Panic attacks and how they are treated

David Taylorby Professor David Taylor, Director of Pharmacy and Pathology, South London and Maudsley NHS Foundation Trust and Professor of Psychopharmacology at King’s College London.

Panic attacks are a frightening experience and can affect people of all ages and backgrounds.  They can be triggered by a specific situation or phobia.

During a panic attack people experience an overwhelming sense of fear along with physical symptoms such as a fast or irregular heartbeat, nausea, sweating and trembling.  Most attacks last for between 5 and 20 minutes.  Some people have attacks once or twice a month, while others have them several times a week.

Panic attacks can also happen for no obvious reason.  If you have a condition called panic disorder, your attacks will occur unexpectedly and without warning.  You’ll also spend a lot of time feeling very anxious about when your next attack might be.

Panic disorder is caused by a combination of physical and mental factors such as:

Difficult life experiences
• Feelings of panic and anxiety can happen after major life events such as when someone close to you dies.  Such feelings may be obvious immediately after the event, or occur years later.

Family inheritance
• Panic attacks sometimes run in families, so if you have a close family member with panic disorder, you may be at increased risk of developing the condition yourself.

Your brain chemistry
• Having an imbalance of neurotransmitters, the natural chemicals in your brain, can increase your risk of developing anxiety and panic disorder.

Severe anxiety
• People who suffer panic can focus on minor symptoms or life events and interpret them in a very negative way which triggers a response from the body in the form of an attack.

Overcoming panic attacks
Talk to your GP about your symptoms.  The treatment you’ll receive will depend on how severe your condition is, your general health and what you’d like to happen. You may be offered one or both of the following:

Psychological treatment
Once your GP has ruled out any physical reason for your attacks, they may offer you sessions with a therapist for cognitive behavioural therapy (CBT).  The therapist may teach you ways of changing your behaviour when you have an attack which makes them easier to deal with and reduces the number of attacks.

Antidepressant tablets can be very useful in helping you cope with panic disorder.  It can take up to a month before you feel a difference, so it’s important that you keep taking them, even though you might feel that they’re not working.

After you start taking an antidepressant, you should visit your GP after two, four, six, and 12 weeks so that they can check on your progress.

Not everyone responds well to antidepressant medicines, so it is important that your progress is carefully monitored.

Support Groups
Support groups, such as Anxiety UK and Triumph Over Phobia UK, will be able to provide you with useful information and advice about how to effectively manage your panic disorder, and they are also a good way of meeting other people who have similar experiences of the condition.
Extra help
If CBT, medication, or attending a support group do not help to improve your symptoms of panic disorder, you may be referred to a mental health specialist for further treatment.