Tag Archive | panic disorder


*the article is based on my private practice observations

Anxiety is often a reason why people knock on my door. It is also the subject that I am most drawn to. That’s why I would like to write a short article based on my work experiences about dealing with anxiety.

In short, I approached anxiety in two levels:

  1. Dealing with symptoms: In the Internet era, people educate themselves about panic attacks and how to ease symptoms. Consequently this level is the most accessible for self-help. Cognitive-behavioral psychotherapy is mainly focused on this level. Many people come to psychotherapy equipped with the knowledge and exercises how to help themselves with panic attacks. But why do those people still come to therapy? I believe focus in this level is not enough for the long term anxiety relief. In my practice, I focus 80% of my time on second level:
  2. Deeper approach: Psychotherapeutic relationship offers safe, understanding, trusting environment which is especially important for people with anxiety. For them, knowing that they have safe place, whit expert who they can trust, play enormous role. I notice that people with anxiety often keep their fears and worries to them self, they are overly consider with other people’s emotions and are on the mission not to hurt others, their true content is locked inside them which one day explode into panic.
    In time, the therapeutic relationship is safe enough for all the hidden content to come to light, having somebody to talk about it, relieves the burden that is kept inside and coses stress. Often we are so used to carrying a burden that we don’t realize how anxious our mind and body are feeling.

What (not) to expect in therapy

A lot of people believe that there is some kind of recipe for panic attacks solution. And they expect to get it from therapist. There is not just one anxiety, I see different kinds of it, some overwhelming others »just« as symptom form some other mental disorder. Therapy needs to get to its core and there is no recipe for that.

I don’t believe that you can cure anxiety response 100%. Let’s not forget that no matter how unpleasant it is, it is still a normal human response. The only difference it is that by people with anxiety, the centers for danger are triggered where there is no actual life threatening situation. The difference after therapy is that less things are causing us stress. Before it was stressful to go to the grocery store, now it would be stressful when having an accident. That’s a normal body/mind response.


Types of anxiety Description
Panic disorder Panic attack feels like sudden attacks of terror which normally peaks within 10 minutes, but some symptoms may linger much longer. Attack can occur at stressful times or it isn’t connected to any particular situation. Many people have just one panic attack. In this case we can’t talk about panic disorder.
Common symptoms: pounding heart, sweating, weakness, faintness, dizziness, flush or feel chilled, tingle or numb hands, nausea, chest pain, smothering sensations, sense of unreality, fear of another panic attack, fear of dying, fear of losing your mind.
Panic attacks can limited us, especially if we don’t seek treatment before it develops into agoraphobia. Good news is that panic disorder is one of the most treatable of all the anxiety types.
Agoraphobia About one in three people with panic disorder develops agoraphobia. It is an outcome of repeated panic attacks. It happens when we avoid different situations because we have intense worry of attacks. We can define agoraphobia in two different ways. One is fear of going outside or to unfamiliar places. Other is fear that there is no escape. Early treatment of panic disorder can often prevent agoraphobia.
Generalized anxiety disorder (GAD)


GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least 6 months (health, money, family, work issues). If person worry just about one thing, we can’t talk about GAD.
Physical symptoms: fatigue, headaches, muscle tension or aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, frequent visits to the bathroom, feeling out of breath, hot flashes, difficulty concentrating, insomnia.
Specific phobia Intense fear of something that poses little or no actual threat (closed-in places, heights, escalators, tunnels, highway, water, flying, dogs, blood etc.). Even though people realize that fear is ungrounded, they can have panic attack or anxiety when facing or thinking of facing the situation.
Separation anxiety disorder (SAD) SAD is normal life stage and occur with 7 months, reach its peak between 10 and 18 months and usually disappear when the child is 3 years old. Parents have trouble with bedtime and time of separation (clinging, crying, anxiety). If parents help his child deal with the anxiety constructively, child outgrowth this phase.
If anxiety is unresolved its’ continue to adulthood. Around 7% adults have it. In compared to medications counseling is usually considered the best treatment method.
To be diagnosed with SAD, one must have at least 3 following symptoms: experiencing great stress when you separate form home or love (trusted) one; worry to lose love (trusted) one or sth. bad will happen to them; don’t want to go from home because of the fear of separation; don’t want to be alone or without love (trusted) one; nightmares about separation; trouble sleeping when not being near love (trusted) one.
Social anxiety disorder= Social phobia is a great fear in one or more social situations. They can worry for days or weeks before and after social situations. They are afraid of embarrass themselves, being watching or/and judge. As a result, they choose to isolate themselves from society. They often self-medicate with drugs, alcohol, food. More than 66% have other mental disorder (commonly depression or anxiety)
Physical symptoms can occur: blushing, excess sweating, trembling, palpitations, nausea, panic attacks, diarrhea.