A Panic Disorder is an anxiety disorder that is characterised by sudden attacks of fear and panic. Panic attacks can happen any time and for no apparent reason, but often they are triggered by fear-producing events or thoughts, such as taking an elevator or flying.
Panic attacks are quite common; most people will experience them from time to time, however, if they become frequent and start to dictate how you live your life, then it is considered to be a Panic Disorder.
This section deals with the complex issue of panic attacks, why they can happen and develop into a disorder and most importantly, what you can do about it.
What is Panic Disorder?
When we are exposed to a physical threat, our bodies automatically gear up for the fight- flight-freeze response. We become more alert, our heart starts racing, our muscles tense up, we sweat more, and breathe more rapidly.
These changes are designed to protect us from danger, but sometimes our fight-flight-freeze response is triggered out of the blue when there’s no real or immediate danger; this is what’s known as a panic attack.
Some people only get panic attacks occasionally, and they can be brought on by stress.
Panic disorder is when you have panic attacks quite often, say a couple of times a month or more, and you worry after each panic attack that you might have another one. You may even start having panic attacks about HAVING a panic attack.
It starts when the fight- flight-freeze response is too sensitive, like an overly sensitive car alarm that goes off at the wrong time. You can see there is no outside danger, so you start to assume that your physical symptoms are something more dangerous, a sign that your body isn’t working properly. You might start thinking things like, “I’m going crazy”, “I’m having a heart attack”, or “I’m going to die”. This type of thinking leads you to be even more anxious.
Once panic attacks develop into panic disorder, the affect on your life becomes massive. One of the very common issues that affect people with panic disorder is agoraphobia (fear of being helpless in a situation).
Sometimes people get so worried about having a panic attack that they start avoiding certain places or situations. Or they can only go into those situations with someone they trust. If you’ve found yourself avoiding crowds, being home alone, or not using public transport because it might be difficult to escape, you might have agoraphobia.
Agoraphobia can be really disabling and make it hard to do things that many people take for granted; for some people, agoraphobia can get so bad they have trouble even leaving their house without support.
Symptoms include fear and avoidance of places and situations that might cause feelings of panic, entrapment, helplessness or embarrassment.
Approximately one in thirty Kiwis will suffer from panic disorder at some point in their lives, and one in forty will experience agoraphobia. Many people with panic disorder and/or agoraphobia suffer from other mental health conditions as well. Over their lifetime, someone with one of these disorders is about four times more likely than the average person to have depression, and almost three times as likely to have a problem with drugs or alcohol.
What can I do about it?
One of the most effective treatments for panic disorder and agoraphobia is Cognitive Behavioural Therapy (CBT). This approach recognises that the way we think and act affects the way we feel. With the help of a therapist you will learn:
- More about your panic reactions and the fight- flight-freeze response.
- To challenge your fears and worries related to the physical symptoms you experience during a panic attack (e.g. fears of having a heart attack or going crazy).
- To face the situations that you’re afraid of or avoid, in a gradual and manageable way. This will allow you to return to the places or activities that you have been avoiding due to fears of having another panic attack.
- A range of relaxation and anxiety management strategies, like breathing retraining, to help you get control when you feel a panic attack coming on.
It is generally best to start with psychological treatment, however some people need a little extra help to get their anxiety under control, so your doctor might prescribe medication to help you manage.
When it comes to sourcing help:
- A doctor is always a good place to start when trying to overcome a panic disorder, as he or she can make referrals for specialists, and support your efforts with medications if necessary.
- This website has information on a range of professional care options that are available.
- Useful materials are available from the Anxiety New Zealand Trust(external link)