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Panic disorder is much more common than is generally recognised and affects a large proportion of the population. The core symptom of panic disorder is a panic attack. Those with panic disorder suffer from terror, which strikes suddenly without warning. Fearing when the next attack will occur causes persistent worrying and intense anxiety between attacks.


Symptoms of Panic often accompany other  disorders such as are depression , OCD, PTSD and drug or alcohol abuse. Sufferers will also avoid situations where they fear an attack may occur, thus interfering with their everyday life. At the most severe end of the scale, sufferers may become housebound and the condition agoraphobia may develop. However, early treatment of panic disorder can often prevent this.


What is a panic attack?

A panic attack is a severe attack of anxiety and fear which occurs suddenly, often without warning, and for no apparent reason. In addition to the anxiety, various other symptoms may also occur during a panic attack. These include one or more of the following:


  • Palpitations or a thumping heart.      

  • Sweating and trembling.       

  • Hot flushes or chills.      

  • Feeling short of breath, sometimes with choking sensations.      

  • Chest pains.      

  • Feeling sick, dizzy, or faint.      

  • Fear of dying or going crazy.      

  • Numbness, or pins and needles.      

  • Feelings of unreality, or being detached from yourself.


The physical symptoms that occur with panic attacks do not mean there is a physical problem with the heart, chest, etc. The symptoms mainly occur because of an overdrive of nervous impulses from the brain to various parts of the body during a panic attack.

During a panic attack you tend to over-breathe (hyperventilate). If you over-breathe you blow out too much carbon dioxide which changes the acidity in the blood. This can then cause more symptoms such as confusion and cramps, and make palpitations, dizziness, and pins and needles worse. This can make the attack seem even more frightening, and make you over-breathe even more, and so on. A panic attack usually lasts 5-10 minutes, but sometimes they come in waves for up to two hours.


What is panic disorder?

At least 1 in 10 people have occasional panic attacks. If you have panic disorder it means that you have recurring panic attacks. The frequency of attacks can vary. About 1 in 50 people have panic disorder. If you have panic disorder, you also have ongoing worry about having further attacks and/or worry about the symptoms that you get during attacks. For example, you may worry that the palpitations or chest pains that you get with panic attacks are due to a serious heart problem. Some people worry that they may die during a panic attack.

What causes panic attacks?

Panic attacks usually occur for no apparent reason. The cause is not clear. Slight abnormalities in the balance of some brain chemicals

(neurotransmitters) may play a role. This is probably why medicines used for treatment work well. Anyone can have a panic attack, but they also tend to run in some families. Stressful life events such as bereavement may sometimes trigger a panic attack.

Panic disorder, agoraphobia and other fears Some people with panic disorder worry about having a panic attack in a public place where it is difficult to get out of, or where help may not be available, or where it can be embarrassing. This may cause you to develop agoraphobia. About 1 in 3 people with panic disorder also develop agoraphobia. If you have agoraphobia you have a number of fears of various places and situations. So, for example, you may be afraid to:


  • Be in an open place.        

  • Enter shops, crowds, and public places.        

  • Travel in trains, buses, or planes.     

  • Be on a bridge or in a lift.      

  • Be in a cinema, restaurant, etc where there is no easy exit.        

  • Be anywhere far from your home - many people with agoraphobia stay inside their home for most or all of the time.

  • You may also develop other irrational fears. For example, you may think that exercise or certain foods cause the panic attacks. Because of this you may fear (develop a phobia) for certain foods, or avoid exercise, etc.


Cognitive therapy is based on the idea that certain ways of thinking can trigger, or fuel, certain mental health problems such as panic attacks and agoraphobia. The therapist helps you to understand your current thought patterns. In particular, to identify any harmful, unhelpful, and false ideas or thoughts which you have. For example, the ideas that you may have at the beginning of a panic attack, wrong beliefs about the physical symptoms, how you react to the symptoms, etc The aim is then to change your ways of thinking to avoid these ideas. Also, to help your thought patterns to be more realistic and helpful. Therapy is usually done in weekly sessions of about 50 minutes each, for several weeks.


Behavioural therapy aims to change behaviours which are harmful or not helpful. This may be particularly useful if you have agoraphobia with panic disorder where you avoid various situations or places. The therapist also teaches you how to control anxiety when you face up to the feared situations and places. For example, by using breathing techniques.


Cognitive behavioural therapy (CBT) is a mixture of the two where you may benefit from changing both thoughts and behaviours. If you have CBT and it works, the long-term outlook may be better than with treatment with antidepressants. However, CBT may not be available in every area, and does not suit everyone.

Find out more at Swindon Counselling & Advice Service

Panic & Panic Attacks

Generally the most effective means of panic disorder treatment is counselling, and the application of cognitive behavioural therapy (CBT). This approach has long-term benefits and will also help to tackle complications that develop from panic disorder such as agoraphobia. In CBT sessions, therapists will work with clients to focus on the negative thinking patterns and behaviours that are triggering or sustaining panic attacks. By helping you to see your fears in a more realistic light, CBT can teach you new coping skills, which will make it easier to deal with future panic attacks. For example, your therapist may teach you breathing techniques that can be used to help keep you calm during the stress of a panic attack.

Find out more about panic and panic attacks.

Counselling for Panic and Panic Attacks in Swindon