**4. Complications of panic attacks and panic disorder**

Complications that panic attacks and panic disorders may cause avoidance of social situations, problems at work or school, depression with suicidal thoughts, substance abuse.

## **5. Treatment for panic disorder**

The first contact of patient with PD usually is with a family physician. Due to the presence of numerous physical symptoms of panic attack, many people initially perform different somatic tests, from routine, to more complex, to internal and neurological examinations, and fail to timely initiate treatment. This is why the role of a family physician is important in recognizing and treating the disorder, or referring to a psychiatrist. Unfortunately only a minority of patients with panic disorder receive adequate care. One of the reasons is that about 50% of patients seek help [27, 36, 43].

Treatment of panic disorder should in no way be limited to providing first aid during panic attacks (usually by injection of diazepam intramuscularly as an emergency) without planning a targeted and ongoing treatment. The main treatment options are psychotherapy and medications. Combination of them is considered as the most effective [3].

### **5.1 Psychotherapy**

Psychotherapy can help to understand panic attacks and panic disorder and learn how to cope with them.


### *5.1.1 Psychoanalysis and psychodynamic therapy*

Psychoanalysis and psychodynamic therapy deals with problematic behavior, feeling, or thought by finding their unconscious meaning. When focused on panic deal with core conflicts in the person which are involving aggression and fearful dependency, or other intrapsychic conflicts that can also contribute to panic symptomatology [45].
