Panic Attack Treatment

There are several treatment methods that may help to manage symptoms of panic attack.

These range from simple techniques to regulate breathing and maintain control over anxiety to pharmacological management for immediate relief of an attack as well as prevention.

If individuals tend to experience panic attacks on a regular basis or have a panic disorder, they may benefit from methods to prevent panic attacks in the future. This includes cognitive behavioral therapies and dietary changes to focus on nutritious foods that are not associated with an increased risk of attacks.

Breathing Exercises

Hyperventilation is a prominent symptom of the vast majority of panic attacks and often exacerbates other symptoms. As a result, practicing deep breathing exercises to aid in the process of rebalancing the blood oxygen and carbon dioxide levels can be beneficial.

An example of a breathing exercise is 5-2-5 count. This involves using the diaphragm and stomach to inhale for 5 seconds, then holding your breath for 2 seconds. The exhalation should be slow and controlled over another 5 seconds. In this exercise, it is important the chest is not used to breathe and, instead the stomach should be coming out. This cycle of breathing should be repeated twice, followed by 5 regular breaths. This helps to relax the heart rate whilst continuing with regular breathing.

Other breathing techniques include extending the exhalation breath by counting or humming.

Previously breathing into a paper bag has been recommended as a technique to address hyperventilation, although currently controlled breathing is seen as the superior technique. This is largely because the paper bag reduces the oxygen level to the blood stream, which may have potentially dangerous effects.

Pharmacological Management

Anxiolytic drugs such as benzodiazepines have been the most commonly used medication for anxiety related to stress for the past 40 years and continues to be a popular option.

Using these medications at a low dose is often able to alleviate anxiety, agitation and fear associated with panic attacks, due to their action on the receptors in the amygdala, orbitofrontal cortex and insula.

Benzodiazepines can be administered during a panic attack to provide relief from an acute attack. They do not address the underlying fear, but address the immediate symptoms of the attack within about 15 minutes.

Cognitive Behavioral Therapies

It is widely accepted by medical professionals that cognitive and behavioral therapies are the treatment of choice for individuals with a panic disorder, whilst medication is appropriate in selected cases.

Therapy usually begins with provision of information, as many individuals find that they benefit significantly from understanding what panic disorder is and what they can do. Additionally, many feel reassured in the fact that they are not alone in suffering from the condition.

It is quite common for people to believe that they are going crazy or that an attack may induce a heart attack. As a result, making sure that people understand that this is not the case and helping them to view attacks in a more realistic and positive way using cognitive restructuring can be beneficial.

Dietary Changes

Some foods and beverages are associated with a higher chance of experiencing a panic attack. For example, caffeine is known to induce panic attacks in some people, which is likely due to the sympathetic effect it has on the body.

There is also a range of drugs that have the potential to cause panic attacks. As a result, it is worthwhile to consider the medical history of any individual that experiences a panic attack and if any current medications may be influencing this.

References

• http://www.betterhealth.vic.gov.au/bhcv2/bhcpdf.nsf/ByPDF/Panic_attack/$File/Panic_attack.pdf
• http://www.nhs.uk/conditions/stress-anxiety-depression/pages/understanding-panic-attacks.aspx
• http://www.nhs.uk/conditions/panic-disorder/pages/treatment.aspx
• http://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms/index.shtml