Lifestyle and Panic Disorder

Changing aspects of a person's lifestyle (decrease alcohol, caffeine, smoking and increase in water and exercise) can help reduce severe anxiety and panic attacks, according to new research carried out at the University of East Anglia.

A study by Dr Rod Lambert, from UEA's School of Allied Health Professions, has shown that drinking less alcohol and caffeine and smoking less, while increasing water intake and exercise, can be at least as effective as traditional medication and psychological treatments for panic disorder.

About 1.5% of the UK population are affected by panic disorder, with panic attacks being one of the symptoms. Sufferers often experience palpitations, shortness of breath, dizziness and nausea, as well as feelings of impending doom or death. Some also suffer from agoraphobia.
It is thought to be the first time that research has been carried out on how changing a range of lifestyle behaviors can help patients. Dr Lambert said: "It can offer an early input helping many patients to understand and control some of their symptoms.

"Panic disorder can stop people working, it can stop people shopping. I've seen people who have had panic attacks when they are driving and at night. It can affect family dynamics and work patterns. It's a very disabling condition that can last for many years and every single person is going to experience it differently."

The trial was carried out with patients aged 18-65 referred from 15 GP practices in the East of England. They had all been identified as having panic disorder and were then assigned to either routine GP care, such as medication and referral to outside agencies, or to an occupational therapy-led lifestyle approach, which looked at diet, fluid intake, exercise and intake of caffeine, alcohol and nicotine.

Dr Lambert said: "The short term effect was significant, while the longer term effect was at least as effective as routine GP care. If someone is experiencing palpitations, they may interpret that as an impending heart attack. What the therapist was doing in the trial was to suggest other lifestyle-related reasons for the palpitations.

"We can suggest cutting down on caffeine or having a bit more water during the day or night. If doing something as simple as that alters the sensations, then they may no longer misinterpret their symptoms and the associated panic goes."

Those who made changes to their lifestyle showed a decrease in the level of medication and number of doctor visits compared to those following the routine care. Levels of anxiety and panic attacks also reduced the most in patients following the lifestyle treatment - by 10 months, 67.7% of the lifestyle patients and 48.5% of the GP patients had been panic-free for at least one month.

Dr Lambert said he hoped to do further research, with the aim being to see a change in practice. "I am very encouraged by the results. Habitual lifestyle behavior hasn't really been taken seriously enough when looking at this type of condition. This study looked at a range of lifestyle behaviors but ones which people can make fairly immediate changes to. It suggests that patients actually respond to it."

Lambert RA, Harvey I, Poland F. A pragmatic, unblinded randomised controlled trial comparing an occupational therapy-led lifestyle approach and routine GP care for panic disorder treatment in primary care J Affect Disord. 2006, doi:10.1016/j.jad.2006.08.026 In Press.