Panic Disorder (PD) is an anxiety disorder in which the individual, who has a history of suffering panic attacks out of the blue, fears experiencing another attack. At some point, individuals with PD typically associate panic symptoms with concerns about “going crazy,” dying, or losing control. They often avoid certain situations or activities that may trigger a panic attack.
Symptoms of panic attack can include racing heart, sweating, shaking, difficulty breathing, choking sensations, chest pains, nausea, dizziness, temperature changes (i.e., chills and hot flashes), tingling or numbness, dissociation (e.g., feeling detached from oneself), and catastrophic thoughts (e.g., going crazy, dying, losing control).
Cognitive-behavioral therapy (CBT) is the psychological treatment of choice for PD. It consists of psycho-education, exposure exercises, cognitive restructuring, and more. Exposure exercises involve not only situational triggers, but also physiological triggers. That is, individuals with PD might avoid supermarkets because of a fear of having a panic attack. Situational exposure might require patients to face their fear by gradually working towards entering a supermarket.
Additionally, individuals with PD tend to be hypersensitive to physiological cues, such as heart flutters or small pearls of sweat, and this hypersensitivity may in turn trigger further panic symptoms and a full-blown panic attack. Thus, a different type of exposure–interoceptive exposure–requires patients to gradually face the discomfort of experiencing these physiological sensations.