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Panic attacks can be frightening, upsetting, and disabling experiences. Roughly 1 in 4 people will experience a panic attack at some point in their lifetime (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1958997/). For many of these people, panic attacks are a regular occurrence, interfering in most aspects of their lives. But there is treatment available that can help with panic attacks; the most effective of which, is cognitive-behavioural therapy (CBT; http://cognitivepractice.com/is-cognitive-behavioural-therapy-right-for-me/).

What is CBT?

Cognitive-behavioural therapy is a popular form of talking therapy that can improve how you feel by changing the way that you think (‘cognitive’) and act (‘behaviour’). The idea behind CBT is that your thoughts, feelings, and behaviours are all interconnected, each impacting upon each other. As an example, inaccurate, negative thoughts (e.g. “my heart is beating quickly so I must be about to have a heart attack”) can lead to unhelpful behaviours (e.g. avoid going out in public again).

Unlike some talking therapies, CBT focuses on your current problems rather than on your past.

What are panic attacks?

A panic attack is a sudden onset of intense fear and discomfort, usually lasting between 5 and 20 minutes. Panic attacks can occur anywhere and at any time. Some people are able to identify clear triggers for their panic attacks, but others are not.

Those individuals who experience regular panic attacks may be diagnosed with panic disorder. Regular panic attacks may also prevent people from leaving their home, out of fear of having a panic attack in public, and these people may develop agoraphobia.

There are a range of symptoms of a panic attack:

• Racing heartbeat
• Dizziness
• Tingling in your fingers
• Ringing in your ears
• Nausea
• Sweating
• Shortness of breath
• Trembling
• Fear of dying (e.g. of a heart attack)
• Fear of losing control
• Fear of ‘going crazy’

How can CBT help?

Many people experiencing frequent panic attacks find that CBT can help to reduce the frequency of these attacks. Research shows that CBT is more effective than medication for treating panic disorder (https://www.ncbi.nlm.nih.gov/pubmed/16005982); which is why it is recommended by the National Institute for Clinical Excellence (https://www.nice.org.uk/).

Cognitive-behavioural therapy for panic disorder generally takes around 12 sessions, although this may vary, dependent upon the individual. Sessions may take place either face-to-face, through the computer (e.g. using Skype) or over the telephone. Each session of CBT will be slightly different from the last, and a combination of techniques will be explained to you by your therapist. Perhaps the two key components of CBT for panic disorder, however, are:

• Cognitive restructuring: This involves becoming aware of, and changing, unhelpful thoughts. For example, you may misinterpret a panic attack as a sign that you are about to die. Learning to consider the evidence for such catastrophic thoughts, and changing the thought to something more accurate, can be useful in reducing levels of anxiety.

• Exposure: This involves gradually exposing yourself to a feared situation. For example, if you avoid public transport out of fear of experiencing a panic attack, exposure will involve you facing this fear and using public transport. This may seem frightening at first, but the exposure tasks will be broken down into small, manageable components, and the therapist will support you throughout this process.

In addition to cognitive restructuring and exposure, CBT sessions may also involve some relaxation training, stress-reduction training, or mindfulness (http://cognitivepractice.com/what-is-mindfulness-good-for/). Your therapist will provide you with more information about these, if appropriate.

To find out more about CBT, please click here and speak to one of the therapists at Cognitive Practice (http://cognitivepractice.com/contact/)

Connor Heapy
Writer for Cognitive Practice
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