This is the 2007 version. Click here for the 2017 chapter 12 table of contents.

Panic Attacks

Brody (1983) describes a panic attack:

Imagine yourself riding on a crowded bus on the way to work. Suddenly, out of the clear blue, your heart starts to pound, you can't catch your breath, you feel dizzy, disoriented, nauseated and panicky. You think you're going to die or go crazy.

What are panic attacks like?

Though your legs have turned to rubber, as soon as the bus stops you push your way out onto the street and start running, anywhere just to get away from the crowds. This is the third time in a month this has happened on your way to work. You're terrified to think what might be wrong with you. One thing you do know is that you'll never take the bus to work again-if you dare go out at all.

What is agoraphobia?

Panic attacks sometimes lead to agoraphobia: a dread of going into crowds or public places. Dr. Donald Klein, a professor of psychiatry at Columbia University Medical Center, notes that "about 99 percent of agoraphobias start with nonspecific panic attacks."

Panic attacks affect nearly a million Americans, mostly women. They usually start in the teens or early twenties. A variety of methods have been used to treat panic attacks, including traditional psychotherapy and the form of behavior therapy called desensitization, which succeeds with about 30 percent of all cases. Fear of flying, which causes sufficient anxiety in many people that they refuse to travel by airplane, can almost always be treated successfully with desensitization.

What are effective treatments for panic attacks?

Medication is useful for putting an immediate end to a panic attack when it is occurring. Beta-blockers and similar anti-anxiety agents control panic attacks in about 90 percent of cases. Talking psychotherapy may also be helpful to people if there is an emotional cause of panic attacks.

How can therapies be combined in treatment?

Many clinicians feel that drug treatments and talking psychotherapy treatments are best used together in treating panic attacks. A drug can make a quick change in the patient's condition, while psychotherapy can address emotional issues and help a person make positive adjustments in daily living.

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