Panic Disorder | CMCS Nepal
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Panic Disorder

panic disorder
9th February, 2023

Panic Disorder

Panic disorder is a mental health condition characterized by sudden and frequent occurrence of panic attacks. Panic attacks are sudden bursts of inexplicable fear and anxiety that give rise to both physical and emotional symptoms. Sweating, palpitations, tremors, numbness, and shortness of breath are some of the most common physical symptoms. An impending sense of doom, mental haziness, intense fear and uncontrolled spiraling of thoughts are some of the common emotional symptoms. Most of the affected come to believe that they are having some serious health issue especially related to their cardiac function or that they may have a heart attack. This fear drives them to rush to the emergency department of hospital. In many cases this is a repeated occurrence.

Some symptoms of a Panic Attack

  • Fast heartbeat (palpitation)
  • Difficulty breathing (sensation of shortness of breath)
  • Sensation of pain around chest region
  • Feeling dizzy or lightheaded
  • Fear of dying
  • Fear of fainting or collapsing
  • Urge to rush to hospital


In most cases symptoms of panic attack start suddenly, without any apparent trigger or reason. The symptoms are severe and cause significant distress and frightens the person. Many rush to emergency departments eventually to find that nothing physically is wrong.

However, panic attacks can also be triggered by underlying anxiety such as social anxiety and phobias.  In some cases, certain words, imagery or recall of a traumatic memory or event can trigger panic attack. The symptoms following the onset of the panic attack occur in a short span of time, usually no more than ten minutes. Given its overwhelming nature, it is also often mistaken for physiological events such as hypertensive spikes or heart attacks.

While panic attacks are the primary feature of panic disorder, they are also common symptoms to a host of other anxiety disorders. Post-traumatic stress disorder, obsessive compulsive disorder, generalized anxiety disorder, separation anxiety disorder and specific phobias are some examples. In certain cases, panic attacks can also be induced by physical factors such as excessive consumption of psychoactive stimulants (substances such as caffeine, nicotine, cannabis, cocaine, etc.), excessive consumption of other mind-altering substances (alcohol, opiates, hallucinogens, etc.), withdrawal in recovering addicts, history of abuse, family history or even fatigue.

Most of the individuals who suffer from panic attacks use avoidance. They may avoid walking briskly or running in the fear that it will start panic attack. They may be reluctant leaving home alone out of fear of being rescued in case they have a panic attack. Many fear going to public places, crowded places, or buses or any other place where immediate rescue and help is not available. This restricts their day-to-day functioning. Many fear going out alone with the fear that if “something” happens, who will rescue them. These so called “safety behaviors” do not, however, solve the problem since triggers are not always predictable and the episodes of anxiety and panic attacks keep getting progressively worse over time.

Patients with panic disorders can benefit from pharmacological or psychotherapeutic management. Medical intervention includes the prescription of antidepressants or anti-anxiety medications. Medica interventions are made under the consultation of a licensed medical doctor, especially a psychiatrist who specializes in assessing symptoms, making a diagnose and prescribing effective medication.

Similarly, a licensed psychotherapist or counselor should be consulted to seek therapeutic interventions. The required form and duration of such an intervention is determined by the professional. Although cognitive behavioral therapy is the most common form of therapeutic intervention in cases of panic disorders, other forms of therapy such as supportive therapy or counseling may be more appropriate depending on the individual cases. Interoceptive techniques such as exposure to triggers or simulation of key symptoms during episodes of panic attacks are also often employed simultaneously during therapies.

The core objective of this form of intervention is to enable patients to live through and over time become aware that the symptoms are not life threatening and will eventually subside and they will be OK in the end. It involves the active and conscious reasoning by patients to realize the irrationality of their fears that are part of panic attacks. The goal is to learn under support of a caring therapist to navigate the anxiety that follows and learn that these symptoms do not cause any tangible or physical harm beyond the distress it causes for a certain period.

Panic disorders often develop in early adulthood, although cases of juvenile panic disorder also exist. It is twice as common in women than in men, and research shows it is more prevalent in people with intelligence above average.

Oftentimes, people may not seek help for panic disorders due to the stigma around it, fearing that they will be called weak or unstable. However, the condition can get much worse when left untreated. It is known to hamper personal relationships, professional accolades, education and other aspects of life.

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