Panic Disorder
Individuals with panic disorder suffer from recurrent panic attacks. Panic attacks involve a sudden increase in fear and anxiety in addition to having at least four symptoms such as palpitations, difficulty breathing, nausea, and dizziness (APA 2000). Individuals with panic attacks over focus and interpret body sensations (particularly anxiety symptoms) as indicating imminent physical or mental catastrophe (e.g. “if I continue to feel this way I will go crazy”). Approximately 6 million American adults ages 18 and older, or about 2.7 percent of people in this age group in a given year, have panic disorder (Kessler et al. 2005).

CBT is indicated for the treatment of panic disorder. Treatment focuses on how body sensations are misinterpreted and avoided. CBT is associated with significant reductions in panic, fear, avoidance, anxiety and depression in patients with panic disorder (Oei et al. 1999). In multiple studies CBT for panic disorder has been found superior to placebo (Sokol L et al. 1989, Beck AT et al. 1992, Clark DM et al. 1994). Some reviews and studies indicate CBT to be superior to medication treatments of panic disorder. CBT is generally considered to have longer treatment effects (longer periods in remission) and is better tolerated when compared to treatment with medication (Gould et al. 1995).

Treatment for panic disorder typically lasts for 6-12 sessions delivered weekly followed by maintenance sessions delivered monthly for 3-6 months. We recommend committing to 8 sessions with close monitoring of response. With 8 sessions one can usually determine if the panic disorder is going to respond to CBT.

To read more about Panic Disorder and CBT click on the following links:

http://www.adaa.org/gettinghelp/treatment.asp
(Links to the Anxiety Disorders Association of America website on treatment of anxiety disorders)

http://www.nami.org/Template.cfm?Section=By_Illness&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=54&ContentID=23050
(Links to National Alliance on Mental Illness (NAMI) guide for Panic Disorder)

http://www.nimh.nih.gov/health/publications/anxiety-disorders/treatment.shtml
(Links to the National Institute of Mental Health (NIMH) guidelines for Panic Disorder).

1. American Psychiatric Association. Diagnostic and stastical manual of mental disorders (4th edition text revision). American Psychiatric Association, Washington DC, 2000.
2. Beck AT, Sokol L, Clark DA, Berchick RJ, Wright FD. A crossover study of focused cognitive therapy for panic disorder. Am J Psychiatry 1992;149:778-783.
3. Clark DM, Salkovskis PM, Hackmann A, Middleton H, Anastasiades P, Gelder MG. A comparison with cognitive therapy, applied relaxation, and imipramine for the treatment of panic disorder. Br J Psychiatry. 1994;164:759-769.
4. Gould RA, Otto MW, Pollack MH. A meta-analysis of treatment outcome for panic disorder. Clin Psychol Rev. 1995;15:819-844.
5. Kessler RC, Chiu WT, Demier O, et al. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Arch Gen Psychiatry 2005;62:617-627.
6. Oei TPS, Llamas M, Devilly GJ. The efficacy and cognitive processes of cognitive behaviour therapy in the treatment of panic disorder with agoraphobia. Behavioral and Cognitive Psychotherapy 1999;27:63-88.
7. Sokol L, Beck AT, Greenberg RL, Berchick RJ, Wright FD. Cognitive therapy for panic disorder: a nonpharmacological alternative. J Nerv Ment Dis. 1989;177:711-716.