*5.1.2 Cognitive behavioral therapy*

Cognitive-behavioral therapy involves teaching patients to recognize their distorted thinking. The goal is to clarify the patient's misinterpretation of the physical symptoms of panic attack and act on avoiding behavior by gradually exposing the situations that led to the attack. Useful relaxation exercises as well as regular breathing exercises, with moderate physical activity, are also useful.

In cognitive-behavioral treatment of panic disorder patients learn useful information about how and why anxiety, fear and panic occur, learn to apply various relaxation techniques, go through a gradual exposure to situations that create fear when are prepared, learn how their thoughts, assumptions and beliefs about anxiety and panic and their consequences worsen their problem and how they can deal with them, along with the therapy they go through various experiments to test their beliefs about fear and panic, and find out what to do in case of panic attacks [14].

Research shows that CBT efficacy is between 85 and 90% for treatment consisting of 12–15 meetings. In addition, most of the participants maintained this progress a year after treatment when monitored. Some studies have shown that CBT is at least as successful in the treatment of panic disorder as pharmacotherapy, but that treatment has been more prolonged by CBT. Namely, in CBT, an individual learns strategies to efficiently cope with his anxiety that is the skill he can use for his entire life [1, 49, 51, 67].

### *5.1.3 Humanistic therapy*

Humanistic therapy (client-centered therapy, gestalt therapy, and existential therapy) is focused on people's capacities to make rational choices to use their potential and to accept the responsibility for themselves. It helps people to understand what is happening with them and to focus on the present by making new, more functional choices [65].

### *5.1.4 Self-help tips for panic attacks*

The following self-help techniques can make a difference to overcome panic:

**121**

*Panic Attacks and Panic Disorder*

of panic.

effective.

**5.2 Pharmacotherapy**

*DOI: http://dx.doi.org/10.5772/intechopen.86898*

• Learn how to control your breathing. Deep breathing can relieve the symptoms

• Practice relaxation techniques—yoga, meditation, muscle relaxation to increase

• Exercise regularly. At least 30 min on most days (three 10-min sessions is just as good) like walking, running, swimming, or dancing can be especially

• Connect face-to-face with family and friends. Symptoms of anxiety can become worse when you feel isolated, so building supportive friendships can help.

There are a large number of drugs that have been studied in patients with panic disorder, but no drug has proven superior to other drugs used in the treatment of patients with panic disorder. Pharmacological agents with sufficient evidence to

• Antidepressants—selective serotonin reuptake inhibitors (SSRIs), serotonin noradrenaline reuptake inhibitor (SNRI), tricyclic antidepressants (TCAs) and

The modern treatment of panic disorder is based on the use of antidepressants from the selective serotonin reuptake inhibitor (SSRI) and antidepressants from the serotonin and noradrenaline reuptake inhibitor (SNRI). Use of these drugs has less danger of creating addiction and abuse than benzodiazepines. The disadvantage of these antidepressants is delayed by the onset of the positive effect and adverse

Clinical studies have demonstrated the significant efficacy of SSRI/SNRI drugs in the treatment of panic disorder. Certain differences in medication do not occur in terms of efficacy, but can be observed in terms of side effects, drug delivery methods during their use, and the occurrence of deterioration in dose reduction and upon discontinuation of the drug. Therefore, it is important to pay attention to these factors in the individual selection of medicines. The dosage of antidepressants

Antidepressants acting on the serotonergic system—citalopram, fluvoxamine,

*5.2.1.1 Efficacy of antidepressants in acute phase treatment of panic disorder*

fluoxetine, paroxetine, sertraline [8, 16, 46, 61], the SNRIs venlafaxine and duloxetine [15, 35, 38, 58], and the TCAs imipramine and clomipramine [5, 39] are

• Learn about panic and anxiety.

feelings of joy and equanimity.

• Avoid smoking, alcohol, and caffeine.

support their use in the treatment of panic disorder include:

• Get enough restful sleep [4].

• Benzodiazepines [8, 37].

effects that occur during treatment.

effective in panic disorder is shown in **Table 1**.

effective in treating acute phase of panic disorder.

*5.2.1 Antidepressants*

others and decreasing their shame.

attack or disorder in an appropriate way.

*5.1.1 Psychoanalysis and psychodynamic therapy*

symptomatology [45].

life [1, 49, 51, 67].

*5.1.3 Humanistic therapy*

more functional choices [65].

*5.1.4 Self-help tips for panic attacks*

*5.1.2 Cognitive behavioral therapy*

• Individual therapy: That is, the most usual form of psychotherapy when dealing with panic disorder, but also other form of psychotherapy can be applied.

• Group therapy: Group therapy has positive sides because by sharing the experiences with others, people are creating opportunities for reinforcement by the

• Couples and family therapy: Symptoms of panic disorder usually affect the relations among the members in the family. Family and couple therapy helps them to improve the communication and to support the person with panic

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

Cognitive-behavioral therapy involves teaching patients to recognize their distorted thinking. The goal is to clarify the patient's misinterpretation of the physical symptoms of panic attack and act on avoiding behavior by gradually exposing the situations that led to the attack. Useful relaxation exercises as well as regular

In cognitive-behavioral treatment of panic disorder patients learn useful information about how and why anxiety, fear and panic occur, learn to apply various relaxation techniques, go through a gradual exposure to situations that create fear when are prepared, learn how their thoughts, assumptions and beliefs about anxiety and panic and their consequences worsen their problem and how they can deal with them, along with the therapy they go through various experiments to test their beliefs about fear and panic, and find out what to do in case of panic attacks [14]. Research shows that CBT efficacy is between 85 and 90% for treatment consisting of 12–15 meetings. In addition, most of the participants maintained this progress a year after treatment when monitored. Some studies have shown that CBT is at least as successful in the treatment of panic disorder as pharmacotherapy, but that treatment has been more prolonged by CBT. Namely, in CBT, an individual learns strategies to efficiently cope with his anxiety that is the skill he can use for his entire

Humanistic therapy (client-centered therapy, gestalt therapy, and existential therapy) is focused on people's capacities to make rational choices to use their potential and to accept the responsibility for themselves. It helps people to understand what is happening with them and to focus on the present by making new,

The following self-help techniques can make a difference to overcome panic:

breathing exercises, with moderate physical activity, are also useful.

**120**

