Panic Disorder

What are panic attacks and Panic Disorder?

A panic attack can be extremely distressing and frightening. In a panic attack, strong physical sensations come on unexpectedly including (but not always) a racing or fluttering heartbeat, chest pain, feeling extremely hot, shaky, tingly, sick, faint, dizzy or disconnected, needing to go to the toilet, shortness of breath, dry mouth, or a feeling of dread. Panic attacks do not cause any physical harm.

Panic disorder is diagnosed based on the frequency of panic attacks, and the impact of the panic attacks or the fear of having them. In panic disorder, the problem has started to affect daily life, including significant changes to avoid having panic attacks such as staying at home, and avoiding crowded places or public transport. Avoiding places or focusing on the physical sensations can sometimes lead to noticing the sensations more, which keeps the problem going.

Panic disorder is estimated to affect 1.7% of the population, with a much larger number of people affected by panic attacks. People experiencing panic attacks are often unable to work and experience high levels of impairment in their daily lives.

Panic disorder is sometimes accompanied by Agoraphobia. Agoraphobia is a fear of being trapped or not being able to escape situations, or that help would not be available if needed. This can lead to avoidance of being in crowded places, using public transport or at its worst, people can become extremely isolated and never leave the house, or can only do so if accompanied.

Agoraphobia can often trigger many of the physiological symptoms associated with panic or can lead to panic attacks when the feeling of being trapped is activated.


Can treatment help?

The evidence-based treatment for panic disorder is Cognitive Behaviour Therapy (CBT). Panic problems can become very severe and restrict day to day life. A short course of CBT may be effective for less chronic or severe Panic Disorder, but for people experiencing the problem over a longer period of time, or who have additional anxiety problems, a longer or more intensive course of treatment may be required. The evidence based treatment is the same for panic that occurs with or without agoraphobia.


Aims of treatment

An assessment at OHSPIC will include use of standardised questionnaires that assess the severity of the problem, how it impacts on daily life, what thoughts and beliefs are associated with the problem, and an assessment of other difficulties.

Cognitive Behaviour Therapy (CBT) at OHSPIC includes:
• Working collaboratively; the goals of the sessions will be agreed between the person experiencing panic and the therapist.
• Building a comprehensive shared understanding of the problem
• Testing out beliefs about panic sensations
• Working on going out to places or doing activities that are currently avoided
• To gradually plan activities to restart a life less restricted by panic problems.

OHPSIC will liaise with local teams to ensure that the work on overcoming panic can successfully continue, including offering joint work and supervision. Home visits or out of office sessions will be included and encouraged as part of joint work with local teams.