Panic Disorder
Panic disorder involves recurrent, unexpected panic attacks — sudden surges of intense fear with physical symptoms including racing heart, chest tightness, breathlessness, and dizziness. The attacks themselves are terrifying, and the fear of having another attack can become as disabling as the attacks themselves. With the right treatment, panic disorder responds very well.
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This page provides general health information only. If you have chest pain or severe breathlessness, call 112 to rule out a cardiac cause first.
What is panic disorder?
A panic attack is an abrupt surge of intense fear that peaks within minutes, accompanied by physical symptoms so alarming that many people believe they are dying or having a heart attack. The first panic attack is often completely unexpected and out of the blue.
Panic disorder develops when panic attacks recur and the person becomes persistently worried about having further attacks, changes their behaviour to avoid triggers, or develops agoraphobia — avoiding places where escape might be difficult if an attack occurs. This secondary avoidance often becomes more disabling than the attacks themselves.
What happens during a panic attack?
- Racing or pounding heartbeat (palpitations)
- Shortness of breath or a feeling of being smothered
- Chest pain or tightness
- Dizziness, lightheadedness, or feeling faint
- Tingling or numbness in the hands, feet, or face
- Sweating, trembling, or shaking
- Nausea or abdominal discomfort
- Feelings of unreality (derealisation) or being detached from oneself (depersonalisation)
- Fear of dying, losing control, or "going crazy"
Panic attacks are not dangerous — they cannot cause a heart attack, fainting, or loss of control, despite feeling that way. Understanding this is a key part of recovery. A medical assessment to rule out a physical cause is always worth having after a first episode.
Causes
Panic disorder is thought to involve a hypersensitive "fight or flight" response — the body's alarm system fires inappropriately in the absence of real danger. Genetic factors, significant life stressors, major life changes, and a history of anxiety increase susceptibility. It is particularly common in people who have recently experienced major disruption — including relocation to a new country.
When to see a doctor
See a doctor after any first panic attack — both to rule out a cardiac or respiratory cause and to get early support. If you are having recurrent attacks or avoiding situations because of fear of panic, professional treatment will significantly improve your quality of life.
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No referral, no waiting room. Online consultations available within 24 hours.
Treatment options
- Cognitive Behavioural Therapy (CBT) — the gold-standard treatment; teaches how to understand and interrupt the panic cycle, confront feared situations, and prevent avoidance
- SSRIs (e.g. sertraline, escitalopram) — first-line medication; reduce attack frequency and severity
- SNRIs (e.g. venlafaxine) — effective alternative
- Breathing and relaxation techniques — help manage the physical symptoms during an attack
- Psychoeducation — understanding what panic attacks are and why they occur reduces fear significantly
How eMedClinic can help
Our psychiatrists and psychologists provide assessment and treatment for panic disorder — including CBT, medication, and psychoeducation. We understand the particular anxiety challenges that come with living abroad and provide compassionate, effective care entirely in English.
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