A panic attack is an episode in which you may overwhelmingly feel intense fear and anxiety and experience physical symptoms of anxiety. It generally starts suddenly and manifests through both physical symptoms and thoughts.

Panic attack symptoms can happen at any time and usually develop rapidly. Panic episodes can leave you feeling exhausted. Some of the symptoms include:

• heart palpitations
• dizziness
• sweating
• feelings of choking
• feeling short of breath
• trembling or shaking
• chest pain
• nausea
• feeling that you are not experiencing yourself or reality normally
• fear of losing control or going crazy
• fear of dying
• chills and hot flushes
• tingling in the fingers and toes.

Having an isolated panic attack does not necessarily mean that you have a panic disorder. People with panic disorder experience repeated panic attacks to the point that they disrupt their life. People with panic disorder also live in constant fear of having another panic attack and start changing their behaviours and start avoiding certain places.

Although panic attacks can occur when a person comes into contact with a particular situation, such as public speaking, they can also occur out of the blue. When these keep happening, and the person has become fearful of them occurring again, they may be diagnosed by a mental health practitioner as having panic disorder. Some people are affected so much by the fear of another unexpected panic attack that they may start to avoid certain situations that they perceive as places where they may panic and be unable to escape or get help (e.g. crowds, public transport, elevators). This avoidance is called agoraphobia.

The physiological reactions which people with panic disorder become fearful of are caused by the body’s natural alarm system when it believes it is under attack – the fight-flight-freeze response.

The symptoms of panic are the result of changes the body makes to increase your chance of survival if a predator is attacking you. For example, the increase in heart rate allows more blood and oxygen to be pumped around the body. Similarly, the feelings of nausea and dry mouth are due to a reduction in activity in the digestive system, to allow more energy to be diverted to fight/flight systems. We naturally begin searching for threats with our attention, and because no external threat exists, we then interpret our own body symptoms in a catastrophic way – “I must be dying/having a heart attack/losing control/going crazy”.

Cognitive Behaviour Therapy or CBT Therapy for panic disorder and agoraphobia begins with this initial understanding and teaches you how to challenge your thinking about your symptoms.

Exposure to the symptoms helps you tolerate these feelings in a safe environment so that you can build a belief that the symptoms cannot actually hurt you or result in a loss of control. You are then helped to re-enter the places you have been avoiding.

Panic disorder treatment may require medication besides psychoeducation, breathing and relaxation techniques, and CBT Therapy with a psychologist.