Panic Disorder

Panic Disorder can be described as experiencing intense fear unexpectedly, or “out of the blue”. These experiences are called panic attacks. When someone has a panic attack, along with intense fear they feel a range of physical symptoms which may include:

Chest pain
Nausea
Dizziness
Difficulty breathing
Racing heart beat
Sweating
Shaking

While many people experience some of these sensations at times, a person with Panic Disorder will experience several of these symptoms all at once, and these symptoms will become extremely intense very quickly, peaking within minutes, and for no obvious reason. Sometimes a person with Panic Disorder will wake up having a panic attack. A common belief when having a panic attack is that it is a heart attack or that they are “losing their mind”. This then leads them to feel even more anxiety and so the panic attack becomes more intense. Underlying Panic Disorder are beliefs that the physical feelings of anxiety are dangerous or negative, and so when these feelings are experienced, anxiety about them quickly increases.

People who experience Panic Disorder will often avoid places where they fear having a panic attack. When this avoidance becomes severe and interferes with their day to day life, it is called Agoraphobia.

Common places and situations that people with Panic Disorder may want to avoid include:

Shopping centres
Taking public transport
Movie cinemas
Being in a car
Being far from home
Crossing bridges

Causes

Genetics and temperament

A family history of anxiety disorders is linked to an increased chance of developing Panic Disorder. This may be linked to the genes a child inherits, as well as through children observing and learning anxious behaviours and thinking styles from family members. Some people appear to be particularly sensitive to the feelings of anxiety, which may be linked to genes, and these people appear to be more at risk of developing Panic Disorder.

Parental factors

Children of parents who worry about feelings of anxiety, or think of anxiety as dangerous, have an increased chance of developing Panic Disorder.

Parenting styles that are controlling and restrictive, and that offer less love and care (also known as a punitive parenting style) have been linked to Panic Disorder.

Thinking (cognitive) style

Certain styles of thinking have been linked with Panic Disorder. A “looming” cognitive (or thinking) style is a tendency to think about and pay attention to thoughts about upcoming dangers and risks. This thinking style has been linked to Panic Disorder. In addition, people with Panic Disorder often think that having a panic attack will result in far worse consequences than it actually does, and tend to overestimate the chances of having a panic attack in a particular situation.

Learning experiences and negative life events

Traumatic life events such as the death of a parent, experiencing a severe childhood illness, and violence in the family appear to be linked to developing Panic Disorder.

Seeking help

If you experience high anxiety and worry which is significantly interfering in your day to day life, there are effective treatments available. You can seek help at:

Your GP. Your GP can refer you to a mental health professional, such as a psychologist or psychiatrist. Your GP is the best person to start with when looking for effective treatment for Panic Disorder.

Like all anxiety disorders, Panic Disorder is highly treatable.

Treatment

Psychological therapies

Cognitive behaviour therapy (CBT) is a recommended psychological treatment for Panic Disorder. CBT is a practical treatment, and involves teaching practical skills to deal with anxiety symptoms. CBT helps people understand how their problems, thoughts, feelings, and behaviours affect each other, as well as strategies to gain more control over their anxiety. CBT helps people to question their negative and anxious thoughts, and to do things that would normally be avoided due to anxiety. CBT helps people to begin to change these behaviours, and reduce their anxiety. For Panic Disorder, this involves challenging anxious thoughts about the symptoms of anxiety and panic, and learning how to face situations and feelings that cause anxiety.

Online treatment programs for some anxiety disorders, including Panic Disorder have recently been developed. Online treatment programs are based on CBT. Online treatment programs may involve some contact with a therapist over the Internet. Recent research has shown that online treatment programs can be effective in reducing anxiety symptoms.

Medication

A type of anti-depressant medication known as selective serotonin reuptake inhibitors (SSRI) has been found to be effective in treating Panic Disorder over the short-term and the long-term. If the medication does not help, a different SSRI may be offered. If this does not help, a different type of medication called a serotonin-noradrenalin reuptake inhibitor (SNRI) may be offered. Your GP or psychiatrist will need to prescribe this medication to you.

Self-help

Self-help has been shown to be an effective treatment for Panic Disorder. Self-help treatment should include books or other written material based on CBT; access to support groups (sometimes run by people who have experienced Panic Disorder); and advice from a GP on using exercise to improve mood. It is recommended that a person using self-help as a form of treatment for Panic Disorder should see their doctor (GP) regularly (every 4 to 8 weeks).

How family and friends can help

Try to understand the person with Panic Disorder’s anxiety, and remember that although you may not find them worrying, to the person with Panic Disorder the worries will cause intense anxiety
Avoid telling a person with Panic Disorder to just snap out of it or get over their worries
Encourage the person with Panic Disorder to seek professional treatment and encourage them to persist with it

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