Panic Disorder

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Woman sitting on floor with hands on chest

Panic disorder is characterised by frequent panic attacks. 

A panic attack is a sudden intense feeling of anxiety. Panic attacks can be scary and overwhelming. Some people say they feel like they are dying, having a heart attack, going crazy, or losing control. Physical symptoms of a panic attack include an increased heart rate, shortness of breath, shaking, nausea and feeling dizzy. These attacks can be triggered by anxiety or stress, or may occur for no obvious reason. Panic attacks usually last 10 to 20 minutes but the feelings of anxiety can last for hours afterwards. 

If these panic attacks are frequent and cause significant disruption to a persons life and daily routine this may be panic disorder. Panic disorder can make everyday activities such as going to work or to the supermarket difficult or impossible. The fear of having a panic attack can lead to avoidance of certain situations or places. One third of people with panic disorder have agoraphobia, which is the fear of being in situations or places where you may have a panic attack. The individual may not feel able to leave home causing huge disruption to their lives and leading to social isolation. 

Panic disorder and panic attacks can affect anyone and may be triggered by a period of major stress. Those with a family history of panic attacks or who have certain personality characteristics, such as being anxious, sensitive or nervous, can be at an increased risk.

Common symptoms
  • Recurrent panic attacks - a sudden intense anxiety/ fear which triggers a physical anxiety response.
  • Fear that you will have more panic attacks.
  • Changing behaviour and avoiding situations that might lead to a panic attack.
  • Increased heart rate
  • Shortness of breath, or feeling smothered.
  • Sweating
  • Shaking or trembling
  • Tightness in throat, feeling like you are choking.
  • Pain or tightness in chest.
  • Nausea
  • Feeling lightheaded, dizzy, or faint.
  • Numbness or tingling in fingers.
  • Stomach pain, diarrhoea
  • Feeling hot and cold.
  • Feeling detached from yourself [depersonalisation].
  • Feeling of unreality [derealisation].
  • Feeling like you are dying, losing control, in danger, or going crazy.
How common is in the general population
It is estimated that 2-3% of the general population will experience panic disorder at some time in their life.
Gender differences
Panic disorder is more common in women than men.
Onset
Panic disorder commonly begins in late adolescence or early adulthood. The average age of onset is 20 to 24 years old.
Typical Course
Panic disorder tends to last a few months with regular panic attacks, then attacks lessen over time. Panic attacks can come back and occur less frequently over several years. If not treated, symptoms can last and avoidance behaviours may get worse.
Common Comorbid (concurrent) Conditions
Depression, anxiety disorders, substance use disorders, agoraphobia, obsessive compulsive disorder (OCD).
Common treatments

If you are experiencing panic attacks it is important to see your doctor. Without treatment the frequency and intensity of panic attacks can get worse and can lead to other problems such as depression, substance abuse, and social isolation. Luckily there are effective treatments available. The main treatment approach is a combination of psychological therapy and medication.

Psychological Therapy:

Cognitive behavioural therapy (CBT) has been shown to be an effective treatment for panic disorder. CBT is a structured form of talk therapy which aims to identity and change unhelpful beliefs, thoughts, and behaviours. Through CBT you can develop an understanding of the thoughts and behaviours that lead to panic attacks, learn what to do during an attack, develop ways to reduce general anxiety, and learn how to overcome avoidance behaviours.

Another psychological treatment for panic disorder is exposure therapy. Exposure therapy involves gradual exposure to situations which are avoided due to the fear that they will cause a panic attack.

Medication: 

Medication may be prescribed to reduce general anxiety and/or panic attack symptoms. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), or sedative medications, such as benzodiazepines, may be prescribed. 

Other Ways to Manage Panic Disorder and Anxiety:

Staying physically active, getting enough sleep, eating a healthy diet, and avoiding substances such as alcohol, caffeine and cannabis can help to reduce general anxiety and the chances of a panic attack. Deep breathing exercises, progressive muscle relaxation and other relaxation techniques can also be effective at reducing anxiety and stress. Talk to your friends/ family about what you are experiencing and how they can support you when you are having a panic attack.