The Psychology Service
Panic Disorder

What is a Panic Disorder?

Panic Disorder is a cluster of intense anxiety-based symptoms, “panic attacks”, that can occur anywhere and at any time. Unlike Phobias, they are not attached to specific situations or objects, although some people with Phobias do experience panic attacks. Panic attacks can also be a symptom of other conditions such as Depression or Agoraphobia. However, a Panic Disorder is diagnosed when other conditions are not present, and when the panic attacks occur in any situation, over a prolonged period of time.

What are the symptoms?

A panic attack is a discrete episode of intense fear and discomfort, starting abruptly, with a range of physical symptoms, such as a racing heart, sweating, shaking, breathing difficulties, chest pain, nausea, dizziness, numbness and tingling sensations, mainly in the hands. Many of the physical symptoms are actually secondary effects of hyperventilation - the fast shallow breathing pattern that mostly accompanies a panic attack. The person fears losing control and "going mad" and often has feelings of unreality. Because of the intense physical symptoms, the person often believes they are having a heart attack or a stroke. It is a very frightening experience, and can lead to the sufferer avoiding situations where panic attacks have happened. This can, secondarily, lead to their suffering from a Phobia.

How long does it last?

Panic attacks vary in frequency and duration. Each episode usually lasts several minutes, leaving the sufferer feeling “washed out”, but they can go on for as long as an hour. Attacks can occur daily, but in some cases are less frequent. While some cases do resolve spontaneously, without appropriate treatment, a Panic Disorder can continue indefinitely. A Panic Disorder often becomes more severe over time due to the sufferer developing a “fear of fear” and becoming more and more anxious about having attacks, thereby intensifying their anxiety.

What is the treatment?

The treatment of choice is CBT. This involves learning to cope with anxious catastrophic thoughts, and relaxation techniques, especially focusing on learning to control breathing, to overcome hyperventilation. Education about how panic attacks arise is also beneficial as it offers some basic insight into the mental and physical mechanisms at work. Given the intensity of the symptoms, anxiolytic medication (i.e. a minor tranquilliser) is sometimes used, in combination with psychological therapy.