Panic disorder

Panic disorder is when you keep having panic attacks, often with no obvious reason behind them.

Everyone feels anxious or panicky at some point in their life. It's a natural response when a situation is stressful or dangerous. But if you have panic disorder, these feelings of anxiety, stress and panic come on regularly, and they can come at any time.

A panic attack can be very frightening and distressing. The symptoms tend to come on suddenly, without warning, and often for no obvious reason.

Along with overwhelming anxiety, a panic attack can cause other symptoms, including:

• a sensation that your heart is beating irregularly (palpitations)
• sweating
• trembling
• hot flushes
• chills
• shortness of breath
• a choking sensation
• chest pain
• nausea
• dizziness
• feeling faint
• 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 sensation in your fingers
• shivering
• shaking

The physical symptoms are unpleasant, and you might also feel fear and terror. Because of this, people with panic disorder can start to dread the next attack. That creates a cycle of living in "fear of fear", which adds to the sense of panic.

• panic is affecting your daily life
• you're not looking after yourself
• you're finding it hard to manage any responsibilities you have

Find out how to get urgent help for your mental health

Sometimes the symptoms of a panic attack are so intense that you feel as if you're having a heart attack or you're dying.

Panic attacks can be frightening, but they don't cause any physical harm. People with panic disorder sometimes learn to recognise this "heart attack sensation". They may also become more aware of how to control their symptoms.

Most panic attacks last for 5 to 20 minutes. Some can last up to an hour. In those cases, though, it's likely that one attack came straight after another, or that high levels of anxiety kept going after the first attack.

Doctors don't fully understand the exact cause of panic disorder. It's thought to come from a mix of physical and psychological factors, such as:

• traumatic life experiences like bereavement
• having a close family member with panic disorder
• an imbalance of neurotransmitters (chemical messengers) in the brain
• over-breathing or hyperventilating
• catastrophic thinking

Everyone who has panic disorder will have panic attacks. But the reverse isn't true, because not everyone who has panic attacks has panic disorder.

Doctors will only diagnose panic disorder if your panic attacks keep coming back and happen unexpectedly. There's a second condition too. The attacks must be followed by at least one month of continuous worry or concern about having further attacks.

Your doctor will ask you to describe the symptoms you've been having. They'll also want to know how often the symptoms come and in what situations.

Tell the doctor how you've been feeling and how the symptoms have affected you. Talking about your feelings and personal life can be hard, but try not to feel anxious or embarrassed about it.

The doctor needs to understand your symptoms to make the right diagnosis of panic disorder. That helps them recommend the most appropriate treatment for you.

The aim of treatment for panic disorder is to cut down the number of panic attacks you have and to ease your symptoms.

The main treatments are talking therapies and medicine. Some people need only one of these, and others need both together. No single treatment works for everyone, so you may have to try a few different ones before you find the one that suits you.

Cognitive behavioural therapy (CBT) is one of the treatments used for panic disorder. You have regular sessions with a therapist, who can teach you ways of changing your behaviour so you can manage an attack when it comes.

If you and your doctor think it might help, you may be prescribed medicine for panic disorder. And if you ever want to stop taking a medicine you've been prescribed, talk to your doctor before you stop.

If your panic disorder symptoms don't get better after CBT, medicine and joining a support group, your doctor may send you to a mental health specialist. This could be a psychiatrist or a clinical psychologist.

The specialist will assess you and put together a treatment plan to help you manage your symptoms.

The next time you feel a panic attack coming on:

• stay where you are, if possible
• try to breathe slowly and deeply
• remind yourself that you're not in danger and the attack will pass

Fighting a panic attack can often make it worse. So during an attack, reassure yourself by accepting that it isn't life-threatening. Focus on the fact that it will eventually end, and try your best to let it pass.

Read more about how to deal with panic and anxiety

Try our self help guide. It's based on cognitive behavioural therapy and is meant to help you:

• understand panic and panic attacks
• understand symptoms of panic attacks and their purpose
• cope with panic attacks and make them less severe

Support groups can give you information and advice to help you manage your panic disorder. They're also a good way of meeting other people who've had similar experiences.

You might find these links useful:

• Mind: understanding anxiety and panic attacks
• SAMH: anxiety and panic attacks
• Young Scot's AyeFeel page all about anxiety
• NoPanic

Ask your doctor about support groups for panic disorder near you.

Find anxiety services in your area

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