Panic Disorder

Learn more about panic disorders and panic disorder symptoms.

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  1. What is Panic Disorder?
  2. Diagnosing Panic Disorder
  3. What Causes Panic Disorder?
  4. Help for Panic Disorder
  5. More Information on Panic Disorder

What is Panic Disorder?

Panic disorder is a type of anxiety disorder characterized by the experience of at least three panic attacks in a three week period under circumstances not involving physical exertion or life threatening events.

Many people experience an occasional panic attack related to life stress and anxiety and this does not necessarily mean that you have a diagnosable Panic Disorder. However, if the panic attacks become more frequent, as indicated above, then the psychiatric diagnosis would apply.

The body has a natural flight or fight response to danger. When faced with a life threatening situation, one may either stay put and face the danger (fight), or run away from the danger (flight). However, in many situations in which panic attacks occur, there is no danger or the fear is disproportional to the threat.

What distinguishes the occasional panic attack from Panic Disorder is the frequency of the attacks as well as a persistent fear or worry about experiencing another one.

Diagnosing Panic Disorder

The most common age of onset for Panic Disorder is between the late teens and early adulthood. However, panic attacks don’t discriminate and the disorder can develop at any time and for a variety of reasons. The important thing to remember is that although there are no cures for panic disorders, properly managed, you can reclaim your life and restore your inner balance.

The first step would be to seek a professional diagnosis from your health care professional or psychologist.

A detailed history of your symptoms will be taken in the consultation. You will be asked when the symptoms started, how they manifest themselves and when and where they occur during your daily routine.

Your feelings towards the panic attacks will also be explored, as well as the degree to which they may be affecting your life. Once a diagnosis is made, it is a good idea to research all possible treatment options in order to decide which ones would best suit you!

Symptoms of a Panic Attack

A panic attack is usually experienced as an intense feeling of fear. During a panic attack a variety of physical symptoms may occur. These include:

  • A pounding heart and increased pulse
  • Excessive sweating
  • Trembling or shaking
  • Feeling of choking
  • Chest pain or discomfort
  • Nausea
  • Shortness of breath
  • Dizziness or feeling like you’re going to faint
  • Feelings of unreality or detachment
  • Feeling of losing control or going "mad"
  • Chills or hot flushes
  • Fear of dying

Because of these intense and frightening feelings, many people experiencing panic attacks are seen in Emergency Hospital Rooms with suspected heart attacks. However, panic attacks are not known to affect the heart or precipitate a heart attack.

What Causes Panic Disorder?

There is no single theory that adequately explains the cause of Panic Disorder. However, a combination of genetic, physical and psychological factors are thought to work together to predispose the individual to the development of Panic Disorder – usually under conditions of stress or after a traumatic event.

Genetics – Studies have shown that Panic Disorder, like other anxiety disorders, often runs in families. Current research suggests that a genetic tendency to anxiety might increase your chances of suffering from Panic Disorder.

Physical – Some people are more sensitive to their body’s reactions to fear, such as heart rate, breathing and sweating. As a result, they are more inclined to a physical response to feelings of anxiety and fear.

Psychological - In some cases the physical symptoms of fear become the main focus to the person suffering from the anxiety. Every change in their heart rate or breathing (even if it is due to exercise) can cause them to become anxious about having a panic attack. Without realizing it, they become their own worst enemy.

Help for Panic Disorder

There are a number of options for treating Panic Disorders and it is important to explore which option or combination works best for you.

As with many psychiatric disorders, treating Panic Disorders usually involves a combination of treatment modalities, tailored to suit individual circumstances and characteristics.

Treatment Options for Panic Disorder

Cognitive Behavioral Therapy (CTB)

This form of therapy is practiced by psychologists and has been very successful in treating Panic Disorders. By investigating and recognizing the thoughts and situations that ‘trigger’ the panic attacks, strategies and coping mechanisms can be put into practice – at your own pace. The therapist will provide you with ‘life tools’ and behavioral techniques to help you manage the panic attacks and ultimately address the source of the disorder.

Relaxation Techniques

Meditation, yoga and deep breathing are some techniques that can be used to help control anxiety and lessen the stress that might be triggering the attacks.

Drug Therapy

Conventional medications for Panic Disorder include: Monoamine oxidase inhibitors (MAOIs); Tricyclic Antidepressants and Benzodiazapines. While prescription medication can be effective as part of a broader treatment plan, it is not always a necessary part of treatment. While on these medications you should be closely monitored as side effects are not uncommon and they have a well known potential for addiction.

Inappropriate and indiscriminate usage of these drugs can cause distressing side effects and it is therefore strongly advised that you research these drugs thoroughly and make an informed decision.


Other Disorders Related to Panic Disorders

It is important to get a proper diagnosis as panic attacks can also occur in other disorders or conditions such as:

  • Phobias
  • Social anxiety
  • Generalized anxiety disorder (GAD)
  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic-stress disorder (PTSD)
  • Depression
  • Hyperthyroidism
  • Mitral Valve Prolapse
  • Hyperadrenocorticism (Cushings Disease)
  • Drug withdrawal
  • Side effects of prescription drugs
  • Caffeine overdose

More Information on Panic Disorder

Tips for Coping with Panic Disorder

Though there are no magic cures for panic disorders, there are many things that can help you cope with panic disorder symptoms. Even if you know what triggers your panic attacks, try not to avoid the situation completely. Oftentimes we fear the unknown and, by running away, the ‘trigger’ itself can become larger than life and all-consuming.

Try to remember that you are not expected to rid yourself of panic attacks overnight. While it’s very easy for onlookers to simply say "Don’t panic, just relax and it will pass," for the person suffering with a panic attack, it is extremely hard to imagine the attack being over. Taking small ‘steps’ (that you feel you can cope with) and very gradually increasing the demands on yourself can help facilitate a smooth transition back to a panic-free life.

If you are experiencing stress – whether in your relationships or at work, try and work on ways to improve the stressful circumstances – stress is a major precipitant of Panic Disorder. Take steps to change things that can be changed and learn stress management techniques.

Make sure that you eat regular wholesome meals, have sufficient sleep and also exercise regularly – all important in the management of Panic Disorder.

Avoid stimulants such as caffeine and CNS depressants, especially alcohol.

While having a panic attack:

  • Try not to let your mind get the better of you by running away with negative thoughts of death, disaster or fainting. Try to focus on the thought that the "this too shall pass." Try saying this out loud – remember if you can talk, it means you are still breathing!
  • Slow down your breathing by closing your eyes, taking deep breaths and blowing each breath out through pursed lips. By keeping your hand on your stomach you will become more aware of your breathing.
  • Don’t concentrate too hard on the symptoms as this will only increase your anxiety. Try to simply ‘let go’ of the need to stop the attack and rather try to ride it out - getting yourself ‘through’ the worst of it until it passes.
  • Keep in mind there is no actual danger in having a panic attack. Reassure yourself that the fear of harm is only sustaining the attack and allowing it to last longer than necessary!
Determining the Seriousness of Panic Disorder

It is a good idea to seek help if you experience any symptoms of a panic attack. As many of these panic disorder symptoms can mimic an underlying medical condition it is important that your health care professional rules out these possibilities. If you are concerned that you may have panic disorder, it is best not to try and diagnose yourself.

Though there are no cures for panic disorder the condition is treatable and even though it may seem like the end of the world, help is available! Left untreated, the long term consequences of Panic Disorder can be very distressing. If the disorder is preventing you from functioning properly in your daily life, you need to get help.

There is a solution, help is available – there is no reason to live in fear!

What are the possible long term effects of Panic Disorder?

Panic Disorder, if left untreated, may lead to:

  • Drug and alcohol abuse - A person may self-medicate by abusing a substance in order to ‘escape’ the fear and provide relief.
  • Isolation - People with Panic Disorder tend to avoid activities and places, often things that they once enjoyed, and remain as close to home and the familiar as possible.
  • Dependency - Intense fear can cause sufferers of Panic Disorder to become increasingly financially and emotionally dependent on others.

Depression - Panic Disorder symptoms can have a devastating effect on the ability to function and to fulfill one’s roles in life. This loss of control and ability can easily lead to depression.

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