Panic Disorder

A body’s natural response to potential danger is the fight or flight response. This brain response occurs immediately upon perception of danger and activates many brain areas designed to protect you from danger.  As part of this response, the brain orchestrates the release of adrenaline and other hormones throughout your body, so you can respond to the threat.   This protective mechanism  is called the fight or flight response and the emotional and physical components are know as panic.

Sometimes, panic can occur "out of the blue", when there is no danger. This is clearly not useful, and can cause significant problems for the person who experiences the panic.  If a person experiences many panic attacks they often begin to worry in anticipation of having an attack.  Sometimes this worry becomes so strong that they avoid going to places where a panic attack might happen.  For some people this may lead to agoraphobia or severe limitations to where they feel comfortable going (such as: school; the mall; driving on the highway; etc.).


What Are the Components of a Panic Attack?

A person experiencing a panic attack demonstrates four or more of the following symptoms which come on rapidly and peak within 10 minutes:

1. Palpitations, pounding or accelerated heart rate
2. Sweating
3. Trembling or Shaking
4. Sensations of shortness of breath or smothering
5. Feelings of choking
6. Chest pain or discomfort
7. Nausea or abdominal pain
8. Feeling dizzy, unsteady, lightheaded or faint
9. Feeling of unreality or being detached from oneself
10. Fear of losing control or going crazy
11. Fear of dying
12. Numbness or tingling in the body
13. Chills or hot flashes
14. Feeling like you need to urinate immediately

Panic Disorder occurs when people suffer from sudden and unexpected, uncontrollable panic attacks, anticipatory anxiety and phobic avoidance. 

Those who experience frequent panic attacks, worry about having another pending attack or the consequences of having another attack. This is called anticipatory anxiety.  Avoiding going to places where a person fears a panic attack might happen is called phobic avoidance.


Panic Disorder is diagnosed when...

1) A person experiences frequent panic attacks
2) They worry excessively about having another attack
3) They avoid situations in which they fear having an attack

And because of this their quality of life suffers and they have significant problems at home, work, school or interpersonally.

Note: Panic attacks can not be due to substance abuse, medications or a general medical condition and are not better accounted for by another medical disorder

While the frequency and severity of attacks can vary for some people this can lead to agoraphobia (fear of being in places in which escape is difficult). A person may start to avoid so many situations that they become bound to their home.

What Can You Do?

> During a Panic Attack: Identify the symptoms as a panic attack and provide a calm, supportive environment until the attack passes. Reinforce that the person experiencing the attack will not die. Try to have them hold their breath for a few seconds repeatedly, this may help decrease the symptoms.


After the Attack

Educate Yourself: Understanding what your loved on is going through will help alleviate frustrations about their behaviour and will help you better support them.

Be Supportive: Be encouraging and empathetic, and help them find treatment. A good place to start is with the family doctor.

Love Them For Who They Are: Change  your expectations and accept the person for who they are. They are not their panic attacks and they can not snap out of them.

Be a Good Listener: Set your own thoughts and expectations aside and really listen to the person talk about how they are feeling and what they are going through.

Have Fun: You need to be supportive, but remember having fun, laughing and relaxing are just as important.


Someone In Your Life is Diagnosed with Panic Disorder, Now What?

Make sure you take the time to educate yourself about panic disorder and its treatment.  Discuss any concerns you have with the health providers who you are working with.  Here are some additional  tips to help your loved one.  These will not treat panic disorder but will help them cope better.

• Help them relax. Take them to yoga or out for a walk, learning how to release pent up stress and breathing deeply are helpful in relaxing someone.
• Get lots of rest and have a well-balanced diet. Having at least eight full hours of sleep each night, and steering clear of junk foods is helpful. Some people with panic attacks find that caffeine (coffee, tea, cola, cocoa) make things worse.
• Add variety to life. Take up new activities, learn to laugh and chase away those negative thoughts.
• Help them learn time management skills. The less stress they exert on themselves, the less overwhelmed they will feel.
• Being socially active. Get out and get involved, go the mall, hang out with friends or play sports.
• Avoid marijuana and drug use. Smoking marijuana can initiate a panic attack in some people. If panic disorder or other anxiety disorders run in your family, its best to avoid this (and other) drugs(s).



• Panic attacks may begin as early as 14 years of age (or earlier), while Panic Disorder usually begins in late adolescence between (18-25 years)
• Individuals who have first degree relatives with panic disorder are up to 20 times at higher risk of developing panic disorder

What Treatment Options Exist?

Treatment using Cognitive Behavioural Therapy is effective for many people and is recommended as the first approach. Cognitive Behavioural Therapy combines learning about the disorder with specific treatment interventions including special exercises using your mind to control symptoms.  If CBT by itself does not work, or is not available, panic disorder can be treated with medications.  For some people, a combination of medications and CBT is most helpful. A variety of effective medication choices exist, but it may take some trial and error to find a medicine that is best for you. 

Other Common Types of Mental Disorders That May Occur Alongside Panic Disorder Include:

Depression (Youth with panic disorder are at a high risk for developing depression)
• Substance Abuse

Resources for Teens and Families

Guide to Understanding Panic Disorder: For Youth and their Parents
Evidence Based Medicine for Patients
My Brother/Sister has a Mental Illness: A Guide for Young People Ages 11-16
My Brother/Sister has a Mental Illness: A Guide for Young People Ages 17-24


Other Helpful Resources

Facts for Families
National Institute for Mental Health

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