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Cbt for Panic attacks

This page aims to describe the features of anxiety and panic, different options for treatment, and how one form of treatment - Cognitive Behavioural Therapy (CBT) can be of help. It is hoped that this leaflet will be useful for sufferers of anxiety and possibly for friends and family who also wish to know more about anxiety, panic attacks, and CBT.




Anxiety is a very common problem in the community. About one in twenty of the population will suffer from anxiety symptoms that are present for most of the time. It results in considerable suffering. This is known as Generalised Anxiety Disorder or GAD. A smaller number of people suffer from anxiety symptoms that come in short very distressing bursts. This is known as panic disorder.




What we mean by anxiety can vary a lot between individuals but tends to be made up of features of altered thoughts, emotions, behaviours and physical sensations. These are described below. Each of these features can influence each other leading to a worsening of the anxiety.




Often anxious people are aware of their heart beating harder and faster. This is known as palpitations. Sweatiness and shaking can also occur. Sometimes people feel light-headed, dizzy and nausea as well as a range of other symptoms.




Very often worrying is a feature of anxiety particularly in generalised anxiety disorder. Here people often become concerned that the worrying will harm them. In panic attacks people often believe that they may be at risk of fainting. Sometimes they interpret the palpitations as evidence of heart problems and again fret about the risk of ensuing harm or even death.




With anxiety the person may be uneasy, jumpy and restless. They appear to be always on the lookout for possible danger in order to avoid such situations. In panic disorder the panic attacks may happen at any time. In some people, however, they happen only in certain situations such as when there are lots of people about. In this case a panic sufferer may simply avoid those situations and appear on the surface to have few problems in their lives. While in a panic attack, they may lie down, sit, or quickly remove themselves from the situation. Others use drugs or alcohol in the hope that this will help. Unfortunately, in the longer term they make anxiety worse.




In panic disorder the main emotion is fear. In less severe anxiety people feel keyed up and irritable. Unfortunately, in generalised anxiety disorder when the symptoms last for much of an individual's day people can feel desperate. Sometimes their mood can drop.




There is no one cause of anxiety disorder. In some cases it appears to run in families. Sometimes it also starts after a big life change such as a bereavement, childbirth, or losing a job. A smaller number of cases are associated with physical or other psychological illnesses. These include depression or thyroid problems. Anxiety can also be a feature of phobias, which are fears of different situations such as types of animals or of crowds. Lastly, some prescribed medications can make people feel anxious as a side effect, including some anti-depressants.




Sufferers begin to avoid those things or places that they associate with their symptoms. This can get worse until it forms a significant part of the person's life. Fear of having a panic attack can be very disabling. Eventually it can prevent people from going about normal work or social activities and can lead to agoraphobia. Less commonly the distress and disablement caused by anxiety may cause periods of depression or drug and alcohol problems.




Treatment of anxiety can be by psychological (talking) treatments or by using prescribed medications.

Medications: In the past benzodiazepines (tranquilliser) medications were used such as diazepam (another name for Valium). Unfortunately, these drugs are addictive and become much less effective in the longer term. They are used much less commonly nowadays. More commonly anti-depressant medications are used. They have been shown to be effective but unfortunately the anxiety often comes back when the medication is stopped.


Psychological Treatments: Counselling and practical techniques to teach relaxation are found to be helpful by some. Likewise, self-help materials on tapes or in books can teach strategies to help people feel better. The psychological approach with the most evidence of effectiveness for anxiety disorders is Cognitive Behavioural Therapy (CBT).


CBT is likely to include the following:


1. Teaching about the nature of anxiety, including the physical symptoms. Any misinterpretations that such symptoms such as palpitations are harmful or dangerous can be corrected.


2. Exploring the extreme and unhelpful thoughts that happen particularly when the sufferer is very anxious. Learning techniques to balance some of these biased thoughts.


3. The features of worry can be explored and techniques tried to lessen the impact of worrying.


4. Where many situations are being avoided they will be looked at. The therapy will attempt to reintroduce these into the life of the sufferer. This is done gradually in small steps and only when the client feels ready to try.


5. Sometimes the therapy may include training in relaxation techniques to reduce the physical symptoms of anxiety.


6. Where depression has become a feature of the person's problem this can also be treated using CBT.









Cbt for Panic Attacks

Cbt for Panic and Anxiety

Psychotherapist Alex Drummond explains how Cognitive Behavioural Therapy can help people suffering from Stress, Anxiety and Panic Attacks. In this video Alex shows that anxiety and worry are related to fear and that effective counselling can help people understand the factors that underlie the symptoms and help you develop strategies to overcome symptoms and achieve resolution.

Recommended Cbt self help books

Overcoming Anxiety has been developed as a self-help manual by Dr Helen Kennerley at her clinic in Oxford. A whole range of anxieties and fears is explained, from panic attacks and phobias to 'burn out' and executive stress. It is an indispensable guide for those affected, their friends and families, psychologists and others working in the medical profession. Includes an introduction to the nature of anxiety and stress. Contains an easy-to-follow self-help program and check sheets. Is based on successful, clinically proven techniques of cognitive therapy.


What is a panic attack? What does it feel like? What causes attacks? Can they be cured? The authoritative yet practical book helps the reader toward an in-depth understanding of panic. It is essential reading for sufferers, their friends and family, and clinicians. In clear and concise language, it describes a psychological self-help programme for panic sufferers that has been tried and tested over many years. Now in its third edition, this book has been updated throughout to reflect recent research, including the latest developments in cognitive behavioural therapy and new techniques for managing anxiety. "A full recover is possible," Dr Baker explains. "It certainly is not easy, nor quick, but it definitely is possible."


The Extent of the problem

What is Anxiety

Altered Thoughts

Altered Physical Sensations

Altered Behaviours

Altered Emotions




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