Hello everyone and welcome to our Licensure Exams podcast . I'm Stacey Frost and I'll give you three guesses about where my co-host Linton is . If you've listened to some of our other episodes , you've probably guessed correctly that he's off to Publix to pick up some Bogo sushi .
So while Linton is talking Kai into getting extra help with wasabi , I'll be manning today's podcast episode about panic disorder , which is part of our Demystifying Disorders series .
Like many disorders , panic disorders' etiology is multifaceted , involving genetic predispositions , physiological factors and certain environmental factors like chronic stress , limited economic resources and smoking . Like chronic stress , limited economic resources and smoking , the average age of onset is the mid-30s . Childhood onset and over age 55 is unusual , but they're possible .
Now let's talk about criteria . Panic disorder is characterized by recurrent , unexpected panic attacks . That's really a key here unexpected panic attacks . They come out of the blue and after at least one of the attacks , there's at least one month of concern about having additional attacks .
Or the person is experiencing maladaptive changes in behavior to avoid situations that they believe might trigger an attack , like avoiding exercise or avoiding situations where getting help might be difficult , for example , riding in an elevator or avoiding situations where getting help might be difficult , for example , riding in an elevator , riding in a submersible 32,000 feet
underwater , or shooting around earth at over 17,000 miles an hour on the International Space Station . Now , some people might find that exhilarating , but my heart is beating a little faster thinking about it , and not necessarily in a good way , which brings me to the criteria for a panic attack .
In the DSM-5-TR , a panic attack is described as a sudden surge of intense fear or discomfort that reaches a peak within minutes , and it includes a variety of physical and cognitive symptoms .
The person needs to exhibit at least four of these symptoms for it to be classified as a panic attack , and I'll go through that list Heart palpitations , or the feeling that your heart is going to explode or pop out of your chest .
Sweating , trembling , sensations of shortness of breath , feelings of choking , chest pain , nausea or other abdominal distress , feeling lightheaded or dizzy . Chills or heat sensations . Paresthesias , which means numbness or tingling sensations . Derealization , which is a feeling of disconnect from your surroundings , almost like you're in a dream .
Or depersonalization , where you're feeling detached from your body or feeling like a robot , fear of losing control or like you're going crazy and fear of dying . Those are the different kinds of symptoms that present with a panic attack .
Now , the heart palpitations that I mentioned can be so strong that the person actually winds up in the emergency room thinking they're having an honest to goodness heart attack . In fact , many people with panic disorder often end up seeking medical help . Initially , their symptoms feel so intense that they believe they're having a life-threatening emergency .
Now let's talk about how you can distinguish between panic disorder and some other disorders , particularly in the anxiety category . One of the key aspects of panic disorder is the unexpected nature of the attacks .
In disorders like social anxiety disorder or specific phobias , the anxiety is linked to particular situations or stimuli , like public speaking or spiders , for example . With panic disorder , the panic attacks come on out of the blue . There's no real obvious trigger , and that unpredictability can add to the fear and the worry .
Also , while generalized anxiety disorder involves chronic worry and tension over various aspects of life , it doesn't typically involve the sudden intense episodes of fear that characterize panic disorder . There are also certain medical conditions that can mimic panic symptoms , so it's really important that you rule out physiological causes before diagnosing panic disorder .
Next , let's explore some of the evidence-based treatment techniques that can be helpful when you're working with a client who has this diagnosis . Cognitive behavioral therapy , or CBT , has a very long proven track record in the successful treatment of panic disorder and it includes several components .
Number one , psychoeducation , and this involves educating clients about panic attacks and the panic cycle , which looks a little like this First there's the anxiety and the body's fight or flight or freeze response and that's activated .
The person starts to feel those physical signs that I talked about , like pounding heart , sweating , difficulty breathing , and then they start to interpret these sensations as signs of something really serious , like I'm having a heart attack or I'm going to suffocate , and this misinterpretation increases their anxiety exponentially .
As their anxiety increases , so do those physical symptoms . For example , if the person fears that they can't breathe , they might start trying to , you know , breathe more rapidly , leading to hyperventilation . This in turn causes more physical sensations like dizziness or lightheadedness .
The fear of losing control or the belief that something catastrophic is happening amplifies the symptoms into a full-blown panic attack . Now , once the panic attack subsides , the person remains fearful of having another one , and you can't blame them .
They might start to avoid situations , places or activities where they're scared that another attack could occur , and in the short term , those avoidant behaviors help to relieve their anxiety . But in the long term , those avoidant behaviors serve to reinforce the idea that panic attacks are dangerous and they should be avoided at all cost .
Instead of learning that the physical symptoms are in fact not life-threatening , even though they feel like they are , and learning how to cope with that anxiety in a healthy way , the person continues to feel trapped in the cycle of anxiety , panic and avoidance . So around and around they go . Now that's the panic cycle in a nutshell .
Cognitive restructuring , another technique used in CBT , can be particularly helpful in targeting the catastrophic thinking often seen in individuals with panic disorder . Like my heart is racing , that must mean I'm having a heart attack or I can't catch my breath , I'm going to suffocate and die . Intraceptive exposure is another component of CBT .
That involves the gradual exposure to feared bodily sensations through exercises that actually induce those symptoms . For example , spinning around really fast in a chair to induce dizziness , and doing this in a safe environment , helps clients learn that these sensations are not actually dangerous .
Mindfulness-based cognitive behavioral therapy can also help clients manage panic symptoms more effectively . Mbct interventions focus on present moment awareness and developing a nonjudgmental awareness of one's thoughts and bodily sensations through the use of mindful breathing , body scan exercises , grounding exercises and other mindfulness exercises .
Well , that has certainly gone by quickly . We've reached the end of the trail today . So , to wrap up , just remember these key points . Panic disorder involves recurrent , unexpected panic attacks and anxiety about having future attacks .
To diagnose a panic attack , the person must exhibit at least four or more symptoms like increased heart rate , feelings of choking , shortness of breath , fear of losing control . Those kind of symptoms . Some of the most effective interventions include psychoeducation , cognitive restructuring , interoceptive exposure and mindfulness-based exercises .
Now , before I sign off , I want to leave you with this message Keep pushing forward in your studies . Your dedication is definitely going to pay off . Trust in your preparation , stay focused and believe in your abilities . You are building a solid foundation that will support you throughout your career as a therapist .
And I know that because you're listening to this podcast episode Until next time , from both Linton and myself . Remember it's in there .