Panic Disorder

Dr. David L. Kupfer, Ph.D.

A panic disorder is an anxiety disorder that might begin with a person having a panic attack that scares them, and then might develop into a worry about additional panic attacks leading to catastrophic consequences. Some people respond to a panic attack by developing agoraphobia; they restrict their lifestyles by avoiding situations in which another panic episodes seems likely.

A panic attack itself is a sudden burst of uncomfortable anxiety, often including scary physical symptoms coupled with fears of disasters. The physical symptoms can include heart palpitations, a rapid heart rate, shortness of breath, sweating, shakiness, nausea, or dizziness. When experiencing these physical symptoms, people often fear a loss of control. This could mean a fear of going crazy, fears of developing severe medical problems or actually dying, or simply fearing the embarrassment of needing help in a public setting.

For example, Bill came for therapy with symptoms of panic disorder. He feared driving long distances from his home, and also was nervous about passing out in a public place. His first panic attack occurred when he was driving home after visiting a relative who lived about 50 miles away from Billís home. He was nervous about getting lost and about not seeing well on the highway at night, and generally felt unsafe when far from his familiar home and neighborhood. He had a panic attack so severe that he felt unable to complete his drive home. He called his wife who had to come to give him a ride back home. Cognitive-behavioral therapy helped Bill over a period of about three months. He first learned a set of techniques useful in managing his anxiety. He learned some methods of reducing his anxiety while on the road or in a public place like a grocery store; mostly he learned a new view of anxiety as a tolerable and unlikely to lead to the catastrophes that he feared. He used behavior therapy principl to go into a grocery store, where he had previously had panic attacks, and use coping techniques to stay in the store until his anxiety level had diminished. Then he drove gradually increasing distances from home, putting into use the anxiety management techniques that he had learned in the therapy office. This allowed him to regain confidence that he could comfortably resume the unrestricted life he had previously enjoyed.