Panic disorder - A brief introduction

Experiencing feelings and physical sensations of panic, anxiety, worry or fear will happen to us all at some point. It is a natural reaction to certain situations which are either dangerous or stressful. However for some people, these feelings can be intensified to almost paralysing levels. This article aims to give a brief explanation of panic disorder, explain how it begins, and talk about what causes it. I also aim to look at the symptoms of panic disorder and discuss treatment and self-help for panic disorder.

What is panic disorder?

Panic disorder is one of several anxiety disorders, such as generalised anxiety disorder, obsessive compulsive disorder and post-traumatic stress disorder. Put simply, panic disorder is where an individual has reoccurring and regular panic attacks which can often appear for no apparent reason, and without warning. Feelings of anxiety of fear will often be present and can at points be crippling. Those who experience panic disorder will be plagued by intense periods of terror and anxiety and the time spent in between attacks is a highly stressful time because a sufferer will be living in fear of another attack occurring.

The beginnings of panic disorder

As mentioned above, feeling anxious, fearful or nervous are all normal human reactions, and most of us will experience a panic attack at some point and find ourselves overwhelmed, but we will for the most part recover, move on and manage these experiences. However, for some people this is not possible. The development of panic disorder comes from a panic attack or series of panic attacks which got out of control, and became unmanageable. Times of increased stress can mean that one panic attack cannot be managed, and escalates to increased attacks with more frequency.

What causes panic disorder?

The direct cause of panic attacks or panic disorder are not known, and can vary from person to person, however, there is evidence to suggest that it can run in families, or can be triggered through major life changes, upheaval or transitions. For example, finishing university, getting married or the end of a long term relationship. As well as the aforementioned causes, high levels of stress are often associated with panic disorder, and the attacks and episodes of panic could be viewed as a physical release of built up anxiety, tension and fear.

Traumatic life experiences can also play a role in the development of panic disorder. Experiencing something distressing or traumatic in your past, such as sexual or physical abuse or a traumatic or sudden loss, can contribute to high levels of anxiety, which in turn can develop into an anxious disorder.

What are the symptoms of panic disorder?

For those experiencing panic disorder, the symptoms and effects can be incredibly frightening, disturbing and distressing. During these episodes people can experience huge levels of dread and it can feel for people as if they are literally going to die. This feeling is increased dramatically due to the sudden nature of the attacks, and how they occur with little warning, and can happen in any setting, even when spending time in an environment which would usually be safe and secure, such as being at home.

One of the key symptoms of panic disorder is the fear of future attacks, known as anticipatory attacks. The fear of having another creates a cycle of fear, which serves only to reinforce the already existing high levels of fear and anxiety. This can lead to very low confidence, and can severely restrict a person’s day to day life, and impact on their ability to function.

In addition to the thoughts and feelings experienced by people with panic disorder, the body is also impacted physically. People may experience bodily sensations similar to a heart attack, which if not experienced before can be incredibly scary. People who may have lived with panic disorder for some time may develop an ability to recognise these sensations and know that they will not create any physical harm despite being uncomfortable. Some common physical symptoms of panic disorder are listed below.

  • The sensation that your heart is beating irregularly (palpitations).
  • Excessive sweating.
  • Trembling or shaking.
  • Hot flushes or chills.
  • Shortness of breath.
  • Feeling as if you are choking.
  • Pains in your chest.
  • Nausea or dizziness.
  • Feeling numb or experiencing pins and needles.
  • A need to go to the toilet.
  • Ringing in the ears or tingling sensation in the fingers.

Treatment and self-help

Cognitive behavioural therapy is viewed as the most successful way of treating people with panic disorder because it seeks to explore and modify our thoughts, feelings, ideas and attitudes as well as our behaviours. CBT aims to get to the underlying causes of panic disorder, so that they can be explored and dealt with, through offering the sufferer practical coping techniques to manage their disorder. These techniques could include teaching breathing exercises which can be undertaken during the onset of an episode of panic, or techniques which address managing anxiety generally. The end result with a course of CBT is to allow the person to live a more independent life free from their panic disorder.

In addition to CBT, there are also ways in which people can manage their own panic disorder. Listed below are some examples.


  • Remind yourself that even though the feelings you are experiencing are frightening, they will pass. Try to focus on something non-threatening during an episode.

Slow your breathing

  • Try breathing slowly and deeply while counting to three on each breath in and out.

Challenge your fears

  • Identify the fear and challenge it, remind yourself that the fear is momentary, and that it will pass.

Don’t fight against the attack

  • Although it may seem embarrassing, and your symptoms may be difficult to deal with, the attack isn't life-threatening. Focus on the fact that the attack will eventually end.


  • Relaxation techniques such as yoga, aromatherapy or Pilates can assist you in managing every day levels of anxiety.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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London N6 & NW5
Written by Joshua Miles, BA, MSc, BPC, BACP Accredited Psychodynamic Psychotherapist
London N6 & NW5

Joshua's an experienced Integrative Therapist who's worked with people to develop techniques to manage anxiety, panic attacks & overwhelming feelings of worry. He has assisted people in gaining deeper understanding of the underlying reasons behind their anxieties. He also works with loneliness, bereavement & depression. He's based in Shoreditch.

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