Bruce Fountain - Licensed Marriage and Family Therapist  

Bruce A. Fountain
101 Redlands Blvd
Suite 200
Redlands, CA 92373
(909) 792-9797

Click to Return to Home Page


Panic Disorder Responds to Cognitive-Behavioral Therapy


Everyone has felt nervous. It is an unsettling feeling that generally precedes an event that we have associated with fear of failure or embarrassment. The sensation usually goes away when the threatening event is out of our awareness.

Even at its worse nervous energy is perceived to be normal and even useful in certain situations. In school we have all been called to the front of the class to give a presentation or recite a poem. Some of us still get butterflies simply recalling those images. We prepare as well as we can and we get through it. Others relish the spotlight and get excited by public speaking.

Anxiety is much stronger than nervousness. It is a constant in many peoples lives and interferes with their ability to function. Some people cannot leave their homes as is the case with agoraphobia or the fear of situations where escape may be impossible or a panic attack might occur. Others are constantly worrying about work, finances, and past failures to the detriment of their relationships.

One extremely frightening form of anxiety is called panic disorder. A person with panic disorder has had persistent and recurring panic attacks and is preoccupied with the fear of another attack occurring. It can consume there time an energy.

A panic attack is a discreet period of intense fear that reaches a peak within ten minutes. The person may be afraid they are dying or going crazy. Dizziness, numbness, nausea, a feeling of choking and accelerated breathing and heart rate are possible symptoms.

Dave was on his way to work and suddenly felt pressure in his chest. He had recently had a full body scan that showed some moderate calcification in his arteries. His doctor had run a series of tests and determined that everything was normal. However, when the pressure in his chest appeared he immediately assumed he was having a heart attack. His heart rate quickened further escalating his fear. His breathing increased and he started to feel light-headed. He worried that he was going to pass out so he quickly pulled over. He called his wife then an ambulance. He was taken to the emergency room and after spending the better part of the day there, he was released with orders to reduce his stress and follow up with his doctor.

This panic attack had occurred because Dave had become preoccupied with the sensations in his body and filtered his perceptions through past experiences. He jumped to inaccurate conclusions. His internal alarm system went off sending danger signals even though there was no real danger. There is a little group of nerves deep in the brain called the locus ceruleus that plays a part in regulating the fear response. One hypothesis about panic attacks is that the locus ceruleus gets out of whack somehow and sends out false alarms.

Dave developed panic disorder and became preoccupied with having another attack. Education about panic attacks helped him. So did cognitive-behavioral therapy. Cognitive means how we perceive things and therapy focuses on rational and accurate thinking. Dave learned how to accurately interpret what was going on inside his body and respond differently to the sensations. His therapist helped him induce a panic attack in the safety of the therapy office and coached him through the experience. Dave was able to quickly reduce his fear of losing control and stop focusing on his internal sensations.

Panic attacks are terrifying but usually peak within a few minutes. They may subside and re-escalate over the course of hours but with time they will burn themselves out. A person can have panic attacks for months and not know what they are or what to do about them. Without treatment, they may suffer needlessly.

It is important to get a consultation with a psychiatrist to discuss the appropriateness of medication. There are some very effective pharmacological treatments that are worth considering.

Bruce A. Fountain, MS is a licensed marriage and family therapist. He has a practice in Redlands, CA and can be reached at (909) 792-9797 or via e-mail at © 2006-2010