Panic Disorder

1) What it is

Panic Disorder is when you experience repeated panic attacks (sudden waves of intense fear) and develop an ongoing fear of having another one. This fear can lead to avoiding places, activities, or situations where panic attacks have occurred or might occur.

2) What it feels like

• “I feel like I’m going to die.”
• “I can’t breathe.”
• “I’m losing control.”
• “Something terrible is about to happen.”

3) Common signs & symptoms

• sudden racing heart, chest tightness, shaking
• sweating, dizziness, nausea
• feeling faint or detached from reality
• sensation of not being able to breathe
• fear of dying, collapsing, or “losing control”
• avoiding places where attacks have happened

4) Why it happens (causes & risk factors)

• high stress, overwhelm, long-term anxiety
• trauma or frightening experiences
• genetic vulnerability (can run in families)
• caffeine, alcohol, poor sleep
• major life changes (bereavement, job change, relationship difficulties)

5) Triggers

• bodily sensations (heart rate changes, breathlessness)
• stress and pressure
• lack of sleep
• stimulants such as caffeine
• certain places or situations linked to past attacks

6) What helps now (during a panic attack)

• panic reset breathing (1 minute):
  breathe in for 4 → hold for 2 → breathe out for 6 (repeat)
• grounding:
  name 5 things you can see, 4 you can feel, 3 you can hear, 2 you can smell, 1 you can taste
• cold shock support:
  hold an ice cube or splash cold water on the face
• remind yourself:
  “This is panic. It will pass. I am not in danger.”

7) Daily self-help support

• reduce common triggers (less caffeine, regular meals, stable sleep, reduced alcohol)
• keep a panic diary to identify patterns and triggers
• practise breathing and grounding daily, not only during attacks
• gently re-enter avoided situations at your own pace

8) Professional treatment options

• CBT for Panic Disorder (most common and effective)
• exposure therapy to reduce fear of sensations and situations
• GP support and referral pathways
• medication if needed, via GP

9) Medication

Medication may be prescribed to reduce panic frequency and intensity, particularly if anxiety is severe. This is usually combined with therapy and reviewed by a GP.

10) Practical tips

• panic symptoms are uncomfortable but not dangerous
• avoidance keeps panic going; gradual exposure reduces it
• progress comes from repetition, not perfection
• treat panic recovery as nervous system retraining

11) When to seek urgent help

Urgent help if:

• panic attacks are constant or escalating
• you feel unable to cope or function
• panic is accompanied by suicidal thoughts
• dissociation or fear becomes overwhelming

12) Where to get help (UK)

• NHS 111 (urgent advice)
• Samaritans 116 123 (24/7 support)
• Mind (information and local services)

‍