Panic Disorder

A severe, spontaneous form of anxiety that is recurrent and unpredictable. Most attacks last 2 to 10 minutes, but some may extend over an hour or two. This type of anxiety occurs with attack-like symptoms (often during sleep), while chronic anxiety (generalized anxiety) is a persistent state of anxiety.


Physical symptoms:

  • Palpitations, rapid heart beat; chest pains.
  • Shortness of breath; choking feeling; hyperventilation.
  • Fainting (occasionally).
  • Sweating and trembling.
  • Feeling of “butterflies in the stomach”.

Emotional symptoms:

  • Intense fear of losing one’s of reason (fear of going crazy).
  • Fear of dying.
  • Feelings of unreality, loss of contact with people and objects.


  • Most often an unresolved emotional conflict or unrecognized conflict. The physical symptoms are a result of the autonomic nervous system’s being set in motion by the arousal of frightening fantasies, impulses and emotions.
  • A variety of disorders can stimulate panic attacks (heart rhythm problems, angina, respiratory illness, asthma, obstructive pulmonary disease, endocrine disorders, seizure disorders, stimulating drugs, and withdrawal from certain drugs).


  • Stress.
  • Feelings of guilt.
  • Fatigue or overwork.
  • Illness.
  • Alcohol and/or drug abuse.


There are no specific measures to prevent a first panic attack; once diagnosed, therapy helps prevent additional episodes.


For many, this disorder may run a limited course with a few attacks and long periods of remission. For others, treatment with psychotherapy and/or medication is effective.


  • Chronic anxiety.
  • Phobias, including agoraphobia, a fear of being alone or being in public places.
  • Chronic depression.
  • Drug dependency.


  • Diagnosis is usually determined by patient history and interviews and a description of behavior by the patient, and the family and friends.
  • Treatment involves psychotherapy or counseling and/or medications. Psychotherapy may involve cognitive (which involves the way you think) or behavior (which focuses on the behavior itself) type therapy.
  • Talk to a friend or family member about your feelings. This sometimes defuses your anxious thoughts.
  • Keep a journal or diary about your anxious thoughts or emotions. Consider the causes and possible solutions.
  • Join a self-help group. Call your local mental health society for referrals.
  • Learn relaxation techniques. For some, meditation, a specific form of relaxation, is effective.
  • For hyperventilation symptoms, cover the mouth and nose with a small paper bag and breathe into it for a few minutes.


  • Get physical exercise regularly.
  • Get adequate rest at night.

Consider giving up caffeine (coffee, tea, soft drinks). You may experience withdrawal symptoms of headache or tiredness, but they stop in a few days.