There are a range of treatment interventions that psychologists may use to address symptoms of panic disorder. These can be used alone or in conjunction with pharmacological therapies if needed.
Cognitive behaviour therapy (CBT) has the most research evidence as an effective treatment for panic disorder. CBT is a type of psychological therapy that helps a person identify and modify unhelpful thoughts and behaviours that may lead to feelings of panic. CBT for panic disorder involves a range of strategies and techniques, including psychoeducation, self-monitoring, cognitive restructuring, exposure therapy, and relaxation. This is commonly provided by psychologists, who have specialised training and experience with mental health difficulties such as panic disorder and treatments including CBT.
Psychoeducation
Psychoeducation involves providing important information about how panic disorder develops in order to improve symptom awareness and empower the person to cope effectively with the disorder. Psychoeducation might also include information on the lifestyle factors that are thought to contribute to feelings of panic (e.g., smoking and the use of stimulants) and those that could decrease the experience of panic symptoms (e.g., regular exercise).
Self-monitoring
Monitoring a person’s thoughts, behaviours, and symptoms is a core feature of CBT. By asking a person to monitor their panic symptoms, the situations in which they occurred and any associated thoughts and behaviours, the psychologist can help develop therapeutic interventions to reduce the number of panic attacks experienced and the way in which the person responds to panic symptoms.
Cognitive restructuring
Feelings of panic often stem from a person’s unhelpful thoughts and misinterpretations of panic symptoms (e.g., “my heart is beating fast... I must be having a heart attack”). Cognitive restructuring is a CBT technique which helps a person to identify and challenge these negative thoughts and develop a more rational and helpful style of thinking (e.g., “a racing heart does not mean I am having a heart attack”).
Exposure therapy
Exposure therapy is a CBT technique where the psychologist guides a person through scenarios which are known to trigger feelings of panic. This may involve directly exposing a person to a feared situation (e.g., a crowded train) or by inducing physical sensations which the person finds distressing (e.g., a racing heart). Through a gradual process of exposure, often beginning with the least anxiety-provoking situation, the person builds a tolerance of the uncomfortable feelings and sensations that they experience during times of panic and learns to confront their fears with decreased levels of anxiety.
Relaxation skills training and breathing retraining
Relaxation techniques, such as progressive muscle relaxation, have been found to improve symptoms of panic disorder by decreasing muscle tension and the body’s physical response to stressors. Another technique which can be incorporated into CBT for panic disorder is breathing retraining which teaches people about the role of breathing in panic disorder and outlines strategies to correct unhelpful breathing patterns which commonly occur during panic attacks (e.g., rapid and shallow breathing).