Why Medication is Usually Contraindicated in the Treatment of Panic: What is 90% Effective

Overview:

Panic attacks are amongst the most dreaded of mental health problem. The most effective strategy for relieving panic attacks is interoceptive exposure (IE) which involves systematically bringing on the symptoms such that the person habituates and desensitizes to them.

Other mechanisms may also account for improvement (e.g. being in control of i). IE combined with other exposure therapy and coping strategies is 88% effective in completely eliminating panic attacks even after one and two year follow-ups. The remaining 12% still experience a significant reduction in the frequency and intensity of those panic attacks. Another strategy, mindful acceptance is very effective for a subset of patients. 

For these individuals, it's nearly magic in eradicating a panic attack after which the frequency and intensity of subsequent attacks drop dramatically and sometimes even stop. The combination of these treatments easily leads to a 90% improvement.

Unfortunately when medication is added to IE and coping strategies, the effectiveness drops from 88% to 58% (Westen & Morris, 2001). Benzodiazepenes are contraindicated for numerous reasons, which will be discussed. However,SSRIs and SNRIs are very effective for a subset of patients and do not generally interfere with the more effective treatments. 

Nonetheless, some patients experience an increase in panic attacks when the side-effects mimic panic thereby triggering an increase in attacks. Other concepts about the genesis of panic attacks and ways to treat them will be discussed. 

Why should you Attend: Due to the physiological nature of panic, many patients are convinced that they have a medical condition. Therefore they typically first seek help at an ER or from a physician where they usually get a prescription. 

However, medication is only about 40% effective in treating panic. Furthermore fast acting benzodiazepenes (e.g. Xanax, Ativan) negatively reinforce anxiety, create a risk of addiction, and interfere with the most effective treatments. 

Unfortunately, not only are most physicians unaware of the most effective treatment for panic attacks, in my experience training mental health care professionals, less than 5% of providers use the most effective treatments for panic. 

Areas Covered in the Session:

• Criteria for a Panic attack and Panic Disorder
• Standard, but Ineffective Treatments
• The First Panic attack is usually the perfect storm of events. Understaning this can be a tremendous comfort to your Patient
• The role of Anxiety Sensitivity
• What's going on when it's NOT the perfect Storm?
• Turn off Fluorescent Lights in your office.Why?
• Panic Attack Monitoring Guides Treatment
• Fighting Anxiety Fuels it
• Mindful Acceptance
• Interoceptive Exposure
• Nip it in the Bud and Prevention
• The Data: Research supporting Cognitive-Behavioral therapy, Especially IE
• How to find the Right Therapist

Who Will Benefit:

• All Practitioners
• Physicians
• Nurses
• Psychotherapists
• Any Practitioner who sees Patients that may have Panic Attacks (Occupational Therapists, Physical Therapists, Massage Therapists)

Speaker Profile 

Dr. Jennifer L. Abel is an experienced international speaker who has conducted 100's of workshops and seminars for health professionals with very positive feedback. She was trained as a scientist-practitioner specializing in the cognitive-behavioral treatment of anxiety disorders and has crafted evidence based strategies of her own in her clinical practice of 25 years. She served as the Associate Director of the Stress and Anxiety Disorders Institute at Penn State and has published many articles in professional journals on her work in anxiety and behavioral medicine. 

Dr. Abel's first book Active Relaxation (2010) received outstanding reviews from mental health care professionals and readers alike. Two additional books have also received high praise Resistant Anxiety, Worry, and Panic: 84 Practical Treatment Strategies for Clinicians (2014) and The Anxiety, Worry & Depression Workbook (2018). Her most popular product is The Melt Worry & Relax Card Deck (2016) which provides 56 strategies from the four most effective types of therapy for worry. She is also co-author of The Melt Worry & Relax Card Deck Card Deck for Kids (in press).