Panic Attacks
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How to Identify and Treat Severe Panic Disorder

Denise Griswold, MSc, LCAS
How to Identify and Treat Severe Panic Disorder

It's somewhat unfair to tell someone suffering from panic attacks without panic disorder that their panic attacks aren't severe, because all panic attacks are severe - otherwise they would not be panic attacks.

Just because all panic attacks are severe doesn't mean there cannot be subtle differences in severity. Below is an explanation of what would constitute severe panic attack, and tips about how to treat it.

What Makes a Panic Attack Severe

Since all panic attacks are severe, how does one figure out what makes a severe panic attack?

There are two important characteristics that make some panic attacks more severe than others:

It's not whether the attacks themselves are severe, but rather whether the entire disorder is causing a severe disruption of your ability to lead a healthy or happy life. Think of it in terms of the entire disorder rather than the attack itself.

When assessing severity, psychologists will generally look at the following:

Someone with severe, debilitating panic attacks that does not show any avoidance behaviors or depression may still have severe attacks, but someone with slightly less severe attacks that has developed agoraphobia and depression and struggles to focus on work or attend social functions may have more severe panic disorder.

How Do Psychologists Assess Severity?

Psychologists may use a variety of tests to determine how severe your panic disorder is, or they may simply use their own experience and expertise. In general, severity of panic disorder plays only a moderate role in treatment, since the treatments for panic disorder tend to be similar regardless of severity.

How to Fight Severe Panic Disorder

Severe panic disorder requires a complete and intensive treatment. All anxiety is treatable, but the process does take time and requires you to be committed to your own mental health.

For severe panic disorder though, it starts by simply reducing the severity of your panic attacks and how you react to them. Less severe panic attacks cause less fear, which causes less avoidance, which causes fewer attacks. So while reducing panic attack severity doesn't cure panic disorder, it does improve the likelihood that a treatment of panic disorder will work. Consider the following:

These strategies are not a replacement for better coping, nor are they going to cure severe anxiety on their own. But what they should do is make your panic attacks slightly less severe. Less severe panic attacks should create less fear, which should reduce other severity problems with panic disorder.

Article Resources
  1. Griez, Eric, et al. Response to 35% CO2 as a marker of panic in severe anxiety. Am J Psychiatry 147.6 (1990): 796-797.
  2. Broocks, Andreas, et al. Comparison of aerobic exercise, clomipramine, and placebo in the treatment of panic disorder. American Journal of Psychiatry 155.5 (1998): 603-609.
  3. Norton, G. Ron, John Dorward, and Brian J. Cox. Factors associated with panic attacks in nonclinical subjects. Behavior Therapy 17.3 (1986): 239-252. 
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