Panic Disorder

Key points

• A panic attack is a sudden, intense surge of fear that people often mistake for a heart attack or a loss of control.
• Cognitive behavioural therapy helps people challenge catastrophic thoughts about these sensations and gradually return to situations they had been avoiding.
• Escitalopram, sertraline and paroxetine, common SSRIs taken steadily for several weeks, cut both how often panic attacks strike and how severe they feel.

What a panic attack actually feels like

The sudden onset is what makes panic attacks so alarming. Common physical sensations include a racing or pounding heart, shortness of breath, chest tightness, dizziness, sweating, and a feeling of unreality or detachment. Many people describe an overwhelming conviction that something is seriously wrong, a heart attack, suffocation, or loss of control. Most attacks subside within 10 to 20 minutes, though the aftermath can leave a person exhausted and on edge for hours.

How panic disorder is managed

Effective treatment almost always combines talking therapy with medicine. Cognitive behavioural therapy (CBT) is the most evidence-backed psychological approach; it teaches people to reframe catastrophic interpretations of physical sensations and gradually re-engage with avoided situations.

On the medicine side, antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are the standard first-line choice. Agents such as escitalopram, sertraline, and paroxetine reduce the frequency and severity of panic attacks when taken consistently over several weeks. They are also used long-term to prevent relapse.

If your panic attacks are severe or you are experiencing thoughts of self-harm, contact a mental health professional or a crisis line in your country promptly.

Further reading

• Panic Disorder - Anxiety and Depression Association of America, ADAA
• Panic disorder - NHS
• Panic Disorder: What You Need to Know - National Institute of Mental Health (NIMH)