Common Treatments for Panic Disorder

General Practitioner: It is important to see a doctor to get a full medical evaluation, as panic disorder can mimic a variety of medical conditions. It is important to rule out the possibility of a medical cause.

Medication: Several types of medications can alter the ways in which the chemicals in your brain interact and reduce anxiety and panic attacks. Tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), benzodiazepines (minor tranquillisers) and selective serotonin re-uptake inhibitors (SSRIs) have been found^{6, 15} to be safe and effective in the treatment of panic disorder in the short-term. Many people have reported problems while taking medications¹⁶ which include: negative side effects, severe dietary restriction while taking monoamine oxidase inhibitors. People have also had difficulties withdrawing from the medications (eg. benzodiazepines). Additionally, after discontinuing medication, some people find the panic attacks return as strong and frequently as ever. However, the newer SSRI's have been shown to be very effective for treating panic disorder.

Therapist Based Cognitive Behaviour Therapy: Cognitive Behaviour Therapy (CBT) can teach you to anticipate and prepare for the situations and bodily sensations that may trigger the panic attacks. Treatment usually includes learning how to identify the thinking patterns that lead you to misinterpret your sensations. You may learn breathing exercises that will calm you down and prevent over-breathing that often occurs in a panic attack. You may also be taught how to gradually become less sensitive to the frightening bodily sensations and your feelings of fear. This is done safely, in a step-by-step fashion, so you can test yourself in the places and situations that you have been avoiding. A program of CBT usually takes about 12 weeks. Most people with panic disorder have been successful in controlling and preventing their panic attacks after completing this CBT treatment^12-14. Additionally, studies^{16, 17} have shown that the relapse rates are considerably lower, in comparison to medication. Unfortunately however, there may be limited access to professionals trained and experienced in CBT.

Combing CBT and Medication and Psychotherapy: Combining CBT and medication (i.e., anti-depressant and/or anti-anxiety) can be appropriate and beneficial in some cases. However, insight-oriented psychotherapy has not generally been found to be an effective treatment for Panic Disorder, although it may assist with other emotional issues.

CBT Self-Help Methods: In recent years, due to the limited access to trained CBT therapists and the cost involved, CBT researchers have increasingly used self-help methods (e.g., using a workbook manual based on CBT principles and techniques with less need for therapist contact) for people with panic disorder. These alternative formats contain the same information and exercises that would be normally provided to you in a typical face-to-face therapy session and are an effective CBT for panic disorder. More specifically, most of the people who completed these therapist-assisted manuals clinically improved and experienced significant benefits in their daily life functioning and general quality of life^{18, 19}.

Internet-based Cognitive Behaviour Therapy (CBT): An alternative to using a workbook CBT manual is receiving the same treatment information through an internet-based program. Over numerous clinical trials, Panic Online Step 1 and Step 2 (Step 2: is an internet-based CBT treatment program for Panic Disorder) has demonstrated its effectiveness without^{20, 21} and with email assistance from a psychologist^22-25 or with face-to-face assistance from a general practitioner²⁶. We have also conducted a small pilot²⁴ trialling the effectiveness of a Self-Help Version of Panic Online without email therapist assistance.

Subsequently with have re-written and re-designed a new 12 week CBT internet-based treatment program for Panic Disorder with or without Agoraphobia called Panic Stop! with funding assistance from the Federal Department of Health and Ageing.