Panic Disorder

Panic disorder is a mental health condition characterised by recurrent, unexpected panic attacks — sudden episodes of intense fear accompanied by physical symptoms — along with persistent worry about having further attacks.

• Sudden episodes of intense fear or discomfort that peak within minutes
• Physical symptoms during an attack: rapid heartbeat, sweating, trembling, shortness of breath, chest discomfort, dizziness, or a feeling of choking
• A sense of losing control, going crazy, or dying during an attack
• Persistent worry about having future attacks, or avoidance of situations where attacks have occurred, which can significantly limit daily activities

• Believed to result from a combination of genetic, biological, and psychological factors affecting the body's fear and stress response systems.
• Family history of panic disorder or other anxiety conditions increases risk.
• Significant life stress can trigger the onset or worsening of panic attacks, though the underlying vulnerability is not caused by stress alone.

• Diagnosed through a detailed clinical history of recurrent, unexpected panic attacks together with ongoing worry about future attacks or significant behaviour change (such as avoidance) related to this worry.
• Physical causes of similar symptoms, such as thyroid problems or heart conditions, are considered and excluded, particularly if physical symptoms are prominent, since panic attacks can closely mimic other medical emergencies.

Cognitive behavioural therapy is an effective, evidence-based first-line treatment, helping people understand and reduce the fear response associated with panic attacks and address any avoidance behaviour.

For moderate to severe symptoms, or when therapy access is limited, an antidepressant medicine (commonly an SSRI) may be used, generally continued for a period even after symptoms improve to reduce relapse risk.

Learning specific breathing and relaxation techniques can help manage symptoms during an acute panic attack.

Gradual, supported exposure to avoided situations, as part of therapy, helps reduce the impact of the condition on daily life over time.

• Learn and practise relaxation and breathing techniques to help manage acute symptoms.
• Limit caffeine and stimulant intake, which can trigger or worsen panic symptoms in some people.
• Avoid avoiding situations associated with past attacks where possible, as ongoing avoidance tends to reinforce the condition over time.
• Seek support early from a health worker or counsellor rather than waiting for the condition to significantly limit daily activities.