Panic Disorder and Helpful Treatments


The main feature of panic disorder is the experience of recurrent, unexpected or “out of the blue” panic attacks which are followed by persistent worry about having additional attacks, worry about the implications of the attacks (e.g. “going crazy”, having a heart attack), or significant changes in behaviour related to the attacks (e.g. avoiding grocery stores or public transit).

A panic attack is characterized by a sudden onset of physical symptoms such as sweating, heart racing, dizziness, feeling of choking, tingling sensations, hot/cold flushes, nausea, dry mouth, and many other sensations. The physical symptoms typically peak within 10 minutes.

Although panic attacks are not physically dangerous, they are often interpreted by the person experiencing them to be threatening due to their sudden onset and the perceived similarity of the symptoms to serious medical conditions such as a stroke or heart attack. Often people who suffer from panic disorder continue to interpret panic attacks as dangerous despite reassurance from medical professionals that a medical condition is not present.

Individuals with panic disorder may start avoiding situations where they are concerned that escape might be difficult should they have a panic attack. Typical situations which cause distress or are avoided by people with Panic Disorder include: social situations, work, public transit, stores, malls, crowds, standing in a line, dentist or doctor visits, elevators, planes, long car journeys or riding in a car.

As a first step it is always recommended that individuals experiencing symptoms such as those described above see their family physician to determine whether there is a medical explanation.

Cognitive-Behavioural Therapy for Panic Disorder

The efficacy of CBT treatment for panic disorder has been supported by numerous controlled clinical trials.  In a meta-analysis by Gould et al. (1995), the effects of 43 studies examining both pharmacological and CBT treatment were evaluated.  It was shown that CBT had the largest effect sizes and the smallest rate of dropout from treatment compared to drug treatments or combined CBT and drug treatments.