Panic disorder

What is panic disorder?

Panic disorder is a type of anxiety disorder.

We all know the meaning of panic — a feeling of being overwhelmed by great terror and loss of the ability to think and behave logically. Panic is a mental condition that usually results from a dangerous or frightening situation. It is, fortunately, a rare event for most of us.

For people who suffer from panic disorder, this feeling is triggered by non-dangerous events and may be a frequent part of their life.

Panic disorder tends to affect women twice as often as men, and symptoms usually begin in the teens or early 20s.

Symptoms of panic attacks and panic disorder

Those affected by panic disorder experience feelings of panic known as panic attacks. These can occur out of the blue and for no apparent reason. The panic attacks are recurrent and unpredictable.

During a panic attack, the affected person may experience a variety of symptoms. These can include:

  • intense fear or discomfort;
  • nausea;
  • feeling short of breath;
  • choking sensations;
  • chest pain or discomfort;
  • dizziness or light-headedness;
  • rapid ‘thumping’ heartbeat;
  • sweating;
  • numbness or tingling sensations;
  • tremor (shaking); and
  • fear of dying, losing control or going crazy.

The symptoms of a panic attack usually peak within 10 minutes and last less than 30 minutes.

Many people have had one or 2 panic attacks at some time in their lives, but people with panic disorder have repeated attacks. Also, in people with panic disorder the panic attacks are accompanied by additional problems, including:

  • a persistent fear of having more panic attacks;
  • worrying what the symptoms of panic attacks mean (such as going crazy or losing control);
  • elevated levels of generalised anxiety or tension; and
  • agoraphobia.

Agoraphobia — the fear and avoidance of being in places from which escape might be difficult or in which help might not be available in the case of a panic attack — is common among people with panic disorder. Commonly avoided places include public transport, shopping centres and theatres, and some people avoid leaving their homes altogether. Agoraphobia is a major problem that can totally disrupt work and social life.

Treatment of panic disorder

Those with panic disorder can be helped. They can be taught to recognise the early signs of an attack and learn ways to overcome it. Psychoeducation — learning about the nature of the illness and how a panic attack can cause physical symptoms — is an extremely important first step. Education may also involve dispelling fears that people with panic disorder commonly have, such as that they are going crazy, or that they will die as a result of the symptoms. Special breathing techniques and relaxation strategies are also particularly helpful.

Cognitive behavioural therapy (CBT) is very effective in breaking the cycle of panic and avoidance that characterises untreated panic disorder. One of the most commonly used forms of CBT is panic control treatment, which involves exposure to deliberately induced symptoms, together with techniques for controlling symptoms.

A number of medicines are available for panic disorder. In particular, some of the newer antidepressant medicines have been shown to be very effective in some cases. Medicines are usually only tried if CBT is not effective or not available.

Last Reviewed: 26 January 2010
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References

1. Panic disorder [revised October 2008]. In: eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited; 2010 March. (Accessed 2010, Mar 30.)
2. Panic attack [revised October 2008]. In: eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited; 2010 March. (Accessed 2010, Mar 30.)
3. Royal Australian and New Zealand College of Psychiatrists [website]. Panic disorder and agoraphobia. Australian treatment guide for consumers and carers (updated Aug 2009). Available at: http://www.ranzcp.org/images/stories/ranzcp-attachments/Resources/Publications/CPG/Australian_Versions/AUS_Panic_disorder.pdf (accessed 2010, Apr 13)
4. Kumar S, Malone D. Panic disorder. Clinical Evidence [online] 2008 [cited Dec 16]. URL: http://clinicalevidence.bmj.com/ (accessed 2010. Mar 30)
5. Mayo Clinic [website]. Panic attacks and panic disorder (updated 2010, March 25). Available at: http://www.mayoclinic.com/health/panic-attacks/DS00338 (accessed 2010, Apr 13)
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