Panic Disorder and Panic Attacks

What is it?

People often talk about having a “panic attack” and feeling “panicked” in an anxiety provoking situation, alluding to a state of heightened anxiety and arousal. Panic attacks tend to start relatively quickly, and peak within 10 minutes. This peak generally lasts for approximately 5-10 minutes before gradually declining. However, it can take longer for all the symptoms of subside. Panic Disorder is characterised by repeated panic attacks which occur often without warning and are accompanied with a preoccupation with the fear of experiencing another attack. It typically begins in adolescence or early adulthood; however, children can also experience panic-like symptoms and panic disorder. Panic Disorder affects 1-2% of the Australian population each year, and women seem to be two times more likely to develop it than men.

What are the signs and symptoms?

A Panic Attack is defined by a sudden period of intense fear or discomfort, which reaches a peak within minutes, and during which time, four or more of the following symptoms occur:

  • Palpitations, pounding heart, or accelerate heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • Feeling of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, lightheaded, or faint
  • Derealisation (feeling ‘unreal’) or depersonalisation (feeling detached from yourself)
  • Fear of losing control or going crazy
  • Fear of dying
  • Numbness or tingling sensations
  • Chills or hot flushes

For panic attacks to become Panic Disorder, at least one of the panic attacks is followed by persistent worry about further panic attacks or their consequences (e.g., having a heart attack, embarrassment), and significant changes to a person’s behaviour to attempt to mitigate the chance of a panic attack (e.g., avoidance of places or situations). These must be present for one month or more.

How do we treat Panic?

Cognitive Behavioural Therapy (CBT) is an effective first-line treatment for panic attacks and panic disorder. Working with a psychologist, CBT teaches you to develop different ways of thinking and behaving in response to the feelings and sensations that come with a panic attack. Treatment for panic disorder also incorporates gradual exposure to bodily sensations and/or situations previously avoided due to panic attacks, with the goal of gradually decreasing the sensitivity of the anxiety system so that it is less frequently activated.

Other forms of therapy that are also effective in treating panic disorder include Acceptance and Commitment Therapy (ACT) and Mindfulness-based CBT. These strategies differ from traditional CBT in that they provide individuals with the tools to separate and distance themselves from their thoughts and feelings, and accept that these can be present without making a negative impact on their lives.


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