Panic disorder is an anxiety disorder where a person regularly experiences 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.
However, someone with panic disorder has feelings of anxiety, stress and panic regularly and at any time, often for no apparent reason.
Symptoms of panic disorder
Anxiety is a feeling of unease. It can range from mild to severe and can include feelings of worry and fear. Panic is the most severe form of anxiety.
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.
Panic attacks
During a panic attack, you get a rush of intense mental and physical symptoms. It can come on very quickly and for no apparent reason. A panic attack can be very frightening and distressing.
Symptoms 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
- Most panic attacks last between 5 and 20 minutes. Some 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 will not cause you any physical harm, and it’s unlikely you’ll be admitted to the hospital if you have one.
Be aware that most of these symptoms can also be symptoms of other conditions or problems, so you may not always be experiencing a panic attack.
For example, you may have a racing heartbeat if you have very low blood pressure.
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When to get help
See a doctor if you’ve been experiencing symptoms of panic disorder. They’ll ask you to describe your symptoms, how often you get them, and how long you have had them.
They may also carry out a physical examination to rule out other conditions that could be causing your symptoms.
It can sometimes be difficult to talk about your feelings, emotions and personal life, but try not to feel anxious or embarrassed.
You may be diagnosed with panic disorder if you have regular and unexpected panic attacks followed by 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.
Talking therapies and medicine are the main treatments for panic disorder. Your treatment will depend on your symptoms.
Psychological therapies
You can refer yourself directly to a psychological therapies service for treatment based on cognitive behavioural therapy (CBT).
Your therapist may discuss with you how you react when you have a panic attack and what you think about. They can teach you ways of changing your behaviour to help you keep calm during an attack.
You may need to see your doctor regularly while you’re having CBT so they can assess your progress.
Medicine
If you and your doctor think it might be helpful, you may be prescribed:
A type of antidepressant called a selective serotonin reuptake inhibitor (SSRI) or, if SSRIs are not suitable, a tricyclic antidepressant (usually imipramine or clomipramine).
An anti-epilepsy medicine such as pregabalin or, if your anxiety is severe, clonazepam (these medicines are also beneficial for treating anxiety).
Antidepressants can take 2 to 4 weeks before they start to work, and up to 8 weeks to work fully.
Keep taking your medicines, even if you feel they’re not working, and only stop taking them if your doctor advises you to do so.
Preventing a further attack
It may help to read a self-help book for anxiety based on the principles of cognitive behavioural therapy (CBT). You can ask your doctor to recommend one.
Try complementary therapies such as massage and aromatherapy, or activities like yoga and pilates, to help you relax. Also, learn breathing techniques to help ease symptoms.
Do regular physical exercise to reduce stress and tension.
Avoid sugary food and drinks, caffeine and alcohol, and stop smoking, as they can increase the severity of attacks.
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