January 15, 2004
Panic attacks:therapy effective for regaining control
Rachel used to think of herself as a very confident person. Now, though, living away from home at college for the first time, she has some doubts. Rachel has started having sudden unexpected attacks in which she’s short of breath, her heart is racing and she feels light-headed and nauseated. The very worst part is that because she had the first of these panic attacks in a classroom, she’s now afraid to go to class. Going with her friends to a restaurant is out and so is driving on the freeway. She’s joining a group of people who are living in very constricted worlds, because panic and the fear of panic trap them in an increasingly small comfort zone.
Dr. Stephen Dager, professor of radiology and of psychiatry and behavioral sciences at the UW School of Medicine, says that having a panic attack feels very much like suffering a life-threatening event, even though there is no visible threat.
“These panic attacks are typically very abrupt, coming on in a matter of a few seconds and then just as suddenly stopping. There also can be a prolonged aftermath, where the person feels shaky, tired and anxious,” Dager says.
While the panic attack itself feels horrible, it can have severe secondary effects on health and lifestyle. Many people who have these attacks come to associate them with certain surroundings, activities such as driving, foods they happen to have eaten or even just smelling household disinfectants or laundry detergents. Often panic victims may avoid riding or walking over bridges, speaking in front of others, eating in public places or even going outdoors.
“When this kind of avoidance occurs, it often reflects a psychological conditioning process,” Dager says. “These panic attacks are conditioning the person to behave in certain ways or avoid certain situations.”
Dager and his colleagues believe that the underlying cause of panic or anxiety attacks is actually rooted in the brain. There appears to be a mismatch between brain metabolism and its regulation of breathing and some other body processes. Dager’s group is studying both cognitive behavioral therapy and medication as means to control or block the attacks.
“We’re looking at how people’s bodies regain the ability to regulate the mechanisms that cause these attacks,” Dager says. “We’re trying to discover whether people can get over being at risk for having panic attacks – in other words, whether the brain can re-set itself. So far, we’ve had good results from both treatment approaches. Our overall goal is that we want people with panic attacks to be able to live normal lives.”
If you have panic attacks, Dager recommends discussing your symptoms with a physician. He or she may be able to refer you to a therapist who is trained in cognitive behavioral therapy, or explore whether medications known as serotonin reuptake inhibitors may be able to help you. Both approaches take time to show initial results, but Dager says seeking treatment and giving it a chance to work may pay off.
“The most important thing about panic attacks, whether they are being treated with medications or cognitive behavioral therapy, is that they are treatable,” Dager says. “People who have panic attacks can achieve mastery over them.”
