What is a panic attack and how to stop it?

 Patients usually cannot name the source of their fear; they may feel confused and have trouble concentrating. The physical signs often include tachycardia, palpitations, dyspnea, and sweating. Patients often try to leave whatever situation they are in to seek help. The attack generally lasts 20 to 30 minutes and rarely more than 1 hour.

The goal of treatment is to eliminate all of your panic attack symptoms. With effective treatment, most people are eventually able to resume everyday activities. The main treatment options for panic attacks are psychotherapy and medications.

Cognitive behavioral therapy is generally viewed as the most effective form of treatment for panic attacks, panic disorder, and agoraphobia. Cognitive behavioral therapy focuses on the thinking patterns and behaviors that are sustaining or triggering the panic attacks. It helps you look at your fears in a more realistic light. For example, if you had a panic attack while driving, what is the worst thing that would really happen? While you might have to pull over to the side of the road, you are not likely to crash your car or have a heart attack. Once you learn that nothing truly disastrous is going to happen, the experience of panic becomes less terrifying.

In exposure therapy for panic disorder, you are exposed to the physical sensations of panic in a safe and controlled environment, giving you the opportunity to learn healthier ways of coping. With each exposure, you become less afraid of these internal bodily sensations and feel a greater sense of control over your panic.

Medication can be used to temporarily control or reduce some of the symptoms of panic disorder.

The SSRIs fluoxetine , paroxetine , sertraline , fluvoxamine , citalopram , and escitalopram have shown effectiveness. For patients with severe panic disorder and associated disability that has either not responded to an SSRI, we suggest treatment with a benzodiazepine (eg, clonazepam or alprazolam). Patients who do not achieve optimal outcomes at completion of either Cognitive behavioral therapy or pharmacotherapy can be considered for a trial of the other modality.

CART is a new breathing therapy that reduces panic and anxiety by reversing hyperventilation. During the treatment, patients undergo simple breathing exercises twice a day. A portable capnometer device supplies feedback during the exercises on a patient's CO2 levels. The goal of these exercises is to reduce chronic and acute hyperventilation and associated physical symptoms. This is achieved by breathing slower but most importantly more shallowly.

 

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