The Three Main Methods of Treating Panic Disorders - Essay Example

Running Head: METHODS OF TREATING PANIC DISORDER Methods of Treating Panic Disorder Name Institution Date Introduction Panic disorder is a current community’s health problem that can be described as a clinical syndrome that affects an individual through displaying symptoms such as anxiety , phobia, panic and general emotional in balance. People with this particular disorder experience frequent panic attacks that take place without any obvious triggers. Panic attacks which is an abrupt feeling of intense fear is usually accompanied by mental and physical symptoms such as chest pain, shortness of breath, dizziness and heart palpitations. The individual has thoughts of dying or even going crazy. The attacks usually occur abruptly then get to the peak within a period of ten minutes. (Claire etal 2008). In despite of the availability of different methods of treating panic disorder, the problem is still very much common and persistent in contemporary society; the basic question to practitioners in the healthcare sector is that are these methods working. This particular presentation is aimed at analyzing three basic methods of treating panic disorder which include; Tricyclic antidepressant (TCAs), Psychodynamic therapy and Cognitive therapy and how effective they are is solving this particular health problem. The prevalence rate if the disorder is quite high for instance In United States one and a half primary care visits are impetuous of physical symptoms that are mostly associated with nothing less than panic disorder this include, chest pain, abdominal pain, dyspnea and dizziness. 20% of the emergency rooms are filled by patients suffering from panic disorder. The economic and social consequences are much higher and greater than the mood of the disorder. Anxiety disorder treatment cost in U.S is about $US46.6 per annum. This cost is either directly or indirectly incurred by most states if not all. Andrews (2010) further highlights that in countries such as Australia patients with panic disorder are much higher . Over a period of not less that 12 month, they anticipated that patients with panic disorder incurs a direct cost , this includes, special consultation which most of them must be subjected to, diagnostic test, ambulances and other emergency services which they are mostly prone to. Usually diagnosis of panic disorder is mostly associated with social and health effects. It is however useful for the health care system to evaluate if the treatment methods that are currently being used are effective in terms of treating and controlling panic disorder. Evaluation of Treatment Methods The main cause of administering treatment to patient’s suffering from panic disorder is to control any further occurrences of panic attacks, reduce the proneness of relapse in patients and most of all, reduces the level of fear among patients. Psychological and pharmacological treatments are able to achieve the first and the third goals. On a rare occasion will patients with panic disorder seek medical attention especially in hospitals unless it is associated with suicidal depression. These treatments are: Cognitive therapy It refers to the educational process used by therapist to reduce the level of panic attack to an individual. A cognitive interpretation of the treatment focuses on accurate determination of hypersensitivity, physical sensation and misinterpretation of the consciousness as a signal of the impeding attack. According to the theories, patients who under go repeated panic attacks as a result of misinterpreting their physical sensations of mental catastrophe are prone to panic attack (Claire etal 2008). Research indicates that CBT (cognitive behavioral treatment) has the potential of preventing relapse as compared to hospital treatment or rather medications. Cognitive behavioral therapy also enhances interceptive exposure designated to reduce the level of bodily vigilance, panic attacks and palpitation of the entire body. The advantages of cognitive therapy is that it provides treatment for panic attacks which recurs after a period of time as compared to medical treatment that relapses day in day out. The therapy has some side effect such as the that patients see the outcomes of the therapy after a long period of time, it is more expensive even in a short run, time consuming and patients are subjected to stigmatization in one way or the other ( Claire etal 2008). A study undertaken by one of the medical University centers in Groningen to evaluate the effectiveness of the treatment through combining CBT and SSRI through undertaking various post tests for a period on nine months came up with findings that indicated that the response was much more rapid. In addition continues test on the patients showed that they patients could now avoid anxiety, general psychopathology and depression. The patients were panic disorder free within a period of two weeks after a nine months treatment . Psychodynamic therapy This is a therapy that is diagnosed to a panic disorder patient in order to avoid relapse. Psychodynamic therapy is also called insight oriented therapy. The main aim of the therapy is to create self awareness of the ancient and present behavior of the patient. Advantages of the psychodynamic therapy is that patients gain confidence, it helps to reduce depression symptoms and it uses experienced practitioners who must have adhered to long-term psychotherapy model which results to an outcome of 6 month assessments following a three year treatment, this process is basically useful in terms of monitoring the patients effectively (Milord 2007). A new form of application of treatment of panic disorder based on psychodynamic therapy can be more effective if the comparator used the application of relaxation training. This kind of training is basically a type of therapy that is linked to a less elaborate CBT. This kind of application of psychodynamic therapy that applies the relaxation therapy has not yet been formalized. It involves a six hours course , whereby the patient undergoes video tape supervision and minimum clinical experience treatment of two years. The specific training is basically applied on the patients through a combination of applied relaxation training and CBT. In this particular strategy it is essential that all the training therapists be well equipped with CBT experience in order to deliver effective therapy to the patients (Milord 2007). The therapists should undergo individual and group supervision in order to analyze if they are effectively following the treatment protocols through adhering to the required modalities. The procedure also involves the rating of video tapes to evaluate the adherence to individual treatment regulations. The out come of this kind of treatment is very much effective in the prevention of relapse (Milord 2007). Tricyclic antidepressant (TCAs) It is primarily used in clinical treatment of mood impairment such as dysthymia. It is also used in treating various medical disorders, it includes anxiety disorder, for example social phobia, panic disorder, eating disorder and many more one could think of. The diagnosed treatment has the ability of reducing anxiety attack that is thought to be very dangerous . This particular treatment is highly dependant on benzodiazepines (BDZs) in conjunction with antidepressant. This combination has its own advantages, that is initial anxiety in patients can be precipitated by antidepressant. In addition the TCAs imipramine treatment of panic disorder has the effect of reducing the severity panic attack . Bekker (2002) highlights that patients with the disorder experience significant improvement after using this treatment . However Evidence from research shows that, clomipramine; of TCAs has been the major cause of panic decrease as compared with placebo and imipramine after duration of 12 weeks of treatment. The effects of tricyclic treatment is that it usually comes before the actual benefits, and for this reason it may seemingly be very dangerous. Among the symptoms is that, it can subject the patient to commit suicide, profusely sweating of the patients, dry mouth all the time, blurred vision, mydriasis and urinary retention. Maintained treatments have facilitated and boost patience recovery from relapse. A relapse rate of more than 2 1/3 within the initial year of imipramine discontinuation was specifically reported on the same study. Relapse usually takes place in 4-6 month immediately after discontinuation BZD present undesirable side effect, for example sedation, interactions with alcohol and psychomotor damage. However these side effects may reduce after 4-6 weeks of treatment, the very serious risk of this kind of treatment is that of physical dependence, recurrence of panic attack to most patients if not all (Bekker 2002). A study was undertaken to compare the aspect of short term inhibitors known as (SSRIs) vs. tricyclic antidepressants (TCAs) in treating of panic disorder. The researchers conducted a meta- analysis. The findings of the research indicated that there is actually no difference between treating panic disorder using TCAs and SSRIs, both groups are equally effective in the reduction of the main symptoms of the disorder such as general anxiety , agoraphobic avoidance and depression. Furthermore the percentage of patients that were free from form the attacks after the test was undertaken did not actually differ however the use of SSRIs is tolerated better than TCAs. Evaluation of Findings Probably the most pressing matter that has presented itself by the present findings is the idea and question of treatment gain. The dangers of relapse is considerable demonstrated in different types of treatments. For instance one of the reasons of diagnosing cognitive therapy is to reduce the level of relapse. However, the treatment still does not prevent relapse but instead it encourages. Present findings reveal that if these types of treatments for panic disorder are still ongoing in the health care system then this gives the explanation for the high prevalence rate of the disorder. The findings of different new research strategies for treating the disorder through combined treatment such as the integration of (SSRIs) with tricyclic antidepressants (TCAs) in treating of panic disorder, CBT and SSRI and applied relaxation training and CBT, have proven to be much more effective. Conclusion Panic disorder is a health care problem that causes emotional and behavioral disruption in individual life. The treatment methods Tricyclic antidepressant (TCAs),Psychodynamic therapy and CBT(cognitive behavioral treatment, have been used over the years for treating panic disorder it is however essential that new considerations should be enforced in order integrate research proposals on treatment of( PD) . This would assist in the effective treatment and control of the disorder. References Andrews, G (2010). Australian and New Zealand clinical practice guidance for treatment of panic disorder and agoraphobia, Australia. Apeldoorn F.J. (2008). Is combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia Bekker, A. (2002).SSRI vs. TCAs in the treatment of panic disorder: a meta-analysis. Printed in UK Claire, L, Berle, D & Milicevic., D. (2008). A pilot study of cognitive behavior therapy for panic disorder augmented by panic disorder, john Wiley $sons Ltd. NSW, Australia. Milord, B. (2007). A randomized controlled clinical trial of psychoanalytic psychotherapy of panic disorder, Amjpsychiatry. Read More