Understanding panic disorder

What is panic disorder?

While everyone experiences feelings of anxiety from time to time, and about 13% of people in the UK have experienced a panic attack at some point in their lives, some experience both on an ongoing basis.

About 2% of UK adults live with a diagnosable panic disorder, which is characterised by:

  • Frequent, unexpected panic attacks which aren’t related to a specific threat or event. Some people will experience these attacks once or twice a month while others might experience them on a daily basis.
  • Constant worries about having another panic attack.
  • A change in behaviour designed to avoid further panic attacks. For example, some people might avoid activities such as driving, shopping or social situations entirely.

For people with panic disorder, life can feel very difficult and stressful. The condition can cause serious disruption to social, family and working life with two specific challenges involved:

  • Anticipatory anxiety

In between panic attacks, the person can often feel overwhelmed by fear, as if they are waiting for ‘the shoe to drop’. This fear can take over to the point where it causes issues with sleeping, headaches, stomach problems and other stress-related health issues, and if left unsupported, other mental health conditions such as depression.

  • Phobic avoidance

The person living with panic disorder may begin to avoid certain situations or places for fear of having another panic attack. Taken to its extreme, some people with panic disorder develop conditions such as agoraphobia meaning that they find it difficult, if not impossible, to leave their home or another place they feel safe.

Who is at risk of panic disorder?

Although symptoms of panic disorder typically emerge during the late teens or early adulthood, people can develop the condition at any age. More women than men have a diagnosis of panic disorder, but men are affected too despite the fact that we’re unsure of the exact gender split.

Factors that may increase the risk of developing panic attacks or panic disorder include:

  • A family history of anxiety, panic attacks or panic disorder
  • Major life stress, such as the death or serious illness of a loved one
  • A traumatic event, such as an assault or a serious accident
  • Major life changes like divorce, separation or bankruptcy
  • Lifestyle factors including substance misuse, cigarette smoking, or a diet high in sugar or caffeine
  • A history of trauma during childhood.

When to see your GP

It’s important to speak to your GP about your panic attacks as soon as possible, especially if you are experiencing them more frequently, or if you’re starting to avoid certain situations for fear of having another. Your GP will ask you about your health history. Some physical health conditions such as those related to the heart or respiratory system can mimic panic attack symptoms as can very low blood pressure. As a result, your GP may run some tests to rule out any underlying health problems. He or she will also ask you about your diet, sleep and any substances you use.

A diagnosis of panic disorder may be made after recurrent and unexpected panic attacks followed by at least a month of continuous worry or concern about having further attacks.

Treatments for panic disorder

The aim of treatment is to reduce the number of panic attacks you experience, and ease anxiety-related symptoms, with the goal of recovery the focus. Your GP will determine the best course of action for your particular circumstances.

Talking treatments

There are a few types of talking treatment recommended for anxiety and panic and your GP will be able to discuss these with you.

  • Cognitive behavioural therapy (CBT) focuses on how your thoughts, beliefs and attitudes affect your feelings and behaviour. CBT teaches you how to understand possible triggers and how to cope with panic attacks and anxiety. Your therapist can teach you ways of changing your behaviour, such as breathing techniques to help you keep calm during an attack.
  • Applied relaxation therapy (ART) involves working with a specialist ART practitioner to learn how to relax your muscles in situations where you normally experience anxiety.
  • Exposure therapy can be helpful for people who have come to avoid particular situations for fear of having a panic attack (agoraphobia). Exposure therapy helps by supporting you to face (in a controlled manner) the situation which concerns you most until the feelings of panic begin to subside. Through this experience, you gradually learn that the situation isn’t harmful and that you ultimately have control over your emotions in relation to your individual response to the situation you are presented with.

It’s important to stay in touch with your GP regularly while you’re having therapy so they can assess your progress and see how you’re doing.

Medication

Depending on the severity of your symptoms and other factors, your doctor might suggest medication to help ease your symptoms. It’s common to engage in talking therapy and self-help techniques while taking medication.

Self-help

Lifestyle changes can help to manage anxiety and reduce the chances of having further panic attacks. Your GP might suggest that you:

  • Reduce sugar and caffeine in your diet
  • Reduce your intake of processed foods
  • Practice good sleep hygiene
  • Get some exercise every day
  • Write down your worries in a private journal – sometimes when we put pen to paper, we can assess things more clearly and feel more in control
  • Learn more about anxiety and how it can be managed through self-guided support 
  • Use techniques designed to help you to relax such as yogaprogressive muscle relaxation, or mindfulness
  • Talk to a trusted friend or family member about your worries as they arise
  • Speak to a charity specialising in anxiety, panic attacks and panic disorder. 

When is a referral to a specialist needed?

If your symptoms do not improve, or worsen, despite treatment, your GP may refer you to a mental health specialist such as a psychiatrist or clinical psychologist. The specialist will carry out an assessment of your condition and devise a treatment plan to help you manage your symptoms.

For additional support, please take a look at our other articles:

Useful resources

For adults and young people

No Panic 

 

nopanic.org.uk 

 

0844 967 4848 

  • A confidential helpline for anyone experiencing panic attacks, panic disorder, phobias, obsessive compulsive disorder, or other anxiety disorders.

  • Advice and guidance for those supporting someone who experiences any form of anxiety disorder.

  • Downloadable information on all aspects of anxiety, including specific tools to help people manage panic attacks.

  • Information on treatment including counselling, self-help and relaxation techniques.

For adults and young people

Anxiety UK

 

anxietyuk.org.uk

 

03444 775 774

 

  • A confidential helpline for anyone experiencing anxiety.

  • Advice and guidance for those supporting someone who experiences anxiety.

  • Downloadable information on all aspects of anxiety.

  • Signposting to treatment including counselling.

For adults

Anxiety Care

 

anxietycare.org.uk

 

Online only

  • Online guidance for anyone who experiences anxiety and wants information to help them recover.

  • Downloadable information on all aspects of anxiety disorders.

  • Information on treatment including counselling, self-help and relaxation techniques.

For adults

No More Panic

 

nomorepanic.co.uk

 

Online only

  • Online guidance for anyone who experiences anxiety and wants information to help them recover.

  • Downloadable information on all aspects of anxiety disorders.

  • Information on treatment including counselling and self-help.

  • An online chatroom facility and other forums.