New research offers up hopeful news for the millions of people struggling with panic disorder. Two relatively brief types of psychotherapy can help alleviate the often-debilitating symptoms of this anxiety disorder.
Fully 70% of people showed improvements in panic disorder symptoms and 45% were symptom-free in about 12 weeks of cognitive behavioral therapy (CBT) or psychodynamic therapy.
"The results were enduring and even got slightly better at follow-ups, and there were no differences between the treatments at the two-year follow-up," said study author Thomas Nilsson, a clinical psychologist at Lund University in Lund, Sweden.
The best part? "You don't have to go to therapy for years. Twelve weeks of intense psychotherapy, as in this study, is enough for helping most people suffering from panic disorder. That's great," he said.
Close to 3% of U.S. adults have panic disorder. This is an anxiety disorder that can lead to attacks of overwhelming fear often accompanied by physical symptoms such as a racing heart, sweating, breathing problems and dizziness. These attacks can come on out of nowhere, and many sufferers will avoid leaving the house due to fear of having one, according to the U.S. National Institute of Mental Health. Panic disorder is typically treated with psychotherapy, medication or a combination of the two.
In the new study, half of the 221 participants chose their form of therapy; the others were assigned to one or the other. Some were also taking medication to treat their symptoms. The researchers wanted to know if choosing therapy would make a difference in the outcome in addition to looking at how well the therapies worked and for how long. By and large, preference had no effect on how successful treatment was at treating panic disorder.
Both types of therapy work in different ways, but they both work, Nilsson said. "[Cognitive behavioral therapy] helps patients to understand what is happening in their body and mind when having an attack, and learn how to respond in a 'new/normal' healthy way to the panic attacks and the situations that trigger them," he explained. Psychodynamic therapy helps individuals understand how their panic attacks are related to difficulties in experiencing and expressing emotions like anger, frustration, sadness, and emotions linked to closeness and intimacy, he said.
The findings were recently published online in Psychotherapy and Psychosomatics.
Amanda Spray is a clinical associate professor of psychiatry and director of the Military Family Center at NYU Langone in New York City. She said the study results left her feeling hopeful. "It's really good news that two treatments are found to be quite effective," she said.
"Panic disorder can be particularly debilitating, and it's exciting to see that both interventions were providing a great deal of improvement," said Spray, who was not involved in the new study.
Both of these treatments were time-limited, she said. "It's a big misconception of psychotherapy that you have to be in it for many years to have an impact. The fact that you can get really meaningful relief in 10 to 16 sessions is exciting," she said.
It's not just preference that affects how well a person responds to treatment, Spray noted. "We need more data to determine if there are other factors that may contribute to why some patients do better in one treatment over another," she said.
Dr. David Straker, a psychiatrist in New York City, often asks new patients with panic disorder what therapies or medications they have tried in the past before suggesting an approach.
"CBT can give you weapons to tackle the panic disorder and its symptoms, and some patients may say 'I have talked about my childhood and am tired of that,'" he said. This tips the scale toward CBT, said Straker, who was not part of the new study. "Others may say 'I've done CBT and it never worked and I am ready to get into it with psychodynamic therapy.'"
The most important message is that help is out there for panic disorder, he said.
Learn more about panic disorder and its treatment at the U.S. National Institute of Mental Health.
SOURCES: Thomas Nilsson, PhD student, clinical psychologist, Lund University, Lund, Sweden; Amanda Spray, PhD, clinical associate professor, psychiatry, director, Steven A. Cohen Military Family Center, NYU Langone, New York City; David Straker, DO, psychiatrist, New York City; Psychotherapy and Psychosomatics, Nov. 23, 2020, online