Panic disorder is a type of anxiety condition. People who have regular panic attacks that often come out of the blue may have panic disorder. Just to break that down, anxiety is a normal reaction to a situation where someone feels threatened for any reason. This may be anything from taking an exam and facing getting a bad mark to riding on a roller coaster. A panic attack is an overwhelming mental and physical state of anxiety. The mental symptoms can be things like worrying that something horrible is about to happen, that you may die suddenly or that you may be on the verge of losing control or your mind. The physical symptoms are usually having a racing heart, finding it hard to breathe, sweating too much, having a dry mouth, cold hands and feet, churning sensations in the stomach or feeling sick. How many times these attacks happen changes a lot from person to person. Some people can have one or two a month while others could have several a week or even more than one  per day. 

The single most important thing to remember if you have a panic attack is that it is frightening but not dangerous at all to your body. It will not harm you in any way. Some people worry that they may 'die of fear' as this has been portrayed in television and films, but that simply does not happen. 

Why do some people experience panic attacks?

Usually panic disorder is brought about by a combination of physical and mental factor. Panic attacks are more likely in people who have been victims of trauma or people who have experienced a really bad event like losing someone very dear. Very often there is a family link, in that people whose relatives have experienced panic disorder are more likely to get it themselves. Assuming the worst can bring about panic attacks. Some people have a tendency to imagine the worst thing possible is going to happen. This tendency is so strong that they assume that this horrible scenario is definitely going to happen. Because of this certainty they find themselves reaction already as if it had actually happened. They tend to realise that it is unlikely, but they cannot help it; the scenario is so vivid that they can't ignore it. This last cause gives you a big hint as to what the treatment might involve. In many cases stopping yourself from assuming the worst and instead looking at a) how likely is really the worst to happen and b) what other things are likely to happen is very useful. This is a skill that is developed through training over time.

How do I know if I have panic disorder?

If you believe the description above fits what you experience you should ask your doctor about it. There are many medical conditions that may look like panic disorder, but aren't. That is why it is important to see the general doctor first and not a psychologist or a specialist doctor. For the diagnosis the doctor will exclude the other conditions that may look like panic disorder and confirm that the panic attacks are severe enough and frequent enough to warrant the diagnosis. Panic disorder may also present with only a few panic attacks but a constant fear of having more attacks. 

How is panic disorder made better?

There are both psychological treatments and medication that can help in panic disorder. In the first instance it is best to see if you are able to treat yourself by learning relaxation techniques and using one of the self-management techniques available. These take the form of either workbooks or interactive computer programmes that teach you the skills you need to overcome the condition.

If self-directed treatment is not for you there are two main forms of psychological treatment that can help: cognitive behavioural therapy and applied relaxation. These are both delivered in a group or as a one to one and they involve around 15 one hour sessions which can be completed over 6 to 15 weeks.

The main form of medication used is a type of antidepressants called selective serotonin reuptake inhibitors. Specialists can use other forms of medication and they can also use some medications in combination, although the evidence for these combinations is not present in many cases and only specialist doctors should use them. A type of medication called benzodiazepines should only very rarely be used and only if a specialist recommends it as it can easily do more harm than good.

Things you can do to help yourself are: 

  • increase your exercise levels
  • stop drinking alcohol
  • learn and use relaxation techniques regularly - like the ones in our app Feel Stress Free
  • stop using caffeine

What can go wrong if I don't seek help?

Panic disorder is a medical condition. As such you need to seek help from a health professional as soon as you can as treatment is always more effective the sooner you start on it. If you don't tackle it early you could develop agoraphobia. Agoraphobia is the fear of being in a situation where help might not be easy to get or where getting away might be difficult.

There are other complications that may happen, such as excessive use of alcohol or other drugs. This often happens when people try to treat their symptoms using these substances. They are tempting as they can offer temporary relief. To be clear they do not help in the medium to long term and they make matters much worse, so it is best to avoid them

Read more about panic disorder from the NHS choices website.

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