Panic Disorder

Panic Disorder is an anxiety disorder which causes sudden panic attacks, often for no apparent reason. Read our article below for more information on the symptoms, causes, and treatments for panic disorder.

What is panic disorder?

Panic disorder is an anxiety disorder which causes sudden and recurrent attacks of panic or fear. People who have panic disorder may live in fear of their panic attacks or have some periods with few or no panic attacks but have lots at other times. It’s common for people to experience panic disorder and agoraphobia together.

What are the symptoms of panic disorder?

If you have had four or more panic attacks, or you live in fear of having another attack after the first, you may have panic disorder.

Panic attacks begin suddenly, often with no warning, and can be very frightening or distressing. An attack will typically last for 10 to 20 minutes, but in extreme cases symptoms may last for up to than an hour.

Common symptoms of a panic attack include:

• a racing heartbeat
• feeling faint
• sweating
• nausea
• chest pain
• shortness of breath
• trembling
• hot flushes
• chills
• shaky limbs
• a choking sensation
• dizziness
• numbness or pins and needles
• dry mouth
• a need to go to the toilet
• ringing in your ears
• a feeling of dread or a fear of dying
• a churning stomach
• a tingling in your fingers
• feeling like you're not connected to your body

What causes panic disorder?

As with many mental health conditions, it’s not fully understood what causes panic disorder. It’s thought that it may be caused by a traumatic or stressful life experience (like a bereavement), having a close family member with panic disorder, or an imbalance of neurotransmitters in the brain.

How is panic disorder treated?

If you’ve been experiencing more panic attacks than is normal for you, speak with your GP as soon as possible. It can be difficult to speak with someone about how you are feeling, but don’t worry! It’s the first step on the road to feeling better.

The main treatments for panic disorder are psychological (talking) therapies or medication. These treatments will aim to reduce the number of panic attacks you have and to ease your symptoms. Depending on your symptoms, you may need 1 of these treatments, or a combination of the 2.

Psychological therapies

Your GP can refer you for treatment based on cognitive behavioural therapy (CBT). Alternatively, you can refer yourself. CBT focusses on how your thoughts, beliefs, and attitudes affect your feelings and behaviour. It also teaches you coping skills for dealing with different problems. Your therapist can teach you ways to change your behaviour, like breathing techniques to stay calm during a panic attack.

Medication

If you and your doctor agree medication might be helpful for you, they may prescribe:

Antidepressants - There are 2 main types of antidepressant: Selective Serotonin Reuptake Inhibitors (SSRI) and tricyclic antidepressants. Usually, you will be offered an SSRI first, but these can sometimes cause side effects like sleeping problems or feeling more anxious than before. If SSRI’s don’t work or aren’t suitable you may be offered a tricyclic antidepressant.

Anti-Seizure Medications - Depending on your situation your doctor may decide to prescribe Pregabalin. This is an antiseizure drug normally used to treat epilepsy. However, it is also licenced to treat anxiety. If your anxiety is severe, clonazepam may be prescribed instead of pregabalin.

Referral to a specialist

If your symptoms do not improve after CBT or medications, your GP may refer you to a mental health specialist like a psychiatrist or clinical psychologist. This specialist will carry out an assessment of your condition and work with you to create a treatment plan.

Alternative Remedies/Self Help

If you feel a panic attack coming on, you could try the following to stay calm:

• Don’t fight the attack. This is likely to make it worse.
• Focus on your breathing. Concentrate on breathing slowly and steadily, in through your nose and out through your mouth.
• Focus on your senses. You could try chewing a minty gum or touching something soft.
• Remember that the attack will pass. You aren’t losing control, you aren’t going insane, and you aren’t going to die.
• Try grounding techniques. Grounding techniques are a way to stay connected to the present, rather than intrusive thoughts, feelings, memories, or flashbacks. You might like to try taking a big gulp of an ice-cold drink, feeling an ice cube, touching a certain texture, or smelling a strong smell. These are just some simple grounding techniques. It might be a bit trial and error to see which methods work for you, and which aren't as helpful.

After a panic attack it is important to think about self-care. Listen to what your body needs as you may need to rest somewhere quietly, have something to eat or have a drink.