Panic Disorder: Patient Information Leaflet

What is Panic Disorder?

Panic Disorder is characterized not simply by having panic attacks — which can occur in many anxiety and mood conditions — but by the pattern of recurrent, unexpected attacks combined with ongoing worry about having another one, or a significant change in behavior to avoid triggering an attack. This anticipatory anxiety and behavioral avoidance often become more disabling than the attacks themselves, and without treatment can narrow a person's life considerably as they avoid more and more situations.

Common symptoms of Panic Disorder

• Sudden surge of intense fear or discomfort peaking within minutes
• Palpitations, pounding heart, or accelerated heart rate
• Sweating, trembling, or shaking
• Shortness of breath or a smothering sensation
• Feelings of choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Dizziness, light-headedness, or feeling faint

What causes Panic Disorder?

Panic Disorder arises from a combination of genetic vulnerability and dysregulation of the brain's fear-alarm system, which misfires in the absence of real danger. Many first episodes follow a period of significant stress, a major loss, a physical illness, or, in some cases, substance use. Once an initial panic attack occurs, the person often develops a conditioned fear of the bodily sensations themselves (a racing heart, breathlessness) which can trigger a self-reinforcing cycle where fear of the sensations produces more of the sensations.

Treatment options for Panic Disorder

Cognitive Behavioral Therapy — particularly with an interoceptive exposure component (deliberately and safely provoking feared bodily sensations to break the fear-of-fear cycle) — is highly effective and considered first-line. Medication, usually an SSRI or SNRI, is commonly used alongside therapy or when therapy access is limited, especially for moderate-to-severe presentations.

Self-help tips for Panic Disorder

• Reduce or eliminate caffeine and stimulant intake
• Practice slow, diaphragmatic breathing regularly, not only during attacks
• Engage in regular aerobic exercise, which reduces overall anxiety sensitivity
• Avoid using alcohol to 'calm down,' which worsens the disorder over time
• Maintain a regular sleep schedule
• Gradually re-enter avoided situations rather than escalating avoidance

What is the outlook (prognosis) for Panic Disorder?

Panic Disorder responds very well to treatment, with most people achieving substantial reduction in attack frequency and severity within a few months. Left untreated, it frequently leads to agoraphobia and significant lifestyle restriction. Relapse can occur during stressful periods, but people who have learned CBT skills typically manage recurrences more effectively.