Panic disorder

What is panic disorder?

What are the symptoms of panic disorder?

• Palpitations or a strong pounding heart;
• Sweating;
• Hyperventilating;
• Tingling in arms and legs;
• Nausea/vomiting;
• An unpleasant or painful feeling in the chest;
• Trembling and/or trembling;
• Dizziness, feeling of fainting;
• Cold chills or hot flashes;
• A numb or tingling sensation in your fingers;
• Feelings of breathlessness or suffocation;
• Feeling unreal (derealization) or feeling detached from yourself (depersonalization);
• Fear of going crazy and losing self-control;
• Fear of dying.

Panic disorder and agoraphobia

Agoraphobia often occurs in combination with panic disorder. In agoraphobia, you have a distinct fear of two or more of the following situations:

• Using (public) transportation;
• Being in an open space;
• Being in an enclosed space;
• Standing in a line or crowd;
• Standing alone outdoors.

You fear or avoid these situations because of the thought that escape is difficult or that help is not available. Not everyone with panic disorder also suffers from agoraphobia.

What is the difference between panic disorder and other anxiety disorders?

What are the causes of panic disorder?

It is not always clear what causes recurrent panic attacks. There are several possible causes and it varies from person to person. However, there are some factors in which panic disorders are more common:

• Genetics
  There may be a genetic factor if anxiety or panic symptoms are more common in your family.
• Major life events
  Panic attacks sometimes occur after you have experienced a major life event. Examples include having to say goodbye to someone close to you, being overworked or the end of a relationship.
• Lifestyle
  An unhealthy way of life, increases the risk of panic disorder, especially: little relaxation, little exercise, lots of stress. A lot of caffeine, alcohol or drugs also intensify the physical symptoms of anxiety. Sometimes this leads (again) to a panic attack.
• Childhood
  The way you deal with anxiety is partly learned. Perhaps one of your parents was anxious or overprotective? If so, it is more likely that you will also become more susceptible to anxiety and panic attacks. You may learned to want to control everything or to leave difficult situations to others. This doesn’t help.
• Personality
  People with neuroticism (tendency toward emotional instability) are more sensitive to stress, experience ordinary situations as threatening more quickly, and they have more difficulty dealing with setbacks and frustrations.
• Psychological
  Your cognitive perceptions, or the glasses through which you look at life, play a role in the development of panic disorder. The coping strategies you use in fearful situations also matter.

Fear has a protective function

What can panic disorder lead to?

• Avoidance
  You avoid situations or places for fear of panic attacks. Often these include fun things. Such as taking trips or visiting friends.
• Feelings of shame
  Many people with panic attacks feel ashamed of them.
• Gloom
  Gloomy feelings arise, for example, because you feel you cannot live the same life as people without panic attacks. You miss fun things and have the feeling of standing still.
• Social isolation
  If you lapse into avoidance, you’re less likely to do fun things with your friends and you may stop coming to parties. Friendships dilute and you fall into social isolation.
• Worse sleep
  When you experience stress, brooding thoughts and/or tension, it is harder to relax. This makes it harder for you to fall asleep.
• Stopping exercising / moving less
  Out of fear of the physical sensations.
• Poorer concentration
  When you worry, it has your attention. It subconsciously takes up a lot of space in your mind. This makes it harder to focus on a task and concentrating is more difficult.

Advice for panic disorder

Tips for panic disorder – for me

• Don’t hang around with the panic symptoms but seek help.
  Confide in someone and talk about it. But also contact your doctor or a psychologist.
• Avoidance will not help you.
  Although this is very difficult, it is better for you not to fall into avoidance. After all, this only perpetuates your anxiety.
• Dwell on the thought of fear.
  Did your fear thought – the one you had during a panic attack – come true? No. Reflect on what did happen and contrast this with the fear thought as a more realistic thought.
• Understanding safety behaviors.
  Gaining insight into what you do to prevent panic attacks also helps. You can think about this yourself, but therapy also helps you discover what kind of safety behaviors you are exhibiting and what you are currently avoiding out of fear of panic attacks.

• Take good care of yourself.
  That means getting enough exercise; getting enough sleep and eating healthy. Limit alcohol and caffeine consumption. You can, of course, engage in coffee somewhere as part of a social situation.
• Maintain structure in your day.
  Eat at set times and go to bed at the same time every day. Also get up at a set time again.
• Find distractions with relaxing activities.
  Adequate relaxation is important to lower your stress levels. Be careful not to use this as avoidance.

Tips for a partner or loved one (and me) with panic disorder

• Be there for your loved one with panic disorder. Talk about it with each other and make sure there is no shame about it.
• Do not support or encourage your loved one’s avoidant behavior.
• Reassure him or her the moment a panic attack occurs.
• In addition to offering reassurance, you can ask what your partner or loved one needs at the moment of a panic attack. Sometimes indicating where the need lies is difficult for people who are panicking. Encourage your partner to talk about his or her feelings at the time.

Treatment

How is it classified?

How is panic disorder treated?

Treating panic disorder with therapy