Panic Disorder
Panic disorder involves recurrent, unexpected panic attacks, which are sudden episodes of intense fear with strong physical symptoms, along with ongoing worry about having more. A panic attack can feel frightening and disorienting, and many people first mistake one for a medical emergency, which is an understandable reaction to how intense the physical symptoms are.
Panic disorder responds well to treatment. This page covers what panic attacks and panic disorder look like, what tends to cause them, and how treatment works.
What are the symptoms of panic disorder?
A panic attack is a sudden surge of intense fear that peaks within minutes, with physical symptoms such as:
During an attack
- Racing or pounding heart
- Shortness of breath, or a feeling of choking
- Chest pain or discomfort
- Trembling, shaking or sweating
- Nausea or stomach distress
- Dizziness or light-headedness
- A feeling of unreality, or of being detached from yourself
- Fear of losing control, or fear of dying
Panic disorder specifically
- Recurrent, unexpected panic attacks
- Persistent worry about having another attack, or about its consequences
- Changing your behaviour to avoid triggering another attack, such as avoiding certain places or activities
Not everyone who has a panic attack has panic disorder. A single panic attack can happen to almost anyone under significant stress. Panic disorder is the recurring pattern plus the ongoing fear of future attacks.
What causes panic disorder?
There’s rarely a single cause. It tends to develop from a mix of factors.
Biological factors
Genetics and a heightened sensitivity to the physical sensations of anxiety appear to raise risk.
Life stress
Major stress or transitions often precede the first panic attack, though panic disorder can also develop with no obvious trigger.
Learned fear responses
After an initial attack, fear of the physical sensations themselves (a racing heart, say) can trigger a self-reinforcing cycle.
Other health conditions
Panic disorder can co-occur with other anxiety conditions, depression or certain medical conditions, which is part of why an initial assessment often rules out other explanations.
How is panic disorder treated?
Cognitive behavioural therapy (CBT)
A first-line, highly effective treatment, addressing both the catastrophic interpretations of physical sensations and the avoidance that maintains the condition.
Interoceptive exposure
A specific technique that safely and gradually brings on the physical sensations of panic in a controlled way, to reduce fear of the sensations themselves.
Breathing & relaxation techniques
Can help manage acute symptoms, usually most effective as part of broader treatment rather than on their own.
Medication
In some cases, medication from a GP or psychiatrist is used alongside therapy, particularly where symptoms are severe.
Panic disorder is one of the more responsive anxiety conditions to structured treatment, and many people improve substantially.
When should I see a psychologist about panic disorder?
You don’t need to wait until things feel unmanageable.
- Recurrent panic attacks
- Persistent worry about having another attack
- Avoiding places or situations for fear of triggering an attack
- Panic symptoms affecting your ability to go about daily life
- A first panic attack is also worth checking with a GP, since the physical symptoms can overlap with certain medical conditions, and ruling those out is reassuring
A GP can set you up with a Mental Health Care Plan under Medicare’s Better Access scheme, which covers a rebate for a set number of psychology sessions each year.
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Get matched with a psychologistFrequently asked questions
Is a panic attack dangerous?
Panic attacks are intensely uncomfortable and frightening but not medically dangerous in themselves. It’s still sensible to have a first panic attack checked by a GP to rule out other causes, since the symptoms can overlap with certain medical conditions.
How long does a panic attack last?
Panic attacks usually peak within about ten minutes and generally settle within twenty to thirty minutes, though residual anxiety or exhaustion can last longer.
Can panic disorder be cured?
It responds very well to treatment. Many people become largely or entirely free of panic attacks with structured therapy. Some continue to use the skills they’ve learned to manage occasional symptoms.
What’s the difference between a panic attack and an anxiety attack?
Anxiety attack isn’t a formal clinical term and is often used to describe a build-up of anxiety over time. A panic attack is a sudden surge of intense fear that peaks quickly, usually without a clear build-up.
Do I need a GP referral to see a psychologist for panic disorder?
No. A GP referral is only needed for a Medicare rebate through a Mental Health Care Plan, or if you’d like your first panic attack medically assessed.
Is online therapy effective for panic disorder?
Telehealth works well for panic disorder treatment, including CBT and exposure-based approaches, and is more convenient for many people.
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