Areas of Specialization - Adults
Panic Control Treatment and CBT for Agoraphobia Individuals with panic disorder experience intense fear that occurs suddenly and repeatedly without any apparent warning. When a panic attack occurs, an individual typically experiences several physical sensations that cause distress and discomfort. Common somatic symptoms include a racing heart, chest pain or shortness of breath, sweating, nausea, feeling flushed or chilled, and numbness and tingling in hands and feet. An individual may also feel weak, dizzy or faint and experience a sense of unreality or detachment from themselves or their surroundings. The seemingly unpredictable nature of these attacks creates intense worry between episodes about when and where the next attack will occur. People with panic disorder frequently fear that they are going crazy or will lose control as they have a sense of impending doom. These individuals often go to the emergency room out of fear that they are having a heart attack or stroke, losing their mind, or are on the brink of death. Panic attacks typically last for a couple of minutes and can even occur during sleep. Not everyone who has a panic attack will develop panic disorder as panic attacks can occur within the context of any anxiety disorder or be an isolated incident. For many individuals, their first panic attack occurred during a time of acute stress.
Two common types of stress that can precede panic attacks are interpersonal stress, such as marriage or conflicts at work, and physical stress, such as experiencing a loss of a significant other or the use of alcohol and recreational drugs. However, stress is seldom the reason that panic attacks continue. Panic and anxiety persist because they are reinforced by a negative, self-maintaining cycle of thoughts and behaviors. For example, research has shown that people with panic disorder have a low tolerance for or oversensitivity to their body's normal physiological response to stress (e.g., racing heart, sweating). Individuals with panic disorder have seemingly learned to perceive essentially normal physiological events as being dangerous or having catastrophic consequences, thus triggering a "false alarm" stress reaction to benign events with minimal or no provocation.
Life for some individuals with panic disorder becomes significantly restricted as they avoid everyday activities such as going to work, grocery shopping, driving, standing in a line, or in more severe instances, even leaving their home. In other words, these individuals avoid situations that they fear might cause a panic attack and result in their inability to cope with their anxiety. Alternatively they may be able to confront the feared situation and endure their distress if certain "safety" factors exist. These superstitious objects include things that people believe cause them feel secure and less anxious. Common means of reassurance include being accompanied by a spouse or comforting person, cell phones or keeping certain medications readily available. Thus when an individual's life becomes significantly restricted by panic disorder, this condition is referred to as agoraphobia.
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