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Panic disorder
If you have a panic disorder, you experience fear of recurring panic attacks and you change your behaviour because of this fear. It can affect your daily life, for example because you avoid places or situations. Learn more about causes, symptoms and how to cope with panic disorder.
What is panic disorder?
We speak of panic disorder when you fear recurrent panic attacks in which you also show clear behavioral changes, for example avoidance behavior. And when you notice that you can no longer live your life the way you did and want to. Between attacks you are attentive to what is happening in your body because you are afraid of another panic attack.
Sometimes there is a trigger, but often a panic attack occurs “out of nowhere” and you have no idea where the frightening feeling is coming from.
When developing a panic disorder, we see that people tend to modify their behavior to prevent having another panic attack. This might include avoiding places or situations or, on the contrary, always carrying a bottle of water with you to (try to) prevent another panic attack. This is called safety behavior.
What are the symptoms of panic disorder?
Recurring panic attacks are a symptom of panic disorder. During a panic attack, a sudden wave of intense fear overwhelms you. In these brief moments you experience intense fear. Panic attacks look different for everyone, but they always involve a number of physical symptoms together. In doing so, you may experience the following symptoms:
- 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 attacks are so frightening for many people that you become afraid of having another panic attack. This can lead to behavioral changes, such as avoiding certain situations or places. Or safety behaviors.
The moment you have a panic attack, you only want one thing: to get out of this situation. You literally want to flee. Actually, by doing so, you want to flee from what is happening in your body.
Often there is no real “danger. Some people experience the panic sensations as so frightening that they think they are going to die.
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?
Panic disorder is one of many types of anxiety disorders whose symptoms can correspond to social phobia and generalized anxiety disorder.
With social phobia, you have a fear of rejection or critical judgment from others. With generalized anxiety disorder, you mostly worry a lot about what could go wrong and you have trouble keeping these worries in control. These other anxiety disorders may or may not be accompanied by panic attacks. If panic attacks occur frequently and you fear new panic attacks and adjust your behavior accordingly, we call it panic disorder.
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
Fear is a very normal and healthy phenomenon of the body. It has a protective function. Fear warns us of possible danger. To increase the chance of survival, the body prefers to give a false alarm rather than overlook danger.
For this reason, when you feel fear, there is not always actual danger. You can hardly place the physical sensations you experience with fear. These sensations feel unpleasant which may cause you to avoid more or engage in safety behaviors. [3]
What can panic disorder lead to?
Panic disorder can have a major impact on your life. Consequences include:
- 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
Do you have panic disorder? Here are some tips and advice for both you and your loved ones on what you can do if you suffer from recurring panic attacks.
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.
The following advice applies as general lifestyle advice that is good for you. This advice does not aim to prevent panic.
- 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
Panic disorder is treatable. Good results can be achieved with both therapy and medication.
How is it classified?
A psychologist or psychiatrist can make the classification of panic disorder. You have panic disorder if you still suffer from fear of new panic attacks for at least a month after one. Or if you exhibit behavioral changes to prevent panic attacks and if it greatly impacts your occupational and social functioning.
How is panic disorder treated?
Panic disorder is treated with therapy and, in some cases, medication. Or with a combination of both. The preferred treatment is Cognitive Behavioral Therapy. In therapy, you learn that you can handle the anxiety yourself and learn to deal with your panic thoughts.
Treating panic disorder with therapy
Cognitive behavioral therapy (CBT) is the most commonly used form of therapy for panic disorder. In this treatment:
Gain insight into your panic thoughts and learn to counteract them with alternative thoughts;
Learn to challenge your fearful thoughts. You learn to face and cope with anxiety by exposure to physical sensations or exposure to situations that trigger panic attacks for you. This way you learn that nothing serious is happening and you can cope with the physical sensations.
Acceptance and Commitment Therapy (ACT) is other form of therapy also used for panic disorder. In treatment with ACT, you do various exercises:
You learn to detach from panic thoughts, tolerate physical sensations, focus on the here-and-now and what you find important in life. You focus on where you would like to go and what you want your life to look like (you define your values).
Help with panic disorder
Do you have questions about panic disorder? Or are you having doubts about when to consult a psychologist?
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At iPractice, you will work with 2 psychologists. Treatment consists of both online contact and regular consultation room sessions at one of iPractice’s locations. Or find more information about the intake and treatment process at iPractice.
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With a referral letter from the general practitioner and an official diagnosis of a panic disorder according to DSM-5 guidelines, almost every insurer will reimburse the cost. See which health insurance companies reimburse our care.
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Read the personal story of Emma about her panic disorder and how treatment at iPractice has helped her to recover. Or read all personal stories about anxiety disorders.
Psychologists specialized in Panic disorder
Related symptoms
Fear of failure
Almost no one likes to fail. To fall short, to not succeed, to make mistakes. Some find it so bad that they avoid challenges. As a result, they fail to achieve their goals, and this increases anxiety. Do you recognize yourself in this? Read about what fear of failure is, how to recognize it and how to overcome fear of failure.
Social Phobia
Giving a presentation in front of your colleagues or when you get to tell your story in a proposal round; it can be quite scary. Sometimes this anxiety is a major hindrance that can control your entire life. Anxiety about social occasions is a common anxiety disorder that can affect the quality of your life a lot.
Coping with my partner’s anxiety disorder
Your partner, a loved one or loved one has an anxiety disorder. This directly affects you and your interactions with each other. For example, a relationship can be overshadowed by feelings of anxiety. Read how an anxiety disorder can affect a relationship and what you can do for the other person as well as yourself!
Generalized Anxiety Disorder
You worry so much that it affects your daily life. With generalized anxiety disorder (brooding disorder), you keep mulling things over in your head. Learn more about symptoms, causes and treatment of generalized anxiety disorder and get advice on what you can do yourself.
Panic attack
A panic attack is an intense feeling of fear and tension that is often accompanied by various psychological and physical symptoms. It usually begins with a physical sensation, such as a shooting pain or dizziness, that you interpret as something catastrophic. Learn more about panic attacks.
Agoraphobia
Going to a crowded concert or enjoying an evening at the movies? You’d rather stay home. When you suffer from agoraphobia, you find places with many people or situations where you can’t leave immediately frightening. Learn more about agoraphobia; its symptoms, causes, tips for yourself and treatment.
Treatment Anxiety Disorder
An anxiety disorder can be overcome in many cases with the help of therapy. There are different anxiety therapies, depending on which anxiety disorder is involved. Each anxiety disorder expresses itself differently, but the underlying feelings are the same; a fear you want to get rid of.
Get help from a Anxiety Disorder psychologist
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