Panic disorder is an anxiety disorder where you regularly have sudden attacks of panic or fear.
Everyone experiences feelings of anxiety and panic at certain times. It's a natural response to stressful or dangerous situations.
For someone with panic disorder, feelings of anxiety, stress and panic occur regularly and at any time. They often occur for no obvious reason.
Anxiety is a feeling of unease. It can range from mild to severe and can include feelings of worry and fear.
You may start to avoid certain situations because you fear they'll trigger another attack.
This can create a cycle of living "in fear of fear". It can add to your sense of panic and may cause you to have more attacks.
A panic attack is when your body experiences a rush of intense mental and physical sensations. It can come on very quickly and for no apparent reason.
A panic attack can be very frightening and distressing.
- a racing heartbeat
- feeling faint
- sweating, hot flushes
- nausea, a churning stomach
- chest pain, shortness of breath
- trembling, shaky limbs
- a choking sensation
- numbness or pins and needles, a tingling sensation in your fingers
- dry mouth
- a need to go to the toilet
- ringing in your ears
- a feeling of dread or a fear of dying
- feeling like you're not connected to your body
Most panic attacks last for between 5 and 20 minutes. Some panic attacks have been reported to last up to an hour.
The number of attacks you have will depend on how severe your condition is. Some people have attacks once or twice a month, while others have them several times a week.
Although panic attacks are frightening, they're not dangerous. An attack won't cause you any physical harm. It's unlikely that you'll be admitted to hospital if you have one.
Be aware that most of these symptoms can also be symptoms of other conditions or problems. You may not always be experiencing a panic attack. For example, you may have a racing heartbeat if you have very low blood pressure.
When to see your GP
Talk to your GP if the symptoms have made everyday activities difficult for you.
They'll ask you to:
- describe your symptoms
- how often the symptoms occur
- how long you have had the symptoms
They may also carry out a physical examination to rule out other conditions.
It can be difficult to talk to someone else about your feelings, emotions and personal life. Try not to feel anxious or embarrassed.
You may be diagnosed with panic disorder if you have experienced:
- at least two unexpected panic attacks
- at least a month of continuous worry or concern about having further attacks
Treatments for panic disorder
Treatment aims to reduce the number of panic attacks you have and ease your symptoms.
Psychological therapy and medication are the 2 main treatments for panic disorder.
You may need one of these or both, depending on:
- your symptoms
- the severity
- how distressed you've been
- how long you've been experiencing them
- how much it's been impacting on your day-to-to day life
You can refer yourself to primary care psychology for treatment based on cognitive behavioural therapy (CBT).
If you prefer, you can see your GP and they can refer you.
Cognitive behavioural therapy (CBT) helps you manage problems by thinking more positively. It frees you from unhelpful patterns of behaviour.
You can discuss with your therapist how you react and what you think about when you're having a panic attack.
Your therapist can teach you ways of changing your behaviour. For example, breathing techniques to help you keep calm during an attack.
Talk to your GP regularly while you're having CBT. They can assess your progress and see how you're doing.
If you and your doctor think it might be helpful, you may be prescribed an antidepressant.
You may also be prescribed an anti-epilepsy drug such as pregabalin.
If your anxiety is severe, a benzodiazepine such clonazepam may be prescribed. This is for short-term or intermittent use.
Referral to a specialist
Your GP may refer you to a mental health specialist such as a psychiatrist or clinical psychologist. A referral usually happens if your symptoms don't improve after CBT, medication and connecting with a support group.
The specialist will carry out an assessment and create a treatment plan to help you manage your symptoms.
Things you can try yourself
The next time you feel a panic attack coming on, try the following:
- don't fight the attack and stay where you are, if possible
- breathe slowly and deeply
- remind yourself that the attack will pass
- focus on positive, peaceful and relaxing images
- remember it isn't life-threatening
To reduce the chances of a further attack, it may also help to:
- read a self-help book about anxiety based on the principles of CBT
- try complementary therapies such as massage and aromatherapy
- try activities like yoga and pilates to help you relax
- learn breathing techniques to help ease symptoms
- do regular physical exercise to reduce stress and tension
- avoid sugary food and drinks, caffeine, alcohol and stop smoking, these can make attacks worse
Panic disorder can have a big impact on your life, but support is available. It might help to speak to others who have the same condition.
Ask your GP about support groups for panic disorder near you.
Complications of panic disorder
Panic disorder is treatable and you can make a full recovery. It's best to seek medical help as soon as you can.
If you don't get medical help, panic disorder can become very difficult to cope with.
You're more at risk of developing other mental health conditions, such as agoraphobia or other phobias, or an alcohol or drug problem.
As with many mental health conditions, the exact cause of panic disorder isn't fully understood.
But it's thought the condition is probably linked to a combination of things, including:
- a traumatic or very stressful life experience, such as bereavement
- having a close family member with the disorder
Panic disorder in children
Panic disorder is more common in teenagers than in younger children.
Panic attacks can be particularly hard for children and young people to deal with. Severe panic disorder, if not intervened with early, can impact on a young person's life in many ways.
If your child displays the signs and symptoms of panic disorder, they should see a GP.
A GP will take a detailed medical history and carry out a thorough physical examination, to rule out any physical causes for the symptoms.
They may refer your child to a specialist for further assessment and treatment. The specialist may recommend a course of CBT for your child.
Screening for other anxiety disorders may also be needed to help determine what's causing your child's panic attacks.
Content supplied by the NHS and adapted for Ireland by the HSE.