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Panic Disorder

Panic attacks are like having an internal alarm system that's far too sensitive, and often malfunctions. 

This alarm doesn't make a noise; instead, it it brings about a rapidly escalating set of physiological symptoms: shortness of breath, racing heart, dizziness, and more.

Panic attacks may occur in response to a known stressor, or simply 'out of the blue'.

The alarm system may then interpret these symptoms (it's own response!) as a threat, further escalating it's response.

Panic Attacks

A panic attack is an intense and sudden episode of overwhelming fear or discomfort that peaks within minutes. It's a singular occurrence that can happen to anyone, regardless of whether they have a condition called Panic Disorder.

During a panic attack, you may experience a variety of distressing symptoms which often seem to come out of nowhere. The key characteristics of Panic Attacks are as follows:

Sudden Onset: Panic attacks typically begin abruptly and without warning. This sudden onset can make them particularly alarming.


Intense Fear or Discomfort: The core feature of a panic attack is the intense level of fear or discomfort that is not proportional to the situation at hand, often feeling like it's coming out of the blue.


Physical Symptoms: The physical symptoms of a panic attack, such as heart palpitations and dizziness, are pronounced and can be mistaken for other medical conditions like a heart attack. Other symptoms may include sweating, trembling, shortness of breath, a feeling of choking, chest pain, nausea, dizziness, and numbness or tingling sensations.


Cognitive Symptoms: These include fears of dying, "going crazy," or losing control. There might also be feelings of unreality (derealisation) or being detached from oneself (depersonalisation). Despite their at-times frightening nature, panic attacks are NOT physically harmful.


Time-Limited: Although they can feel endless, panic attacks typically peak within a few minutes and then begin to subside. 

Having a panic attack does not necessarily mean you have Panic Disorder; they can occur in the absence of a diagnosable disorder and they can occur in the context of other disorders, such as PTSD, OCD, and Social Anxiety Disorder. 

Panic Disorder can be diagnosed when your panic attacks become recurrent, are followed by persistent worry about having more attacks, and you have significant changes in behaviour related to the attacks.

Panic Disorder

Panic Disorder is perhaps best characterised as a fear of panic attacks.

If you have Panic Disorder, then you likely find the genuinely uncomfortable symptoms of panic to be deeply distressing. This distress makes you vigilant for having additional panic attacks, which leads to significant changes in your behaviour as you attempt to avoid situations you fear may trigger another attack.

This cycle of fear and avoidance has the clear potential to severely restrict your daily activities, and therefore your quality of life.

The onset of Panic Disorder can be related to significant stressors, but attacks can also occur without any obvious cause, making your experience of the disorder particularly unsettling.


Agoraphobia is often goes hand-in-hand with Panic Disorder. It involves intense fear or anxiety about situations where you fear that, if you panic, escape might be difficult or help might not be available.

Commonly feared situations include being outside of the home alone, being in a crowd, being on bridges, or traveling in a car, public transport, or airplane. 

Nocturnal Panic

Yep, this happens. You may have experienced panic upon waking, or indeed been woken by panic symptoms in the middle of the night. There doesn't need to have been a nightmare, or any other obvious trigger. It's just your brain trying to help, but getting it quite wrong. 

This can be particularly disconcerting, and unfortunately may bring about anticipatory worry in the lead up to sleep... 


The most effective treatment for Panic Disorder is Cognitive Behavioural Therapy (CBT). 

Our Penrith Clinical Psychologists will tailor your treatment plan to address your unique challenges when it comes to managing Panic.


For some people, medication may be an important component of treatment, used alongside CBT to manage symptoms more effectively. 


CBT involves identifying and challenging the unrealistic beliefs and fears you may have associated with panic attacks. This includes addressing your thoughts about the dangers of panic symptoms, and your beliefs about the likelihood of catastrophic outcomes.


However, you'll likely find that your greatest leaps in overcoming Panic Disorder will come upon applying behavioural strategies, particularly facing your fear.

Your may feel that the prospect of facing fears directly is daunting or even counterintuitive. It's not uncommon to fear that confronting these situations will only increase your anxiety; after all, that's probably why you've been avoiding certain situations! However, under the guidance of an experienced Clinical Psychologist, a tailored plan can lead to significant improvements.


Initially, confronting feared situations or sensations may indeed increase anxiety. But by staying with these experiences and refraining from escape or safety behaviours (e.g., keeping a bottle of water handy at all time, only leaving home with a trusted person), you can learn that your feared outcomes are unlikely to occur, and that you can tolerate the anxiety and physical sensations of panic.


This process is known as habituation. Over time, and with repeated exposure, your response to these feared situations should diminish. Not only should you experience a reduction in the intensity and frequency of panic attacks, but you will also regain confidence and control over your life.


At Boyce & Dale Anxiety and Mood Disorders Clinic, our approach involves a thorough assessment to tailor the CBT program specifically to your needs. We often use a 'hierarchy' approach, starting with less challenging situations and gradually working up to more difficult ones, allowing you to build confidence and resilience step by step.

We look forward to helping.

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