All Conditions

Panic Disorder.

Sudden, debilitating attacks of intense fear that come without warning.

Panic disorder is an anxiety disorder that is marked by the presence of sudden and unexpected panic attacks. In panic disorder, these attacks are not caused by another physical condition, although they can feel like a heart attack at times. A panic attack is usually experienced as a heightened state of anxiety that can come along with chest pain, shortness of breath, racing heartbeat, sweating, trembling and numbness etc. You may feel terrified when you don’t know what is happening to you and sometimes people fear they are going to die when they have a panic attack. These feelings and accompanying thoughts may peak at around ten minutes and tend to die down in a total of fifteen to twenty minutes. However, since panic attacks can come on unexpectedly and feel so debilitating, people who get these attacks develop a fear of getting an attack at any time and fear that they will be embarrassed or they won’t be able to get help or that their panic attack will actually turn into a heart attack next time. In this way, the anxiety of a panic disorder can become a loop that is difficult to break on your own.

When to seek help

If you have ever experienced panic attacks and you live in fear of getting more panic attacks or tend to avoid situations that may trigger one, it is important to talk to a professional. Untreated panic disorder can lead to a worsening quality of life and even suicidal ideation. This condition can be well-managed with a combination of therapy and medications.

How we can help

Common questions

Is a panic attack dangerous? It feels like I'm having a heart attack.
A panic attack is intensely uncomfortable, but it is not physically dangerous. Your heart will not stop, and you will not suffocate. The symptoms (chest pain, racing heart, shortness of breath, dizziness, tingling, a sense of unreality) are caused by a sudden surge of stress hormones and by hyperventilation, not by anything wrong with the heart or lungs. With that said, if this is your first attack, or if your symptoms differ from your usual pattern, it is sensible to get a medical assessment to rule out cardiac or other causes.
What's the difference between a panic attack and panic disorder?
A panic attack is a single episode. Many people have one or two over the course of a lifetime, often during stressful periods. Panic disorder is the diagnosis when you have recurrent unexpected attacks together with persistent worry about more attacks, or behaviour changes (avoiding particular places, situations, or activities) intended to prevent them. The avoidance is often what causes the most life impairment, and some people end up avoiding so many things that they develop agoraphobia.
What works for panic disorder?
Cognitive behavioural therapy with interoceptive exposure has the strongest evidence base. It deliberately and gradually exposes you to the physical sensations of panic, including rapid breathing, dizziness, and a racing heart, so that your nervous system learns these sensations are not dangerous [1]. Medication (SSRIs first-line, with benzodiazepines reserved for short-term acute use) is also effective. The combination usually works fastest. Most people see substantial improvement within twelve to sixteen weeks of focused treatment [2].
Should I avoid caffeine and exercise if they trigger panic?
Long-term avoidance is usually counterproductive. Avoiding the sensations reinforces the brain's signal that they are dangerous, which makes panic more likely over time. Many CBT protocols deliberately use exercise and caffeine as part of exposure work, in order to help you become familiar with the racing heart and breathlessness in a safe context. That said, in the early stages of treatment a clinician may suggest temporary moderation, especially of caffeine, while you build tolerance to the sensations through structured exposure.