Why the Best Treatment for Complex Panic Disorder is Comprehensive

What people often don’t realize about panic attacks is how intricately connected they are to our physiology. Of the 13 symptoms that define a panic attack, the majority are physical and stem from overactivity of the sympathetic nervous system. These include the following:

• Dizziness
• Chest pain
• Sweating
• Shortness of breath
• Heart racing
• Choking
• Nausea
• Numbness

The three psychological symptoms of a panic attack include fears about dying or completely losing control, along with a sense of distorted reality or unreality. These are linked to overactivity of a brain structure called the amygdala, which is responsible for fear regulation. When you experience a panic attack, your amygdala causes you to react as if you’re in real danger—even if you’re not.

If you heard an explosion in the distance, for example, you would probably experience numerous symptoms that fall under the category of panic attack symptoms. Your heart would race as you wondered what had happened, if anyone was hurt, and if you were in danger, yourself. You might feel numb, unable to grasp what’s happened right away, or begin to hyperventilate. Not so different from a panic attack, on the surface—but there is one crucial distinction. In the case of the explosion, the danger is real. In the case of a panic attack, the danger is only in your mind.

Worse, if you experience one panic attack and become preoccupied with, or fearful of, experiencing another, it can create a feedback loop that paves the way to panic disorder. Without treatment, this cycle of fear may continue and grow stronger and become increasingly harder to break. You may try to cope, as many do, by avoiding certain people, places, and situations that you believe might trigger a panic attack—but while this may seem like a good short-term solution, it will only reinforce your fear and make it more difficult to overcome in the long run. Seeking out professional medical treatment will help you replace negative coping mechanisms with healthier, more positive habits in order to gradually accept and, eventually, overcome your fear.

When seeking treatment for your panic disorder, it’s essential to understand that fear is a natural human response and an indispensable part of life. Treatment will not “cure” you of fear entirely; rather, the goal is to learn how to manage and cope with your fear and diminish it to more acceptable levels. Because it is a complex disorder, each path to recovery is unique, but there are certain cornerstones involved in most panic disorder treatment plans. These include:

• Breathing techniques. We’ve all been told to take a deep breath at some point in our life. And while this can be effective in certain situations, such as meditation, it’s actually counterproductive during panic attacks. Feelings of suffocation or of “not getting enough air” stem from too much carbon dioxide leaving the body, and deep breaths will only release more. Therefore, when experiencing intense feelings of anxiety, you should instead focus on normal, shallow breathing.
• Therapy. Therapy is crucial to the recovery process as it helps you better understand the thoughts that are going through your head prior to and during a panic attack. This can be tough to accomplish on your own—with your heart rate through the roof, finding focus isn’t the easiest task. But with proper breathing techniques and therapeutic tools that promote self-awareness and acceptance, you will learn to restructure the way that you react the anxious thought patterns and replace them with positive ones.
• Medication. When patients hit a wall with therapy, medication can be necessary to overcome this bump in the road. Beta-blockers like propranolol can be very helpful, as they can reduce and even eliminate many of the physical symptoms of a panic attack. Ultimately, they help you gain clarity and focus on dealing with the psychological symptoms more effectively. For people with extreme anxiety that aren’t benefiting from other options, benzodiazepines such as Xanax and Ativan are effective for alleviating both physical and mental symptoms temporarily, although they should be taken with care and only under medical supervision, due to their potential for dependence.

Most of all, it’s important to remember that there is no one single “best” treatment. Panic disorder might seem like a simple case of overcoming fear, but in truth, it is a complex disorder with various physical and mental components, all of which need to be addressed in order to heal. In most cases, multiple different forms of treatment—in combination with strong support from loved ones—are necessary to help people gain control of their disorder and take the first steps toward treatment.