Panic disorder is an anxiety disorder where you regularly have 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.

But someone with panic disorder has feelings of anxiety, stress and panic regularly and at any time, often for no apparent reason.

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Symptoms of panic disorder

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Anxiety

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.

You may start to avoid certain situations because you fear they'll trigger another attack.

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.

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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 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 GP 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.

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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.

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. Psychoeducation is extremely important when working with panic disorder in addition to challenging any unhelpful thoughts around the condition. Exposure work is also utilised in panic disorder to gradually expose the person to feared situations and to document the outcome. With panic disorder, prolonged exposure if used, meaning the person exposes themselves to the feared situation until their distress levels reduce and they habituate.

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Things you can try yourself

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What to do during a panic attack

The next time you feel a panic attack coming on:

• do not fight it

• stay where you are, if possible

• breathe slowly and deeply

• remind yourself that the attack will pass

• focus on positive, peaceful and relaxing images

• remember it's not life threatening

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Preventing a further attack

It may help to:

• read a self-help book for anxiety based on the principles of cognitive behavioural therapy (CBT) 

• try complementary therapies such as massage and aromatherapy, or activities like yoga and pilates, to help you relax

• 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 all they can all make attacks worse

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