circumstances, you may require either one of these treatment types, or a combination of the two. If you are offered psychological therapy, it will probably be in the form of cognitive behavioural therapy (CBT). If this type of treatment does not work, medication may be recommended.
Before you begin any form of treatment, your GP will discuss all of your options with you, outlining the advantages of each type of treatment, while also making you aware of any possible risks or side effects.
Different treatments will suit different people so you may need to try a variety of treatments at first. This is because no single treatment is best for everyone, and the treatment that is recommended for you will depend on your general health and the severity of your condition, as well as your personal preferences.
It is important for you to understand what your treatment will involve. If you do not understand something that your GP has told you, make sure that you ask them to explain it to you in more detail.
Cognitive behavioural therapy
Cognitive behavioural therapy (CBT) is thought to be one of the most effective forms of treatment for panic disorder. CBT is a psychological treatment, and will involve you having weekly sessions.
For example, I may talk to you about the way you react when you have a panic attack, and what you think about when you are experiencing an attack.
Once we have identified any negative thoughts and beliefs, you can work on replacing them with more realistic and balanced ones. I can also teach you ways of changing your behaviour, which should make it easier for you to deal with future panic attacks. For example, I will show you breathing techniques that can be used to help keep you calm during the stress of a panic attack.
Cognitive behavioural therapy (CBT) is a type of therapy that aims to help you manage your problems by changing how you think and act.
CBT encourages you to talk about:
- how you think about yourself, the world and other people
- how what you do affects your thoughts and feelings
By talking about these things, CBT can help you to change how you think (‘cognitive’) and what you do (‘behaviour’), which can help you feel better about life.
Who can use it
CBT is particularly helpful in tacking problems such as anxiety, depression, post-traumatic stress disorder, eating disorders and drug misuse.
Unlike other talking treatments, such as psychotherapy, CBT focuses on the problems and difficulties you have now, rather than issues from your past. It looks for practical ways you can improve your state of mind on a daily basis.
Number of sessions
CBT usually involves weekly or fortnightly session. The number of sessions required varies greatly depending on your problems and objectives, with treatment usually lasting from six weeks to six months.
CBT can help you see how your thoughts and behaviour relate to the way you feel, and how this might contribute to problems in your life.
I will help you find ways to change your thought patterns and behaviour so you can cope with your problems and anxieties better.
CBT cannot remove your problems, but can help you to manage them in a more positive way.
CBT is thought to be one of the most effective treatments for anxiety and depression.
Helpful and unhelpful reactions
CBT helps you to realise that your problems are often created by you. It is not the situation itself that is making you unhappy, but how you think about it and react to it.
The Royal College of Psychiatrists illustrates this using the following example:
- Situation: You have had a bad day, feel fed up, so go out shopping. As you walk down the road, someone you know walks by and apparently ignores you.
- Unhelpful thoughts such as ‘They ignored me - they don't like me’ result in you feeling low and rejected, and you get stomach cramps and feel sick. You decide to go home and avoid the person.
- Helpful thoughts such as ‘They look a bit wrapped up in themselves - I wonder if there's something wrong?’ mean you feel concern for the person, rather than negative feelings, and you get in touch to make sure they are ok.
- Research has shown that cognitive behavioural therapy (CBT) can be as successful as medicine in treating many types of depression and other mental health disorders
- CBT can be completed in a relatively short time compared with other talking therapies.
- Because it is highly structured, CBT can be provided in a number of different formats such as through computer programmes, groups and self-help books.
- The skills learnt in CBT are useful, practical and helpful strategies that can be incorporated into an individual’s life to help them cope better with future stresses and difficulties.
- To benefit from CBT, you need to commit yourself to the process. I can help and advise you, but cannot make your problems go away without your co-operation.
- Because of the structured nature of CBT, it may not be suitable for people who have more complex mental health needs or learning difficulties.
- Some critics of CBT argue that because the therapy only addresses current problems and focuses on very specific issues, it does not address the possible underlying causes of mental health conditions, such as an unhappy childhood.
- CBT focuses on the individual’s capacity to change themselves (their thoughts, feelings and behaviours), and does not address wider problems in systems or families that often have a significant impact on an individual’s health and wellbeing.
How effective is CBT?
CBT can help you to manage problems, such as anxiety and depression, so they are less likely to have a negative impact on your life. There is always a risk that the bad feelings you associate with your problem return, but with your CBT skills it should be easier for you to control them.
Even after you are feeling better and your sessions have finished, it is important to practise your CBT skills. Some research suggests that CBT may be better than antidepressants at preventing the return of depression. ‘Refresher’ CBT courses are available if you feel you need to go through the skills you have learnt again.
Support groups, such as Anxiety UK and Triumph Over Phobia UK, will be able to provide you with useful information and advice about how to effectively manage your panic disorder, and they are also a good way of meeting other people who have similar experiences of the condition.
Panic attacks can sometimes be frightening and isolating, so it can be helpful to know that other people are experiencing the same feelings and emotions as you.
Support groups often involve face-to-face meetings where you can talk about your problems and difficulties with others. Many support groups can also provide support and guidance over the telephone or in writing. Ask your GP about support groups for panic disorderin your local area.