What is a Panic Attack? A panic attack is a sudden and intense burst of arousal with multiple physical symptoms accompanied by fear, fear of dying, or fear of losing control. Most panic attacks are produced by alterations in breathing which produce a sudden change in circulating carbon dioxide, CO2. Panic attacks are real, biological events, not just psychological symptoms. Risk factors for panic attacks include: caffeine, sleep loss, hormonal variation, loss, and negative emotions.
Respiratory Retraining for Panic Attacks: This is an effective three-step procedure that has proven effective in controlling the majority of panic attacks. It is intended to be used in combination with cognitive therapy.
Step 1. Take in a normal-sized inhalation. Do not fill the lungs completely.Step 2. Hold the air in your lungs for two seconds. Step 3. Release the breath slowly through the nose or pursed lips.
Allow about 10 seconds per breath.
Practice producing a series of 6 breaths 15 -20 times a day for 3-4 days until it feels natural. Then continue to practice 3 - 4 times a day to maintain your skill. The hardest part often is to remember to use this breathing technique at the start of an attack. How Does this Work? Most panic attacks are caused by overbreathing which releases too much carbon dioxide (CO2) from the body. Breathing too deeply, too rapidly, frequent sighing, or suspending the breath before taking an inhalation can all produce panic symptoms. This techniques rapidly restores the balance of CO2 in the blood stream.
Biofeedback: A biofeedback capnometer is used during office visits to observe these changes and perfect your technique. You can actually watch the levels of CO2 respond as you practice the procedure. That is the magic of biofeedback.
Small pocket-sized biofeedback devices have recently become available that are excellent for learning how to breathe in ways that are not only very relaxing, but also help prevent panic attacks. These devices cost between $200-300 currently. Contact me for more information or revisit this site in the future. I will be including much more information for you about this exciting new development.
Cognitive Therapy; Cognitive therapy teaches you how to gain control over your anxiety symptoms by attending closely to your thoughts, feelings, and actions. The therapist acts as a coach and helps explore alternative ways of solving problems, restoring balance in your life, and reinterpreting events and symptoms.
Relaxation: Relaxation training is an important aspect of anxiety management. Customized recordings of relaxation instructions are made for you to use between visits. In a relatively short time you no longer need the recordings and can produce the relaxation response easily on your own.
Read a research article on respiratory retraining and panichere (PDF file).
Go to the Anxiety Disorders Association of Americahere to learn more about anxiety and panic attacks.
Depression:
Depression is a thief that constantly robs you of the joy of living. Major depression is a biochemical problem that may require a combination of medication and psychotherapy. Cognitive therapy has an excellent track record in treating depression. I will be publishing much more about depression as I build this site. There are two online tests for depression you may wish to visit. One is by Dr. Ivan Goldberg who specializes in treatment-resistant depression. Click here to take his Mood Scales. Another screening test is on NYU Medical Center's web site. Click here to take the NYU Depression Test. These are not designed to give a definitive diagnosis, but will help you explore the components of depression and may be very helpful to your physician or mental health professional. For more information about depression including some very helpful information about what you can do to reduce depression on your own you may want to visit Dr. Goldberg's site: Depression Central. I will soon be making available a Pocket Guide to Depression which you may have for free.
The combination of cognitive therapy and psychophysiology is a highly interactive treatment approach in which you are asked to be an active participant. It is important to practice the skills which are taught in order to derive benefit. Here are some of the problems for which this approach has been helpful:
Phobias. Panic Disorder. More About Panic Below Post-Traumatic Stress. Obsessive-Compulsive Disorder. Anxiety & Worry. Insomnia. Depression. Stress &Tension. Chronic Fatigue. Headache & Migraine. Pediatric Migraine. Labile Hypertension. Irritable Bowel Syndrome. Fear of Medical Procedures. Coping with Chronic Illness. Coping with Injury or Disability.
Stress is the Rate of Wear and Tear Upon the Body. Hans Selye, M.D.
