Panic disorder is defined by recurrent abrupt surges of intense fear or discomfort associated with various somatic (e.g. palpitations, sweating, trembling, chest pain, sensations of shortness of breath, nausea, dizziness, numbness etc.) and mental symptoms (e.g. derealization, depersonalization, fear of losing control or dying) without cue or trigger.
Four or more of 13 symptoms need to have occurred to make a diagnosis of panic attack:
Panic attacks are usually one-off experiences and far more frequent than panic disorder. Only if there are recurrent panic attacks, the diagnosis of "panic disorders" can be made.
At least one of the panic attacks has to be followed by one month of one or both of the following:
There are certain mental or physical disorders that often come together with panic attacks:
Panic disorder can be treated by psychotherapy, medication (usually drugs such as selective serotonin reuptake inhibitors (SSRI) that are used as antidepressants) or a combination of both (see picture below for an overview).
A training in self-hypnosis (or another relaxation method) is an essential in the therapy of anxiety. Patients suffering from anxiety disorders have symptoms of the stress or fight-and-flight response. For example, they could have symptoms such as sweating, tense muscles, fast breathing, and a fast heartbeat. One of the best ways to regain control over such bodily symptoms is self-hypnosis. This very useful tool allows the patient to relax the muscles, slow down the breathing and heartbeat, and find a calm state of mind.
Catastrophic thinking is one of the core elements in panic attacks. A patient with panic disorder might misinterpret some of the symptoms of the fight-or-flight response (e.g. pounding heart, sweating, and fast breathing) as the opening act to a catastrophic event, such as a heart attack or a respiratory arrest. The task of cognitive restructuring is to challenge these interpretations by countering them with scientific explanations.
We can teach patients to relax on a cue by rehearsing this technique in hypnosis and advising the patient to self-practice after the session. For instance, if you start to think about a job interview you have to go for, press your thumb and index finger together (a way of conditioning the pressing together of the fingers with the relaxation response) and go into self-hypnosis for a short while. Or alternatively, take some calming breaths or shift your attention to the sounds, colours, and aromas around you.