Panic Disorder

What is panic disorder?

Panic disorder is a type of anxiety disorder that causes repeated panic attacks — sudden periods of intense fear, discomfort, or a sense of losing control, even though there is no real danger. Panic attacks often cause physical symptoms; for example, you may have a rapid or pounding heartbeat and feel like you are having a heart attack.

Having a panic attack doesn't mean you will develop panic disorder. Many people have one or two panic attacks in their lifetime and get better without treatment.

Some people go on to develop panic disorder — repeated attacks that can happen as often as several times a day or as rarely as a few times a year. People with panic disorder often worry about the next attack and may start avoiding places where previous attacks happened.

Panic disorder is not life-threatening, but it can affect your quality of life. If left untreated, it can sometimes lead to depression or substance use disorders.

What causes panic disorder?

The cause is unknown. Several factors may play a role:

• Genetics — panic disorder sometimes runs in families
• Brain biology and chemistry
• Your environment
• Major stress

Who is more likely to develop panic disorder?

Panic disorder is more common in women than in men. It often starts in the late teens or early adulthood, sometimes when a person is under a lot of stress. People who have experienced trauma, especially in childhood, are more likely to develop it.

What are the symptoms of panic disorder?

People with panic disorder may have:

• Sudden and repeated panic attacks of overwhelming fear
• A feeling of being out of control or a fear of death during an attack
• Intense worry about the next attack
• Avoidance of places where past attacks happened
• Physical symptoms during an attack — pounding heart, sweating or chills, trembling, shortness of breath, a choking sensation, weakness or dizziness, chest pain, stomach pain or nausea

Panic attacks can happen at any time, without warning, and can last from a few minutes to over an hour.

How is panic disorder diagnosed?

To find out if you have panic disorder, a doctor will:

• Ask about your medical history and symptoms
• Rule out other causes — with a physical exam, blood tests (for thyroid problems and other conditions), and heart-health tests
• Use a panic disorder questionnaire, or refer you to a mental health professional for evaluation

What are the treatments for panic disorder?

Treatment usually includes one or more of the following:

• Talk therapy (psychotherapy or counselling). Cognitive behavioural therapy (CBT) is especially effective — it helps you change negative thoughts and how you react to things that cause anxiety.
• Medicines — including antidepressants (SSRIs and SNRIs) and anti-anxiety medicines

Your doctor may also recommend lifestyle changes that can help:

• Avoiding alcohol
• Reducing caffeine
• Eating regular meals
• Getting enough sleep
• Getting regular exercise

What can I do during a panic attack?

During a panic attack, remind yourself that the symptoms — however frightening — are not dangerous and will pass. Try slow breathing: breathe in through your nose for a count of four, hold for two, breathe out through your mouth for a count of six. Stay where you are if it is safe; do not fight the feeling or try to distract yourself. Focus on something in your surroundings. Panic attacks usually peak within 10 minutes and settle on their own.

Joining a support group can also help — you may feel less alone and learn new ways to cope.