Case study of panic disorder in an adult female

Katie Smith, a $27$‍-year old female, enters the emergency room after experiencing an episode of extreme chest pain, difficulty breathing, and numbness in her arms. She states the following to the admitting physician:

“I was walking my dog earlier when I started sweating. Since it isn’t hot outside, I couldn’t quite understand why…then I started having trouble breathing and really got scared. My heart was pounding so hard I thought it might explode out of my chest. My knees felt weak – it seemed like my whole body was shaking, then my arms went numb. Apparently the whole thing only lasted a few minutes, but it felt like each second was an hour. Did I have a heart attack? Am I going crazy? I felt like I was going to die.”

Katie is given an EKG, but the test comes back in normal range, indicating that she did not have a heart attack. Her physician believes she may have had a panic attack and refers her to a clinical psychologist.

Four weeks later, Katie sees the psychologist and reports that she has experienced over two-dozen panic attacks with similar symptoms since her time in the emergency room. At this point, her day-to-day functioning is significantly impaired; she avoids work, time with family and friends, and walking her dog because she thinks it might trigger another attack. There is no concrete source of anxiety or fear in Katie’s life other than fear of the attacks themselves. Her psychologist diagnoses her with panic disorder and uses a variety of different exercises to improve her functioning.

Katie’s therapist gives Katie a biofeedback monitor that reads her pulse and teaches her to breathe slowly and deeply to lower her heart rate. When Katie experiences a panic attack, she uses the machine to slow her breathing until the machine light turns green. A green light indicates that Katie’s heart rate is no longer dangerously elevated, and typically signals the end of the panic attack. Over time Katie is able to quickly restore her heart rate to normal and no longer experiences panic attacks.