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Behavioral Wellness Clinic


Panic Disorder and Panic Attacks

Symptoms when Panic Strikes

Many people, whether or not they have an anxiety disorder, experience panic attacks over the course of their lifetime. Having a panic attack, does not mean one has "Panic Disorder."

Panic Disorder is characterized by having:

  • Repeated, unexpected panic attacks

  • At least one attack that has been followed by at least one month of
    • Worry about having another attack
    • Worry about what having a panic attack means, or the consequences of a panic attack; for instance, worrying about "going crazy," or "losing control."

  • We don't consider it Panic Disorder if the anxiety it is triggered by things or situations which may be caused by another condition. Such as:


What is a panic attack?

A panic attack is a sudden episode or period of intense fear, accompanied by a range of physical symptoms or reactions. Panic attacks last usually from 5 to 30 minutes, and often occur unexpectedly.

Panic attacks usually involve one or more of the following symptoms:

  • Rapid heart rate
  • Sweating
  • Trembling
  • Shortness of breath
  • Hyperventilation
  • Chills
  • Hot flashes
  • Nausea
  • Abdominal cramping
  • Chest pain
  • Headache
  • Dizziness
  • Feeling faint or lightheaded
  • Tightness in your throat
  • Trouble swallowing
  • A sense of impending doom or death

People with panic disorder may worry that they're having a heart attack, or other physical problems. Often people with panic disorder end up going to the emergency room much more than the average person.

Panic disorder can occur with or without agoraphobia

Agoraphobia is a worry or fear of being in a place from which escape might be difficult or embarrassing. People are usually worried that they might not be able to escape easily or to get help if they have a panic attack, or panic-like symptoms. Situations people might avoid include:

  • Being outside the home alone
  • Driving or being in a car or bus, being on a train, or a plane
  • Being on a bridge
  • Standing in line
  • Crowds

An example of panic disorder with agoraphobia


Judy had always been a highly strung person, but it had never before been a major problem. About a year ago, when taking a car trip by herself, she found herself having what felt like a heart attack. Her heart started beating very rapidly, she felt an extreme pain and tightness in her chest, she was sweating, yet did not feel hot. She worried that she might be dying. She pulled over to the side of the road and called her husband to come pick her up. Her husband took her to the ER — but the doctors and nurses could find nothing physically wrong with her, and suggested that she may have experienced a panic attack.

After this, Judy became afraid of having more panic attacks, as they made her feel so out of control. Whenever she had any physical symptoms that were similar, such as dizziness or chest pain, she would worry that she was going to have a panic attack. Rather than keep her from having panic attacks, this worrying seemed to bring them on more frequently. Judy began to avoid driving in fear that she would have a panic attack and lost control of the car. As time went on, Judy's panic attacks increased — she began to have one every few days, and in between, have smaller "attacks" of one or two physical symptoms such as a fast heart beat or chest pain a few times a day. After awhile, she began to be afraid of going places by herself because she was afraid that she would have a panic attack, and wouldn't know what to do. She began to make sure that her husband was with her wherever she went.

Treatment for Panic Disorder

Overcoming Panic Attacks & Agoraphobia

At the BWC we are committed to empirically-supported treatments. In other words, the treatments that we endorse have been shown, through careful research, to work for many, if not most, people.

Treatment normally lasts between 10 and 20 sessions, but the exact number of sessions depends on each individual case.

In this treatment three main aspects of panic disorder are addressed that serve to keep its symptoms going:

  1. Unrealistic thoughts or beliefs about the negative consequences of panic attacks
  2. Fear of bodily sensations that have become automatic or "conditioned"
  3. Avoidance of tasks and situations due to the fear that one might have a panic attack or panic-like symptoms.

What's involved in the treatment?

Psychoeducation. Education about the physical and psychological of causes panic attacks and panic disorder.

Breathing Retraining: education about how slow, diaphragmatic breathing can help prevent anxiety and panic in certain situations.

Exposure to fear bodily sensations. The therapist will help the patient find ways to bring on physical sensations that may cause a panic attack for the patient. The therapist will help the patient face these sensations and any panic symptoms that they cause and let them "ride their course" rather than trying to avoid or push away the anxiety. Eventually, these sensations will become less anxiety-provoking.

Exposure to feared situations. The therapist will help the patient face situations that they have become afraid of and "ride the anxiety out" rather than trying to run away from the situation. They will start from less feared situations, and move their way up a ladder, or "hierarchy" to more feared situations. As they go, these situations will become less and less anxiety-provoking.

Changing uphelpful, negative thoughts. The therapist will help the patient counteract catastrophic thinking, and to stop themselves from overestimating the likelihood of feared events or consequences.


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