What Is Panic Disorder? A Christian Counseling Perspective

If you’ve ever experienced a panic attack, you know how terrifying the experience is. But rest assured, not everyone who experiences panic attacks develops panic attack disorder. According to the Cleveland Clinic, every year up to eleven percent of Americans experience a panic attack while two to three percent of those Americans go on to develop panic attack disorder.

That’s why in today’s article, we’re going to look at what panic attack disorder is and how to receive a diagnosis. We’ll also look at symptoms of a panic attack, panic attack disorder causes or risk factors, four different types of panic disorders, and treatment options. Finally, we’ll look at four Bible verses to memorize when you feel panicked or afraid.

Receiving a Panic Disorder Diagnosis

It’s important to know the difference between an occasional panic attack and a panic attack disorder. In order to receive a panic attack disorder diagnosis, you would have to have experienced at least two panic attacks accompanied by the constant worry and desire to change your life to avoid having another one.

Essentially, if your panic attacks are beginning to negatively impact your daily living routines and social life, then you may have panic attack disorder. To receive an official diagnosis, you will need to see a doctor or licensed psychiatrist who will review your symptoms, take blood work, and attempt to rule out other health issues.

After other health issues are ruled out, and you match the criteria of having frequent panic attack episodes while constantly worrying about the next one, then your healthcare provider will most likely give you an official diagnosis.

Panic Attack Symptoms

Because panic attack disorder is characterized by frequent panic attack episodes, it’s helpful to recognize the signs and symptoms so that you can take the necessary steps toward prevention and treatment. Panic attacks usually begin suddenly, without warning, and can happen at any time.

Panic attacks usually come with these signs or symptoms:

• Sense of impending doom or danger
• Sudden high anxiety with or without reason
• Fear of loss of control or death
• Sweating
• Rapid pounding heart rate
• Shortness of breath or difficulty breathing
• Chills
• Hot flashes
• Nausea
• Stomach cramps
• Chest pain
• Headache
• Trembling or shaking
• Dizziness
• Lightheadedness or faintness
• Numbness or a tingling sensation
• Feeling of unreality or detachment to surroundings

Typically, a panic attack can make you feel like you’re either dying or going crazy. The symptoms you experience during an episode are typically not in proportion to the true situation and can be unrelated to the situation you find yourself in.

Panic attacks are usually brief, lasting less than ten minutes, but symptoms can last a little bit longer. Experiencing a panic attack is common. While it’s not pleasant, it’s important to remember that it’s not life-threatening.

However, it may be cause for concern if you begin to experience multiple panic attacks while developing an intense fear of when the next one will strike. That’s when isolated panic attacks can turn into panic attack disorder.

Causes/Risk Factors of Panic Disorder

Doctors can’t pinpoint the exact cause of panic attack disorder. But there are a few factors that may play a key role in susceptibility to the disorder, including the following:

Genetics: There may be a biological cause that makes others more prone to fearful tendencies. If you are someone who grew up in a home with an overly anxious parent or a parent that experienced panic attacks, then that may make you more susceptible.

Major stress: Big life changes like getting married, losing a job, having a baby, or losing a loved one can produce major levels of stress which can lead to a panic attack or multiple panic attacks. Traumatic events like physical or sexual abuse, or getting into a severe automobile accident, can also be triggers.

Personal temperament: If you are someone who has a more sensitive disposition, or you’re prone to negative emotions, then it may be more likely for you to develop panic attack disorder.

Changes in brain function: Different changes in your brain may cause frequent panic attacks or worry. Smoking, drinking, or your level of caffeine intake can affect this.

The Four Types of Panic Disorder

According to the National Library of Medicine, there are four clinical types of panic attack disorders.

Let’s unpack the four clinical types below and their characteristics:

Type 1: This type is characterized by an occasional panic attack as the only symptom.

Type 2: Panic attacks occur more frequently but without any other neurotic or depressive symptoms.

Type 3: Panic attacks are happening regularly while also developing neurotic symptoms such as generalized anxiety, agoraphobia, or hypochondriasis.

Type 4: Depressive symptoms begin to accompany the frequent panic attacks and neurotic symptoms.

Working with a doctor or licensed psychiatrist can help determine which type of panic attack disorder you fall under and what treatment options will be most effective.

Four Bible Verses to Memorize to Battle Fear and Panic

Panic attacks and panic attack disorder may sound and feel like very scary things. But the truth is that God did not create you with a spirit of fear, but of power, love, and a sound mind (2 Timothy 1:7).

All of these things are available to you through Christ. And while that can be easy to say, it’s much harder to remember and live out when you feel trapped in your fear and panic.

For the word of God is alive and active. Sharper than any double-edged sword, it penetrates even to dividing soul and spirit, joints and marrow; it judges the thoughts and attitudes of the heart. – Hebrews 4:12, ESV

The word of God is a powerful tool you can use to reshape your thinking and replace your worry with the truth of God’s peace. Below are four Bible verses that you can memorize so that when you start to feel the panic set in, you can pull them out and fight the fear with the truth.

Fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand. – Isaiah 41:10, ESV

No matter what situation you’re in or what may be causing you to feel the rising emotion of panic, God is in it all with you. If you call on Him and lean into Him, He will provide you with the strength and courage you need to face any circumstance.

…for God gave us a spirit not of fear but of power and love and self-control. – 2 Timothy 1:7, ESV

This Bible verse is important to memorize because it’s a reminder of who you are in Christ. You hold within in you the Spirit of God who gives you power, love, and self-control. Fear is not from the Lord, and it’s important to remind yourself of who God is and who you are in Him.

Peace I leave with you; my peace I give to you. Not as the world gives do I give to you. Let not your hearts be troubled, neither let them be afraid. – John 14:27, ESV

God has granted you 24/7 access to His peace. This is a kind of peace that isn’t dependent upon circumstances but rests upon His unchanging faithfulness. You can receive His peace whenever you want. All you need to do is reach out and take it and it will be the anchor that keeps you grounded.

I lift up my eyes to the hills. From where does my help come? My help comes from the Lord, who made heaven and earth. He will not let your foot be moved; he who keeps you will not slumber. Behold, he who keeps Israel will neither slumber nor sleep. – Psalm 121:1-4, ESV

When you feel the worry set in and a panic attack coming on, it can be hard to focus on anything else. But God invites you to look up and remember that He is your Helper. As you take your eyes off of your circumstances and place them on God, your worry will grow lighter. God protects you, loves you, and never takes His eyes off of you. You are always under His tender care.

Treatment Options for Panic Attack Disorder

Three main ways have proven to be effective treatments for those with panic attack disorder:

• Antidepressant medications
• Anti-anxiety medications
• Psychotherapy or Cognitive Behavioral Therapy (CBT)

Let’s take a deeper dive into each therapy option below.

Antidepressant Medications

Certain antidepressants can lessen the frequency and severity of panic attacks. It’s important to speak to your doctor about which medications are right for you, but typically they will prescribe SSRIs, or serotonin selective reuptake inhibitors.

A few common SSRIs include:

• Prozac
• Paxil
• Cymbalta
• Effexor
• Elavil
• Sinequan

Anti-Anxiety Medications

Benzodiazepines are often prescribed to treat and prevent panic attacks by lowering your anxiety levels. As with antidepressant medications, it’s important to discuss the right type of anti-anxiety medication with your doctor.

It’s especially important to discuss these meds with your doctor because anti-anxiety medications have a higher risk of addiction or dependence. Some common Benzodiazepines include:

• Xanax
• Ativan
• Klonopin
• Valium
• Librium

Cognitive Behavioral Therapy

Another very effective way to treat panic attack disorder is psychotherapy Or Cognitive Behavioral Therapy (CBT). During a CBT session, you will talk about your thoughts and emotions with a licensed mental health professional like a counselor or psychologist. The counselor will then help you identify panic attack triggers so you can adapt your thinking, behaviors, and reactions.

As you learn to respond differently to triggers, the hope is that the panic attacks will lessen and eventually stop altogether. At our counseling offices, this is exactly what we aim to do. We want to create a safe environment for you to express your thoughts and feelings openly as we move together toward coping strategies and ultimately, healing.

If you’d like to speak to me or another one of our counselors about your panic attacks or your panic attack disorder, then please don’t hesitate to reach out to me or one of the other counselors in our online directory.

Dialectical Behavioral Therapy

According to WebMD (2022), Dialectical behavioral therapy (DBT) is a type of Cognitive Behavioral Therapy. CBT tries to identify and change negative thinking patterns and pushes for positive behavioral changes. DBT may be used to treat suicidal and other self-destructive behaviors. It teaches patients skills to cope with, and change, unhealthy behaviors.

What’s Unique About Dialectical Behavioral Therapy?

The term “dialectical” comes from the idea that bringing together two opposites in therapy – acceptance and change – brings better results than either one alone. A unique aspect of DBT is its focus on acceptance of a patient’s experience as a way for therapists to reassure them – and balance the work needed to change negative behaviors.

Standard comprehensive DBT has four parts:

• Individual therapy
• Group skills training
• Phone coaching, if needed for crises between sessions
• Consultation group for health care providers to stay motivated and discuss patient care

Patients agree to do homework to practice new skills. This includes filling out daily “diary cards” to track more than forty emotions, urges, behaviors, and skills, such as lying, self-injury, or self-respect.

What Conditions Does DBT Treat?

Dialectical Behavioral Therapy focuses on high-risk, tough-to-treat patients. These patients often have multiple diagnoses. DBT was initially designed to treat people with suicidal behavior and borderline personality disorder. But it has been adapted for other mental health problems that threaten a person’s safety, relationships, work, and emotional well-being.

Borderline Personality Disorder is a disorder that leads to acute emotional distress. Patients may have intense bursts of anger and aggression, moods that shift rapidly, and extreme sensitivity to rejection. People with Borderline Personality Disorder may have difficulty regulating emotions. They experience instability in:

• Moods
• Behavior
• Self-image
• Thinking
• Relationships

Impulsive behavior, such as substance abuse, risky sex, self-injury, and repeated life crises such as legal troubles and homelessness, are common.

The American Psychiatric Association has endorsed DBT as effective in treating borderline personality disorder. Patients who undergo DBT have seen improvements such as:

• Less frequent and less severe suicidal behavior
• Shorter hospitalizations
• Less anger
• Less likely to drop out of treatment
• Improved social functioning

Substance abuse is common with Borderline Personality Disorder. DBT helps substance abusers with Borderline Personality Disorder but hasn’t proven effective for addiction alone. DBT may also help certain people with depression, according to some studies. Your therapist or health care provider may suggest it on its own or in combination with antidepressant medications.

In addition, researchers are investigating whether DBT may be effective in treating these conditions:

• Mood disorders
• Binge eating
• ADHD
• Posttraumatic stress disorder

How Does DBT Work?

Comprehensive DBT focuses on four ways to enhance life skills:

Distress tolerance: Feeling intense emotions like anger without reacting impulsively or using self-injury or substance abuse to dampen distress.

Emotion regulation: Recognizing, labeling, and adjusting emotions.

Mindfulness: Becoming more aware of self and others and attentive to the present moment.

Interpersonal effectiveness: Navigating conflict and interacting assertively.

DBT offers a commonsense, multistage approach:

Stage 1: Treats the most self-destructive behavior, such as suicide attempts or self-injury.

Stage 2: Begins to address quality-of-life skills, such as emotional regulation, distress tolerance, and interpersonal effectiveness.

Stage 3: Focuses on improved relationships and self-esteem.

Stage 4: Promotes more joy and relationship connection.

Psychoanalysis

According to the American Psychoanalytic Association (2022), psychoanalysis arose from an appreciation of the power of people talking directly to one another about questions that matter and issues that are difficult to understand. As human beings are built for communication, we aim to understand and be understood.

When reading the news, interacting on social media, or in everyday conversation, many of us seek to understand “what motivates people?” And many of us are asking why people behave counter to their own interests. Historical, political, and economic explanations provide important insight into the irrationality of everyday life. Psychoanalysis, however, offers another perspective.

In examining what lies beneath the surface of human behavior, psychoanalysis teaches us about the unconscious psychological forces within us outside of everyday awareness. Psychoanalysis, in providing multi-layered and multi-dimensional explanations, seeks to understand complexity.

How Psychoanalytic Treatment Works

Psychoanalytic treatment is based on the idea that people are frequently motivated by unrecognized wishes and desires that originate in one’s unconscious.

These can be identified through the relationship between patient and analyst. By listening to patients’ stories, fantasies, and dreams, as well as discerning how patients interact with others, psychoanalysts offer a unique perspective that friends and relatives might be unable to see.

The analyst also listens for how these patterns occur between patient and analyst. What is out of the patient’s awareness is called, “transference” and out of the analyst’s awareness is called “countertransference.”

Talking with a trained psychoanalyst helps identify underlying problematic patterns and behaviors. By analyzing the transference and countertransference, analyst and patient can discover paths toward the emotional freedom necessary to make substantive, lasting changes, and heal from past traumas.

Typically, psychoanalysis involves the patient coming several times a week and communicating as openly and freely as possible. While more frequent sessions deepen and intensify the treatment, the frequency of sessions is worked out between the patient and analyst.

The couch, which has become so intertwined with the public image of psychoanalysis, is no longer required. While many analysts and patients find that the couch is beneficial and helps patients relax and be more open, others feel a face-to-face arrangement works better for them.

Sometimes also called psychodynamic psychotherapy, this treatment method is based on the theory and technique of psychoanalysis. The primary difference is that the patient and analyst meet less frequently, sometimes only once a week. As with psychoanalysis, the frequency of sessions can be customized to the needs of the patient. Another difference is that the patient usually sits upright and opposite the therapist, rather than reclining on a couch with the therapist out of view.

Other than these differences, psychoanalytic psychotherapy is very much like analysis in its use of free association, the importance placed on the unconscious, and the centrality of the patient-therapist relationship.

Counseling within a Christian Context

One of the ways I think of Christian counseling is from a cultural perspective. Christianity, and its numerous denominations, do (in fact) constitute a culture with many subcultures (denominations). The aforementioned modalities of psychotherapy are taken up, at least with me, from a Christian cultural perspective with great efficacy.