CBT for Panic Attacks

Panic attacks can be debilitating, but there's hope. Cognitive Behavioral Therapy (CBT) has emerged as a highly effective treatment for panic disorder and panic attacks.

What is CBT for Panic Disorder?

CBT is a problem-focused and time bound therapy that concentrating on the interplay between behaviour, feelings, and thoughts. For panic attacks, CBT aims to:

Identify and challenge panic-related thoughts
Reduce avoidance behaviors
Teaches coping strategies for managing physical symptoms

Significant researchin the field of Psychology and Psychotherapy demonstrated CBT to be the most efficient treatment of Panic Disorder, including panic attacks (Pompoli et al., 2016)

Key Processes of CBT for Panic Disorder

1. Psychoeducation
Learning what panic attacks are is the very first step for overcoming them. CBT generally begins with an educational component to the nature of panic, anxiety and the fight or flight response (Sánchez-Meca et al., 2010).

2. Cognitive Restructuring
This entails developing awareness and challenging negative thoughts that are inducing the state of panic. Individuals are tought to replace catastrophic thinking with a rational, realistic understanding of their extreme symptoms (Clark & Salkovskis, 1986).

3. Interoceptive Exposure
In this method panic-like sensations are introduced on a conscious level deliberately in a controlled environment. This safe, controlled and gradual exposure assists people in overcoming the fears associated with body-specific (somatic) associated manifestations that result in panic (Pompoli et al., 2018).

4. In Vivo Exposure
Gradually learning to confront feared situations decreases avoidances and increases confidence. This component is very useful for those who suffer with different phobias (Barlow & Craske, 2000).

5. Breathing Retraining
Often considered as not as important as other thechiques, in CBT, breathing is a vital tool in controlling hyperventilation associated with panic attacks and promote relaxation (Pompoli et al., 2018).

Effectiveness of CBT for Panic Attacks

Current research have shown robust results indicating the efficacy of CBT for panic disorder, with CBT showing a greater effect in reducing panic symptoms and being superior to no-treatment or placebo (Mitte, 2005), also leading to significant improvements in panic symptoms at both 4 weeks post-treatment and 6-month follow-up (Kim et al., 2018).

What to Expect in CBT for Panic Attacks

A usual course of CBT for panic attacks will be structured around the following stageas:

Assessment and goal-setting
Education about panic and anxiety
Learning and practicing relaxation techniques
Identifying and challenging panic-related thoughts
Gradual exposure to feared sensations and situations
Developing a relapse prevention plan

Most CBT protocol for panic disorder is between 12-16 sessions but 4 session is also effective (Kim et al., 2018)12.

Tips for Getting the Most Out of CBT Treatment

Be truthful and authentic to your therapist
Practice the learned techniques between sessions

Conclusion

CBT is a very effective weapon against panic attacks. Its performance has been extensively shown, and its delivery injected with range so it is accessible enough. In the event that one encounter panic attacks, it is worth having a conversation with a mental health professional concerning the treatment given through CBT. Keep in mind is that with the right therapy and support, it is possible to overcome panic and take back your life.

References

Andrews, G., Basu, A., Cuijpers, P., Craske, M. G., McEvoy, P., English, C. L., & Newby, J. M. (2018). Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis. Journal of Anxiety Disorders, 55, 70-78. https://doi.org/10.1016/j.janxdis.2018.01.001

Barlow, D. H., & Craske, M. G. (2000). Mastery of your anxiety and panic (MAP-3): Client workbook for anxiety and panic. Oxford: Oxford University Press.

Clark, D. M., & Salkovskis, P. M. (1986). Cognitive treatment of panic: Therapist’s manual. Oxford: Oxford University Press.

Kim, B., Lee, S. H., Kim, Y. W., Choi, T. K., Yook, K., Suh, S. Y., … & Yook, K. H. (2018). Investigating effective treatment factors in brief cognitive behavioral therapy for panic disorder. Medicine, 97(38). https://doi.org/10.1097/MD.0000000000012422

Mitte, K. (2005). A meta-analysis of the efficacy of psycho- and pharmacotherapy in panic disorder with and without agoraphobia. Journal of Affective Disorders, 88(1), 27-45. https://doi.org/10.1016/j.jad.2005.05.003

Papola, D., Ostuzzi, G., Tedeschi, F., Gastaldon, C., Purgato, M., Del Giovane, C., … & Barbui, C. (2022). Comparative efficacy and acceptability of psychotherapies for panic disorder with or without agoraphobia: Systematic review and network meta-analysis of randomised controlled trials. The British Journal of Psychiatry, 220(1), 1-13. https://doi.org/10.1192/bjp.2021.148

Pompoli, A., Furukawa, T. A., Efthimiou, O., Imai, H., Tajika, A., & Salanti, G. (2016). Psychological therapies for panic disorder with or without agoraphobia in adults: A network meta‐analysis. Cochrane Database of Systematic Reviews, (4). https://doi.org/10.1002/14651858.CD011004.pub2

Pompoli, A., Furukawa, T. A., Efthimiou, O., Imai, H., Tajika, A., & Salanti, G. (2018). Dismantling cognitive-behaviour therapy for panic disorder: A systematic review and component network meta-analysis. Psychological Medicine, 48(12), 1945-1953. https://doi.org/10.1017/S0033291717003919

Sánchez-Meca, J., Rosa-Alcázar, A. I., Marín-Martínez, F., & Gómez-Conesa, A. (2010). Psychological treatment of panic disorder with or without agoraphobia: A meta-analysis. Clinical Psychology Review, 30(1), 37-50. https://doi.org/10.1016/j.cpr.2009.08.011

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