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We all have moments of anxiety at times, but repeated panic attacks that affect your daily life may suggest you have developed a panic disorder. Here we look at what that is and how it can be treated.

What is panic disorder?

Panic disorder is an anxiety disorder characterised by repeated and unexpected panic attacks, intense periods of anxiety or fear that develop rapidly, often without apparent cause.

These attacks can cause physical and emotional symptoms such as heart palpitations, sweating, trembling, shortness of breath, chest pain, feelings of suffocation, dizziness, a sense of unreality, or fear of losing control, going crazy, or dying.

Individuals with panic disorder may experience constant worry about the possibility of future attacks and may change their behaviour to avoid situations they think might trigger a panic attack. This anxiety and behavioural change can significantly limit a person’s daily life and activities.

Fortunately, it is a treatable condition. Read more about how to get help.

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Symptoms of panic disorder

The symptoms of panic disorder mainly involve repeated episodes of panic attacks, sudden waves of intense fear or anxiety that peak within minutes. During a panic attack, individuals may experience a combination of physical and psychological symptoms:

  • Heart palpitations, rapid heartbeat or strong attention to heart rhythm
  • Sweating
  • Trembling or shaking
  • Shortness of breath or feeling of suffocation
  • Chest pain or discomfort
  • Nausea or upset stomach
  • Dizziness, unsteadiness, light-headedness or a feeling of fainting
  • Sense of unreality (derealisation) or separation from oneself (depersonalisation)
  • Fear of losing control or ‘going mad’
  • Fear of dying
  • Numbness or tingling
  • Hot flashes or chills

These attacks can occur unexpectedly, without a clear trigger, and can also occur during sleep. Individuals with panic disorder may experience constant fear or anxiety about further attacks and avoid places or situations where attacks had occurred before. This change in behaviour can lead to significant lifestyle restrictions. Treatment through therapy, medication or a combination of both can help manage the symptoms.

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Treatment of panic disorder

An effective treatment for panic disorder is a combination of psychotherapy, particularly cognitive behavioural therapy (CBT) with exposure therapy, and medication, including anti-depressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).

Lifestyle changes such as regular exercise, mindfulness, and relaxation techniques also play an important role in the management of panic disorder. An individualised treatment plan, created in collaboration between the patient and psychologist or therapist, is central to effectively reducing or eliminating the symptoms of panic disorder.

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12 common questions about panic disorder

What is panic disorder?

Panic disorder is an anxiety disorder characterised by repeated and unexpected panic attacks-intense periods of severe anxiety or fear that develop rapidly, often without apparent cause.

What are the symptoms of panic disorder?

Panic attacks are characterised by sudden and intense feelings of fear or anxiety. Common symptoms include heart palpitations, sweating, trembling, difficulty breathing, chest pain, nausea, and a sense of losing control or fear of dying. The symptoms can come unexpectedly and often for no apparent reason, creating concern about further attacks.

How long does a panic attack usually last?

A panic attack usually lasts between 5 and 20 minutes, but symptoms can feel intense and overwhelming during this time. Some people may experience prolonged or consecutive attacks, which can make it feel like the attack is lasting longer.

Is panic disorder hereditary?

Research shows that panic disorder may have a genetic component, meaning there may be an increased risk if a close relative has the condition. However, environmental factors and personal experiences also play an important role in the development of panic disorder.

Can children and young people get panic disorder?

Children and adolescents can suffer from panic disorder. Symptoms can be similar to those of adults, but younger people may find it more difficult to express their feelings. It is important to recognise the signs of anxiety in children and adolescents and seek professional help if necessary.

What is the difference between a panic attack and a panic disorder?

The symptoms of panic disorder mainly involve repeated episodes of panic attacks, which are sudden waves of intense fear or anxiety that peak within minutes. Having a panic attack does not mean you have a panic disorder.

How can panic disorder be treated?

Panic disorder is usually treated with a mix of cognitive behavioural therapy (CBT), medication such as SSRIs and SNRIs, and lifestyle adjustments, including exercise and stress management techniques. A tailored treatment plan, developed with a healthcare provider, is essential to manage symptoms effectively.

How can I help someone experiencing a panic attack?

If someone is experiencing a panic attack, be calm and supportive. Encourage the person to breathe slowly and deeply, which can help reduce symptoms. Listen without judgement and offer a calm and safe space. Avoid downplaying their feelings and encourage them to seek professional help.

How can I distinguish between a panic attack and a heart problem?

The symptoms of a panic attack and some heart problems can be similar. However, a panic attack is usually characterised by the sudden onset of intense fear or anxiety with symptoms such as palpitations, sweating, and trembling, while heart problems have more consistent physical symptoms such as chest pain and shortness of breath. It is important to seek medical assessment for proper diagnosis.

Can alcohol and drugs affect panic disorder?

Alcohol and drugs can negatively affect panic disorder. While some people use these substances to self-medicate, they actually increase the frequency and intensity of panic attacks in the long-term and even lead to addiction and other health problems.

Is panic disorder more common in women than men?

Studies show that panic attacks are more common in women than men. This may be partly due to biological, hormonal, and psychosocial factors. Both must seek and access appropriate treatment to manage their condition.

Where can I go if I need help?

Lavendla has a team of experienced psychologists and therapists working with CBT who can help you feel better if you have mild to moderate symptoms. If you have more severe symptoms, contact your GP for a referral to a specialist psychiatrist. In an acute mental health crisis, call 111 or visit 111.nhs.uk immediately.

What does treatment for panic disorder involve?

Seeking help is a big step towards better health, it’s a positive thing to decide to take control of how you feel. Here is an overview of the steps usually involved in CBT treatment.

Step 1: Initial assessment session

The first meeting with your psychologist or therapist is an assessment to review your mental and physical health. You may be asked questions about your life situation, feelings, thoughts and behaviours. You may also be asked to complete assessment forms.

Step 2: Goal setting

This is where you and your therapist set concrete goals for the therapy, both short and long-term. It can define which areas of your life are most affected by your well-being and how you would like to change them.

Step 4: Treatment with different techniques and tools

This is the start the actual treatment phase. It involves exercises aimed at providing you with tools to overcome and process the problem you are suffering from.

Step 5: Follow-up and evaluation

Regular follow-ups are scheduled with your therapist to see how well the therapy is working. If necessary, you can adjust or renew the treatment plan.

Step 6: Ending and looking ahead

As the therapy comes to an end, it is time to reflect on the progress made. You will also receive a maintenance plan on how to use the tools and strategies you have learned. It is also important to monitor the results over time.

If you or someone close to you is looking for professional help, don’t hesitate to book a session with one of our licensed psychologists or therapists.

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Written by dominic

Dominic is a Cape Town-based copywriter and editor with a background in psychology.