All Posts Tagged: panic disorder counseling

Treatment Resistant Panic Disorder: A Multidisciplinary Multimodality Approach

Treatment Resistant Panic Disorder: A Multidisciplinary Multimodality Approach

Panic Disorder is one of the most common anxiety disorders. Its impact on quality of life can be significant and incapacitating. One third to one half of panic patients demonstrate incomplete or absent remission after treatment. This Roundtable addressed the importance of the bio-psycho-social components of the evaluation and treatment of the resistant panic disorder patient.
The clinical team is challenged with determining what rendered the individual patient treatment resistant. Examples of complicating variables in such patients include medical mimics of panic disorder, occult substance use disorders, co-morbid psychiatric disorders like trauma syndromes, obsessive compulsive and pediatric spectrum disorders.
Treatment often entails a multi-modality approach that identifies the critical variables discovered during the evaluation phase. At our center the presence of multi-disciplinary clinicians in one location allows for ongoing case discussion and most importantly reassures the patient that they are being supported by an interactive treatment team.
This Roundtable reviewed the appropriate psychopharmacological interventions during the course of treatment that can provide a synergistic addition to the cognitive behavioral treatment plan. The CBT plan must be individually tailored to the patient since not all panic disorders are alike. When possible, we have found that a manualized workbook approach can be invaluable and supports greater patient adherence.
Recent technological advances have allowed for the development of state of the art clinical tools that incorporate specific biofeedback and virtual reality protocols. We will present examples of both and discuss the importance of a multi-pronged approach to the difficult to treat patient. Prevention is the core goal of mental healthcare and early childhood detection of panic disorder has become a major goal. This Roundtable will review early warnings of future panic disorder and importance of interventions that foster resilience and stress control capabilities in children.

Learning Objectives

1. Recognize the seriousness and frequency of treatment resistant panic disorder.
2. Apply the contents of this Roundtable to develop a multimodality treatment plan.
3. Demonstrate an effective systems approach to the evaluation of the treatment resistant panic disorder patient .

Chair(s)

David Gross, MD, Center for the Treatment of Anxiety and Mood Disorders
Dr. Andrew Rosen, PHD, Center for the Treatment of Anxiety and Mood Disorders

Discussant(s)

David Gross, MD, Center for the Treatment of Anxiety and Mood Disorders
Dr. Andrew Rosen, PHD, Center for the Treatment of Anxiety and Mood Disorders

Presenter(s)

Dr. Christiane Blanco-Oilar, PhD, Center for the Treatment of Anxiety and Mood Disorders
Joseph Brand, PhD, Center for the Treatment of Anxiety and Mood Disorder
Ryan Seidman, PsyD, Center for the Treatment of Anxiety and Mood Disorders
Dr. Andrew Rosen, PHD, Center for the Treatment of Anxiety and Mood Disorders

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Panic Attacks and Panic Disorder Therapy

More than four million people experience panic attacks annually, across the country. These attacks can occur anytime and anywhere: on the drive home from work, in the movie theater, at a child’s little league game, or in a thousand other unexpected places. While many people have heard of panic attacks, most may not be aware of the specifics of this frightening anxiety concern.

A panic attack is a sudden episode of intense fear that develops for no apparent reason. These attacks can trigger severe physical reactions and generally make the sufferer feel as if they are losing control or possibly having a heart attack. In the extreme, panic attacks can make a person feel like they may be dying. These attacks often begin without warning and can happen at any time or place. Most symptoms peak within ten minutes and last for approximately half an hour.

Symptoms of panic attack may include:

  • A sense of impending doom or death
  • Rapid heart rate
  • Sweating
  • Trembling
  • Shortness of breath
  • Hyperventilation
  • Chills
  • Hot flashes
  • Nausea
  • Abdominal cramping
  • Chest pain
  • Headache
  • Dizziness
  • Trouble swallowing
  • Tightness in the throat
  • Faintness

You may notice that these symptoms are similar to serious medical conditions, such as a heart attack. Because of this, it is very important to seek the help of a physician if any of the above physical reactions are experienced. Beyond these symptoms, however, one of the worst aspects of a panic attack is that it often triggers fear that another attack is imminent. This fear can take over a person’s life. Over time a panic disorder may develop if a person has four or more attacks or lives in constant fear that more will occur.

Once a panic disorder develops, seeking panic disorder therapy becomes even more important: left untreated, panic attacks can lead to severe phobias or other anxiety disorders, to avoidance of social situations, to suicidal thoughts or actions, to financial problems, to work or school problems, and/or to alcohol or substance abuse problems. Because panic disorders do not go away on their own, experts encourage people to seek therapy as soon as they realize they are altering their day-to-day lives in order to cope. Most sufferers will undergo cognitive behavior therapy or exposure therapy as part of their panic disorder therapy. These treatments may be combined with medication depending on the specifics of each case.

For more information about panic disorder therapy in the Delray Beach, Florida area, contact Dr. Andrew Rosen at 561-496-1094 or email him today.

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