A panic attack occurs when a person experiences an abrupt surge of intense fear or discomfort that peaks within minutes. During this time, four or more of the following symptoms will occur:
- Racing heart
- Sweating
- Shaking
- Breathing difficulties
- Feelings of choking
- Chest pain or discomfort
- Nausea or stomach pains
- Feeling light headed
- Chills or hot flushes
- Numbness or tingling
- Feelings of unreality or detachment from the self
- Fear of losing control
- Fear of dying
Panic Disorder will be diagnosed when at least one panic attack has been followed by repeated concern or worry about having another panic attack or some other consequence related to the panic attack (e.g. dying, heart attack), as well as significant changes in behaviour in response to this that have impaired daily functioning.
People with panic disorder often use unhelpful coping strategies to manage their fear of panic, such as:
- Total avoidance of feared situations (e.g. novel situations, crowds, enclosed spaces).
- Avoiding activities that produce physical arousal (e.g. exercise)
- Avoiding engaging in feared situations (e.g. attending a party but avoiding engaging with others in case a panic attack occurs).
- Leaving feared situations before anxiety and panic symptoms peak.
- Only entering feared situations with ‘safety behaviours’ (e.g. always carrying a paper bag, always having medication available, sticking with a safe person who can assist if a panic attack occurs).
- Relying on substances (e.g. alcohol, medication) to reduce or prevent panic symptoms.
Often these strategies are helpful in the short term but, in the long term, they maintain panic disorder and other problems (e.g. loneliness, substance abuse, depressed mood).
How common is panic disorder?
Approximately 5% of Australians will experience panic disorder in their lifetime. It is estimated that slightly more women than men have panic disorder. The disorder usually develops when people are in their early to mid-20s or in mid-life, and it is rarer in older people and children.
How are Panic Attacks and Panic Disorder diagnosed?
A GP may notice that a person is having panic attacks if they continue to report ‘episodes’ involving the physical symptoms listed above, however, no physical cause can be found. Often patients will present to a hospital emergency department several times with concerns about having a heart attack or stroke, when they are actually having a panic attack. It may not be until potential physical causes are ruled out that a panic attack is diagnosed.
If you believe you may be experiencing panic attacks, it is important to talk to your GP. Your GP should conduct a comprehensive medical examination to ensure that another health problem is not causing the symptoms. The doctor may refer you to a mental health specialist, such as a psychologist, for further assessment and treatment.
How is Panic Disorder treated?
Cognitive Behavioural Therapy (CBT)
The main treatment used for panic disorder is CBT. The focus of CBT is to address unhelpful and unrealistic thoughts that cause and maintain the fear of panic, as well as to identify and eliminate unhelpful behaviours that maintain negative beliefs and anxiety/panic responses.
The key component of CBT for panic disorder is interoceptive exposure. This is designed to test the reality and helpfulness of the beliefs and behaviours that maintain the fear of panic – mainly the notion that a panic attack is dangerous. Thus, the ultimate goal of exposure is for the client to learn that panic is a safe and tolerable response that need not be feared or avoided, particularly as the consequences of avoidance are often more costly than fully experiencing the anxiety and panic whilst engaging in the feared situation.
More resources here: The 10 best anxiety management techniques, apps for anxiety and stress and panic attack tip sheet
Medication
Some doctors may prescribe anti-anxiety medications for patients to use regularly or as-needed in order to reduce their avoidance of feared situations – being able to take medication if needed tends to decrease avoidance behaviours related to potential panic attacks.
Finding assistance
If you live in Canberra and feel that you may be suffering from problems with panic attacks, you can contact Strategic Psychology to arrange to see one of our psychologists. We can assist you to identify the issues that are causing and maintaining your difficulties and recommend strategies that draw on your strengths in order to achieve optimal social, emotional and academic functioning.
No referral is required in order to see one of our psychologists, however, you can contact your GP for a referral under Medicare (if eligible) to receive a rebate on services provided.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Washington, D.C.: American Psychiatric Association.
Beyond Blue. (2015). Panic Disorder. Retrieved from the Beyond Blue website: http://www.beyondblue.org.au/the-facts/anxiety/types-of-anxiety/panic-disorder