What is Panic Disorder?

Imagine sitting at your desk at work, it’s just another day at your 9-5 job. You’ve checked your emails and you’re about to move on to your first project of the day when out of the blue your heart begins racing, you start hyperventilating, you feel dizzy and your entire body begins to tremble. You somehow manage to make your way to the bathroom because you feel as if you might throw up but by the time you get there the sensations have ceased. This scenario is not uncommon by any stretch of the imagination and for people who have panic disorder it can be a regular occurrence.

What is Panic Disorder?

Panic disorder (PD) is an anxiety disorder based primarily on the occurrence of recurrent and unexpected panic attacks. People often mistake panic attacks for heart attacks; particularly if it is the first time they have experienced one due to the physical manifestations that often accompany it.According to the DSM-5 PD is characterised by:Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and during which time four (or more) of the following symptoms occur:

• Palpitations, pounding heart, or accelerated 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, light‐headed, or faint

• Chills or heat sensations

• Paresthesias (numbness or tingling sensations)

• Derealisation (feelings of unreality) or depersonalisation (being

• detached from oneself)

• Fear of losing control or “going crazy”

• Fear of dying

At least one of the attacks must have been followed by at least one month of one or both of the following

• Persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, “going crazy”).

• A significant maladaptive change in behaviour related to the attacks (e.g., behaviours designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations)

These symptoms must not be attributable to substance use or another medical condition and cannot be better explained by another mental disorder. Often people may also begin to worry that they will experience another attack and so their levels of anxiety and avoidance may increase in an insidious loop.

What Causes Panic Disorder?

Genetics: Although it has not been determined whether there is a specific gene that contributes to PD, family studies suggest that there is a significant genetic component to PD, with twins sharing many similarities in their development of PD. Furthermore, some medical conditions such as hyperthyroidism, cardiac arrhythmias and asthma are also associated with PD.

Environment: As with most mental illnesses, there is often a combination of both genetic and environmental influence that contributes to its development. Studies have found that trauma (or particularly stressful life events) and abuse, particularly early on in life may contribute to the onset of PD later on. This may include the death of a parental figure, separation from parents, parent’s alcohol abuse, a childhood illness, family violence, sexual abuse among a range of other factors.

Psychological: From a psychological perspective there are particular traits that may predispose individuals to PD. People who are highly perfectionistic for example, may be more likely to experience PD due to the pressure they put on themselves in different domains of life. Other characteristics that are common among people with PD include a lack of self-confidence, emotional instability, being sensitive to criticism and dependency.

What are the treatment options?

There are generally two main types of treatment for PD – psychological treatment or medication.

Psychological treatments in the form of different types of therapy such as cognitive behavioural therapy (CBT), acceptance and commitment therapy (ACT), and psycho-education around mindfulness, relaxation and breathing techniques can be useful.

Medications that are designed to focus on reducing tension, promoting relaxation or increasing the levels of serotonin (a neurotransmitter that helps in regulating our mood) in the brain.If you are struggling with PD it is important that you reach out for help through both formal supports (such as your GP, psychologist or psychiatrist) and/or informal supports (such as friends and family).

PD can be a difficult and debilitating mental illness to deal with however there is a range of effective treatments for it and recovery is a very likely outcome.