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What are the symptoms of panic disorder?

Panic disorder is characterized by seemingly un-triggered unexpected anxiety. The client experiences a sudden upsurge of sensations, such as palpitations, sweating, trembling, shaking, shortness of breath, chest pain, nausea, dizziness, chills, and numbness. They may fear that they are in imminent danger of going crazy, losing touch with reality, fainting, losing control of their bowels, having a heart attack or stroke, or dying. If combined with agoraphobia, they may avoid crowds, travel, driving, exercise, standing in line, or any situation where they perceive that escape might be difficult. Panic attacks are uncomfortable, but not dangerous. To earn a diagnosis of panic disorder, clients spend at least one month worrying about having more panic attacks, worrying about the consequences of panic attacks and avoiding activities that they value or once enjoyed.

How common is panic disorder?1

Two to 3 out of every 100 people have panic disorder each year. It is twice as common in women.

What is CBT for panic disorder like?

For all disorders, the CBT therapist starts by educating clients about their diagnosis, helps them set goals, and socializes them to CBT by teaching them essential thinking and behavioral skills. CBT therapists teach clients that panic attacks arise from an unexpected sensation and a catastrophic misinterpretation of that sensation. Therapy teaches clients to normalize, if not embrace, anxiety, to mindfully watch it from a distance, and act constructively with it. Rather than viewing anxiety as an obstacle, they are taught to see it as an incentive. CBT therapists also have clients note the subtle ways that they maintain their catastrophic beliefs about anxiety. Through exposure, they learn that anxiety does not cause physical or psychological harm. Clients learn that they can walk, talk, work, and drive with anxiety. They learn to do everything with anxiety, and thereby lose their fear of anxiety.

For health and mental health professionals

Learn to treat panic disorder more effectively at our CBT for Anxiety workshop. 1American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. doi:10.1176/appi.books.9780890425596.744053