Weill Cornell Medical College study finds that Cognitive Behavioral Therapy (CBT), a structured therapy that focuses on changing maladaptive thoughts, emotions and behaviors, is the most effective treatment for panic disorder with or without agoraphobia.
Researchers compared three therapies among about 200 patients diagnosed with panic disorder: cognitive behavioral therapy; panic-focused psychodynamic psychotherapy, a treatment that focuses on resolving unconscious conflicts and emotions underlying their symptoms; and applied relaxation training, a control treatment that incorporated relaxation techniques.
Participants were randomly assigned to one of the three treatment groups at two location sites. Overall, researchers found that all the treatments substantially improved panic disorder but for patients, particularly the most severely ill, CBT showed the most consistent performance. The study will be published in the Journal of Clinical Psychiatry.
Cognitive behavioral therapy has been found to be clinically proven treatment for panic disorder because it is a comprehensive approach that focuses on changing thinking patterns, emotions and behaviors. Specific techniques often include the following:
- Cognitive Restructuring: This is a technique that helps individuals replace catastrophic cognitions with more reasonable and logical beliefs. For example, when you start to feel anxious, you may say to yourself, “Oh my, I won’t be able to control these feelings and I’m going to have a panic attack.” A more adaptive belief would be to say, “This is just a normal feeling and I am not in any danger. I am safe and this will pass.” Eventually, this new way of thinking will be more automatic, as you create new pathways in the brain.
- Exposure: Individuals who experience panic attacks often feel a need to escape or avoid situations that precipitate their anxiety; however, this can actually make the anxiety worse in the long term. You begin to associate feelings of anxiety with danger that you need to avoid. Exposure is a technique whereby you “expose” yourself to the situations that trigger your anxiety. Typically, this exposure happens as a gradual process so that you are relatively comfortable and stable as you experience more stressful situations. Eventually, you will be able to confront situations without the normal anxiety response that would have previously made you panicky.
- Mindfulness Training: Mindfulness is an added component to CBT that teaches you to become more aware and connected to your emotions, bodily sensations and thoughts. You learn to accept your emotional and physical state without judgment, which, in turns, lessens anxiety over time.
CBT for panic disorder is often structured and time limited. Also, CBT therapists typically incorporate homework assignments, so that learning and treatment continues from session to session.