Panic Disorders

A panic attack is a period of intense fear or discomfort with four or more of the following symptoms listed below that develop very suddenly, apparently without warning and for no apparent reason (out of the blue). 

Symptoms can include:

  • a sensation that your heart is beating irregularly (palpitations) 
  • sweating 
  • trembling or shaking
  • sensations of shortness of breath or smothering
  • a feeling of choking 
  • chest pain or discomfort
  • nausea or churning stomach
  • feeling dizzy, unsteady, lightheaded or faint
  • feelings of unreality or being detached from yourself
  • fear of losing control or going crazy
  • a feeling of dread or fear of dying 
  • numbness, or pins and needles 
  • chills or hot flushes 

The physical symptoms of a panic attack are unpleasant, and they can also be very frightening and distressing.

For this reason, people with panic disorder start to fear the next attack, which creates a cycle of living in 'fear of fear' and adds to the sense of panic. Sometimes, the symptoms of a panic attack can be so intense they can make you feel like you are having a heart attack.

However, it is important to be aware that symptoms such as a racing heartbeat, or shortness of breath, will not result in you having a heart attack. Also, although a panic attack can often be frightening, it will not cause you any physical harm.

People who have had panic disorder for some time usually learn to recognise this 'heart attack sensation', and become more aware of how to control their symptoms. The symptoms of a panic attack usually peak within 10 minutes, with most attacks lasting for between 5 and 20 minutes. 

Some panic attacks have been reported to have lasted up to an hour. However, it is likely that the reason for this is due to one attack occurring straight after another or high levels of anxiety being felt after the first attack.

Recurrent panic attacks

People may have a panic attack just as a one-off experience. Other people though may have repeated, unexpected panic attacks, sometimes once or twice a month, or several times a week.

They may worry about having additional attacks and their consequences (for instance, 'I'll lose control') and, as a result, start to change their behaviour, for example, avoid using buses or trains because these are associated with panic attacks). This is seen as having a panic disorder.

Panic Disorder with Agoraphobia

Recurrent, unexpected panic attacks can be linked to agoraphobia for some people. You may be described as agoraphobic when:

1) You are anxious about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available if you have a Panic Attack or panic like symptoms. Situations where this can happen include being outside the home alone; being in a crowd; being on a bridge; and travelling in a bus, train or car.

2) You avoid the situations or travel, or put up with them with a lot of distress or anxiety about having a Panic Attack or panic like symptoms, or you need someone to be with you in these situations.

3) This is not about avoiding social situations for fear of emabarrassment (which may be a social phobia) or avoiding specific objects or situations (which may be a specific phobia) or avoiding something like dirt (which may reflect an obsessive compulsive disorder)  or avoiding reminders of a traumatic or stressful event (which may be post traumatic stress disorder) or feeling anxious about leaving home or family (which may be separation anxiety).

The following short video from NHS Choices describes the symptoms of panic disorder, the treatments available, and what to do if someone you know has a panic attack.


Treating Panic Disorders

The treatments of choice for panic disorder are Cognitive Behavioural Therapy (CBT) or medication.

CBT offers strategies for:

1) learning to 'face the fear' through gradual exposure; and

2) coping with the physical, cognitive and emotional aspects of panic through providing information and education about our fear responses and using techniques such as self monitoring, identifying and changing triggers to panic, breathing retraining / relaxation, changing your thoughts to correct catastrophic misinterpretations of bodily sensations, and getting rid of ‘safety behaviours’ such as always taking a bottle of water with you.

Accessing Talking Therapies in Wirral

If you feel that panic attacks are affecting your quality of life, please talk to your GP about a referral to our service. You might find it helpful to read our self-help guide to coping with Panic or to visit the NHS Choices website for more information on Panic Disorder.

We work from GP practices and other community locations across Wirral, and our aim is to provide the help you need in convenient locations within easy reach of where you live or work.

There's more information about how to access our service via your GP and what happens next in a step by step way in the 'Your Inclusion Matters' section of our website.

 

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