Preventing panic

Panic disorder affects 25 out of every 1000 people, yet many of these people seek no help for their condition. Now, Monash researchers are developing online therapies in the hope that more people with this disorder can be treated. PENNY FANNIN reports.

It is no secret that Australian actor Garry McDonald, noted for his roles as Norman Gunston and the long-suffering son in ABC TV's 'Mother and Son', has spent much of his life struggling to control panic disorder. Psychoanalyst Sigmund Freud and inventor Nikola Tesla are two other high-profile people who experienced panic attacks throughout their careers.

In 1999, a survey commissioned by the Commonwealth Department of Health and Aged Care into the mental health of Australians found that in any 12-month period, almost one in five people have one of the common mental disorders (anxiety, depressive or substance abuse disorders).

The survey also revealed that among the 9.7 per cent of people with anxiety disorders, which include panic disorder, only 28 per cent seek help.

This finding has led Professor Jeff Richards and psychologist colleagues Dr Britt Klein, Mr David Austin and Dr Marlies Alvarenga from Monash's School of Primary Health Care to find new ways of treating people who experience frequent and unexpected panic attacks.

Online therapy: From left, Dr Marlies Alvarenga, Professor Jeff Richards and Dr Britt Klein are developing online treatments for panic disorder. Photo Greg Ford.

Panic attacks can involve a sudden rush of fear or intense anxiety and physical symptoms such as racing heart, shortness of breath, light-headedness or nausea. When these attacks happen unexpectedly, the person has what is known as panic disorder. This disorder can be debilitating, causing people to remain in their homes or change their behaviour so they do not encounter any potentially anxiety-inducing situations (known as agoraphobia).

"Three-quarters of people with anxiety disorders don't go anywhere for help. This is particularly a problem outside the major capital cities and also in the outer suburbs of metropolitan areas," Professor Richards says. "There are different reasons for this, but mostly it comes down to access and affordability.

"To address this problem and the mental health of the population in general, we have developed and are trialling an internet-based program called Panic Online for treating panic disorder."

Panic Online is an interactive program that provides information about panic and anxiety as well as how to control the experience of panic sensations and how to change self-defeating thoughts. An online therapist contacts participants by email and guides them through the program as well as assisting them with other issues relevant to their disorder.

The research team has received $200,000 from the National Health and Medical Research Council to evaluate how well the internet therapy works compared to face-to-face cognitive behavioural therapy and also to medication.

Thirty Victorians have already gone through or are completing the 12-week program. Study participants are limited to Victoria because some people are randomly placed in the section of the study that requires face-to-face therapy.

Professor Richards says previous research by his group shows that Panic Online is better for controlling panic than other self-help procedures. "Some of the many treatment gains found among people who complete Panic Online include a significant reduction in the overall severity of panic disorder, fewer panic attacks, diminished anxiety about future panic attacks and increased confidence in dealing with them, in addition to overall reductions in anxiety and stress," he says.

"If our study shows that Panic Online is as beneficial as face-to-face cognitive behavioural therapy or medication, then we can confidently recommend it to people who are unable or disinclined to enter face-to-face therapy."