Beyond Fight or Flight: Panic Disorder

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Panic disorder remains one of the most frequently misunderstood anxiety conditions in clinical practice and on licensing exams. We dive deep into what makes this disorder truly distinct from general anxiety - the sudden, intense nature of panic attacks compared to anxiety's gradual build.

For therapists and students preparing for licensing exams, understanding the three types of panic attacks is crucial. Unexpected attacks strike without warning, situationally bound attacks consistently occur in specific contexts, and situationally predisposed attacks may or may not occur upon exposure to triggers. This unpredictability creates elaborate avoidance strategies that significantly impact clients' quality of life.

The DSM diagnostic criteria requires recurrent unexpected panic attacks followed by at least one month of persistent concern or behavioral changes, with four or more specific symptoms during attacks. At the core of this disorder lies what we call the "fear response cascade" - a self-perpetuating cycle where bodily sensations are catastrophically misinterpreted, triggering more anxiety and physical symptoms.

We explore essential assessment tools like the Panic Disorder Severity Scale and the Anxiety Sensitivity Index, which help clinicians track symptoms and guide treatment. Effective approaches combine psychoeducation, cognitive restructuring, and breathing techniques, progressing to interoceptive exposure and in vivo desensitization.

Common challenges in treatment include clients' reluctance to abandon safety behaviors and patterns of medical reassurance seeking. Whether you're studying for exams or working with clients experiencing panic, this episode provides clear, practical guidance for understanding and treating this complex condition. Subscribe for more clinical insights and exam preparation tips!

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This podcast is not associated with the NBCC, AMFTRB, ASW, ANCC, NASP, NAADAC, CCMC, NCPG, CRCC, or any state or governmental agency responsible for licensure.