About panic disorder
What causes panic attacks?
Panic attacks are common. Many people will have at least one attack during their lifetime. Panic disorder is also quite common. Women are affected twice as often as men. The problem usually starts between the late teenage years and the mid-30s.
It's important to remember that it’s not your fault if you are experiencing anxiety or panic. There are many causes of panic. Most people experiencing panic disorder will have several of the following factors that contribute to an attack:
- Panic disorder runs in families, so if either parent has panic attacks, it may mean you are more likely to experience them too.
- Personality may play a part. Some people are more sensitive to the world around them, experiencing more intense emotional responses than others might in the same situation. Sensitivity is not a bad thing; in many ways, it can be a strength. But the downside is that highly sensitive people will be slightly more likely to have anxiety problems, including panic attacks. Again, this is not always the case. Some sensitive people never experience sudden panics, and some people who are less sensitive by nature will develop panic attacks.
- Events and situations in your life can put you under stress and make you more likely to panic. Typically, events that make you feel unsafe or insecure or anxious may be causes. General stresses like poverty or relatives dying could increase the chance of panic attacks. They can also occur as part of another mental health condition, such as depression.
- Some common substances can cause or intensify panic. Caffeine, found in coffee and many soft drinks, is the most common. Tea has a similar but weaker effect. People who have panic attacks and panic disorder may be very sensitive to caffeine, and even small amounts may produce physical symptoms such as increased heart rate, shaking and light-headedness. Alcohol does not directly cause attacks, but as its effects wear off, you are more likely to have a panic attack. Cannabis is another drug that some people are sensitive to, and, for them, it can start panic attacks. The effects of cannabis are long-lasting, as the body takes weeks to get rid of it.
For some people, panic seems to start out of the blue. There are often some symptoms of general anxiety, depression or phobias in the months before panic starts.
If you are having panic attacks following an extremely dangerous or distressing experience, like being assaulted or being in an accident, then it may be part of a different condition known as post-traumatic stress disorder or PTSD.
How the doctor determines if you have panic attacks or panic disorder (diagnosis)
Many people with panic attacks, sooner or later, go to see their doctor or a counsellor. When you see your doctor, it’s important to tell them as much as you can about how you are feeling and what you are going through, especially if you experience any of the feelings listed above.
The doctor may do some tests to make sure there are no underlying medical conditions that are causing your symptoms. They may also refer you to a mental health professional if they suspect you have panic disorder.
There are effective treatments for panic disorder, including psychotherapy (sometimes called “talk therapy”), medication, or a combination of both.
These are non-medical treatments that address your emotional needs such as your thinking, behaviour, relationships and environment.
This involves talking with a trained professional who uses clinically researched techniques to assess and help you understand what has happened, and to help you make positive changes in your life.
Cognitive-behavioural therapy (CBT), a psychological therapy which largely focuses on overcoming unhelpful beliefs and behaviours, is the therapy of choice for panic disorder and has been proven to work well.
Antidepressant medication, in conjunction with therapy, has proven effective in improving the symptoms of panic disorder. Anti-anxiety medication is also used sometimes, but doctors are cautious about prescribing this, as it can be very addictive.
Finding the right medication can be a matter of trial and error – there is no way to predict which medication will be effective and tolerated (have fewer troublesome side effects) by any one person.
If you are prescribed medication, you are entitled to know:
- the names of the medicines
- what symptoms they are supposed to treat
- how long it will be before they take effect
- how long you will have to take them for and what their side effects (short and long-term) are
- what the process of stopping taking them (withdrawal) could look like.
If you are pregnant or breastfeeding, medication may still be an option. It’s best to talk to your doctor about what’s right for your circumstances.
Thanks to Natasha de Faria, clinical psychologist, and members of the Thriving Madly peer support network in Christchurch for reviewing this content. Date last reviewed: September, 2022.
Thanks also to Sutherland Self-Help Trust for making the 2022 updates possible.