What is a Panic Disorder or Panic Attack?


At a glance:

  • A panic attack is a brief and intense feeling of terror or anxiety with corresponding physical symptoms of fear
  • An accelerated heart rate, trembling, shallow breathing, dizziness and muscle stiffness are all common physical symptoms of panic attacks
  • Panic attacks are quite a common type of anxiety condition, with up to 40% of people experiencing one during their lifetime
  • People who have frequent panic attacks are considered to have a Panic Disorder according to DSM-5
  • Without help, panic attacks and panic disorders can be severely debilitating 
  • Panic attacks are sometimes known as anxiety attacks, however anxiety attacks are not recognised as a diagnosis in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition)

A panic attack is a brief and intense feeling of terror or anxiety that includes the physical sensations of fear, such as a rapid heartbeat, tremors/trembling, muscle tension or shortness of breath . Panic attacks are typically classified as either expected or unexpected. Expected panic attacks have an identifiable trigger, whereas unexpected panic attacks can appear at any time.

According to Beyond Blue , a panic attack is a common mental health condition with up to 40% of the Australian population experiencing one at some time in their lives . Attacks can be frequent and are almost always unexpected as they can be triggered in the absence of an external threat. Individual attacks themselves may last from a few minutes to around half an hour, but the lingering effects and emotional stress can last a great deal longer.

Without help, panic attacks can become debilitating, prompting people who suffer them to self-isolate, as a way of avoiding any potential triggers, or simply out of fear of having an attack. 

What is a Panic Disorder?

While many people experience panic attacks under extreme stress or when suffering illness, people that have frequent panic attacks are considered to have a panic disorder. Panic Disorder is not as common as panic attacks but according to the Australian Psychological Society , around 5% of adults meet the criteria for having a panic disorder at some stage during their lives.

Women are more likely than men to develop panic disorders. The typical age of onset is around late adolescence to early adulthood, but panic disorders can manifest at any age.

 

No two panic attacks are the same, but people will typically experience a number of the following symptoms when an attack occurs: 

  • Accelerated, racing or hammering heart rate or heart palpitations
  • Chest constriction or pain
  • Breathing difficulties or shortness of breath
  • Muscle tension or stiffness
  • Tingling or pain in the hands and arms, combined with hammering heart and chest pains, can lead people having a panic attack to falsely believing they are having a heart attack
  • Hot flushes and sweating
  • Chills
  • Abdominal pain or nausea
  • Trembling or shaking
  • Lightheadedness or dizziness
  • A dry mouth
  • Irrational thinking including the fear of going mad, dying or losing control
  • Heightened sensitivity and awareness of physical symptoms
  • An overwhelming feeling of dread, unease or foreboding
  • Varying levels of disassociation, with a sense of unreality or detachment from the environment or from self

According to the DSM-5, a panic disorder is diagnosed when a person experiences one or more panic attacks followed by an ongoing period of stress over the possibilities of these recurring, with a marked change in behaviour intended to prevent another panic attack, such as self-isolation.


If you are experiencing panic attacks, or are feeling anticipatory stress at the prospect of having more, consider doing some work with a professional . One of the easiest ways to find and book an appointment with a therapist is online with MyHealth1st.


What Causes Panic Attacks?

No single cause has been identified as being the root cause of panic attacks or panic disorders but there are a number of risk factors that can increase the chance of having a panic attack or developing a panic disorder, including:

  • Genetic predisposition: People who have a first degree relative (mother, father, brother or sister) who has a panic disorder is more likely to develop a panic disorder.
  • Stressors: Stressors experienced in both childhood (developmental trauma) and adulthood can increase the risk of a person having panic attacks or developing a panic disorder. Childhood stressors include all forms of abuse as well as exposure to physical illness (both direct and indirect). Adult stressors include the death of a loved one, loss of job, financial distress, social conflict, alcohol or substance abuse, unhealthy relationships, illness and injury.
  • Brain Chemistry: Research suggests that the mechanisms in the brain that react to danger or fear may react differently in people with panic disorders, causing them to be activated by events or stimuli that do not pose any threat.
  • Personality: Much like other anxiety conditions, people with certain sensitive personality traits appear to have a higher chance of developing a panic condition. 
  • Substance Abuse: The use of stimulants, both legal and illegal can increase the risk of developing panic disorder and panic attacks. One cup of coffee is not a danger, but abuse of caffeine can post as much as a risk as illegal stimulants like cocaine when it comes to experiencing panic attacks.

 

Living with, and getting help for Panic Attacks 

There are a number of approaches available for people experiencing panic attacks or a panic disorder, including psychological treatment as well as medication. Lifestyle changes, including improving sleep quality, exercise and avoiding stimulants can also aid in the treatment of panic attacks and disorders.

One approach for the varying degrees of experiencing panic is Cognitive Behavioural Therapy (CBT) , and in particular the third wave of this being Acceptance & Behaviour Therapy (ACT) and Dialectical Behavioural Therapy (DBT) . These go beyond thoughts and feelings, and help a client be present to, and loosen the grip, on what they are experiencing. 

Psychoeducation around self-regulation ( mindfulness, breathing, muscles relaxation techniques ) and co-regulation (one-on-one resonance with another person- friend, partner or therapist) is important, as well as the ability to cultivate and grow self-compassion.

There are a number of other psychotherapeutic approaches to working with panic, including psychodynamic, solution focused, existential, narrative, Jungian and creative therapies.  Creative therapies are particularly helpful in going beyond the limitations of the mind, and connecting more fully with one’s psyche. 

If you are experiencing panic attacks, or are feeling anticipatory stress at the prospect of having more, consider doing some work with a professional . One of the easiest ways to find and book an appointment with a therapist is online with MyHealth1st.

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