What is Panic?
Panic is a natural fear response, but when panic attacks happen unexpectedly and repeatedly, they can develop into Panic Disorder. Many people experience a single panic attack in their lifetime without developing the disorder itself.1
At Mind Health in Parramatta and Sydney, we help people understand the difference between a panic attack (which anyone can experience, even in other anxiety disorders) and Panic Disorder (a clinical condition involving recurring unexpected attacks, persistent fear of future attacks, and significant lifestyle changes). Our evidence-based approach recognises that panic is treatable, and most people show substantial improvement with the right support.
Panic often occurs alongside other conditions such as anxiety, agoraphobia, stress, depression, and phobias.
Panic Attacks vs Panic Disorder
It’s important to understand the difference between panic attacks and Panic Disorder:
Panic Attacks
- What they are: Sudden episodes of intense fear lasting 5-20 minutes, with peak intensity around 10 minutes
- Common occurrence: Up to 35% of people experience at least one in their lifetime
- Triggers: May have an obvious trigger (stressful situation, caffeine, physical exertion) or occur unexpectedly
- Not necessarily a disorder: A single panic attack doesn’t mean you have Panic Disorder
- Can occur in: Other anxiety disorders, depression, trauma responses, or as a one-off event
Panic Disorder
- What it is: A clinical condition involving recurrent unexpected panic attacks plus persistent fear and avoidance
- The worry cycle: After one or more attacks, people develop persistent worry about having another attack
- Behavioural change: Avoidance of situations where escape might be difficult or help unavailable (often leading to agoraphobia)
- Impact on life: The condition significantly interferes with work, relationships, and daily activities
- Prevalence: Approximately 5% of Australians experience Panic Disorder in their lifetime
Signs & Symptoms
During a panic attack, people typically experience a combination of physical, cognitive, and behavioural symptoms that emerge rapidly and intensify over minutes:
Physical Symptoms
- Racing or pounding heart: Heart may beat rapidly or irregularly, leading to worry about a heart attack
- Shortness of breath: Difficulty breathing or feeling like you can’t catch your breath
- Chest tightness or pain: Pressure, tightness, or sharp pain in the chest
- Dizziness or lightheadedness: Feeling faint, unbalanced, or as if the room is spinning
- Tingling or numbness: Pins-and-needles sensations, especially in fingers, hands, or face
- Excessive sweating: Cold, clammy sweat even when not physically active
- Trembling or shaking: Uncontrolled shaking of limbs or body
- Nausea or abdominal distress: Stomach upset, queasiness, or cramping
- Flushing or chills: Sudden heat or cold sensation spreading through the body
Cognitive (Mental) Symptoms
- Fear of dying: Intense belief that something life-threatening is happening
- Fear of losing control: Worry that you’re going crazy or losing your mind
- Sense of unreality: Feeling detached from your body or surroundings (derealization or depersonalization)
- Catastrophic thoughts: Mind jumping to worst-case scenarios: “I’m having a heart attack,” “I’m going to collapse,” “I’ll never recover”
- Racing thoughts: Difficulty concentrating as attention narrows to the threat
- Hyperawareness: Intense focus on body sensations and any sign of danger
Behavioural Symptoms
- Avoidance: Avoiding places, situations, or activities where a panic attack previously occurred or where escape might be difficult
- Safety behaviours: Using crutches like holding onto something, staying near an exit, or keeping medication nearby to feel safer
- Escape or reassurance-seeking: Leaving situations abruptly or immediately seeking medical help or reassurance
- Lifestyle restriction: Gradually limiting activities and independence due to fear (e.g., not driving, not going to shops alone)
- Body checking: Repeatedly checking pulse, breathing, or other bodily functions to monitor for danger
Causes
Panic Disorder typically develops through a combination of biological, psychological, and environmental factors. The amygdala (your brain’s alarm centre) becomes overactive, leading to a fight-or-flight response when there is no real danger.4
Key contributing factors include: genetic predisposition (Panic Disorder tends to run in families), chronic stress or life adversity, major life changes or trauma, elevated caffeine consumption, sleep deprivation, and respiratory sensitivity. A process called catastrophic misinterpretation often perpetuates the cycle—a racing heart from caffeine becomes “proof” of a heart attack, which triggers more panic, which further increases heart rate, seeming to confirm the feared outcome.3
Once the cycle begins, panic becomes self-perpetuating: physical symptoms trigger fear, fear increases the symptoms, and avoidance prevents people from learning that the feared outcome won’t occur.
Our Approach to Panic Treatment
Panic Disorder is highly treatable. The most effective approaches address both the physiological panic response and the thoughts and behaviours that maintain the cycle.
Cognitive Behavioural Therapy (CBT) is the gold standard treatment, helping you identify and challenge catastrophic thoughts, understand the panic cycle, and gradually face situations you’ve been avoiding. Exposure therapy—both interoceptive exposure (facing the bodily sensations of panic in a safe, controlled way) and in-vivo exposure (gradually returning to avoided situations)—teaches your brain that panic is not dangerous and will naturally decline without avoidance. Acceptance and Commitment Therapy (ACT) helps you develop psychological flexibility, allowing panic to be present without controlling your life, so you can focus on what matters most to you.5
Tips on Managing Panic
- Remember that panic will pass. A panic attack, however intense, always peaks and subsides naturally, usually within 10-20 minutes. The most helpful thing you can do is ride it out without fighting it or trying to escape. Trust that your body knows how to recover.
- Use slow, gentle breathing during an attack. When panic strikes, breathing often becomes rapid and shallow (hyperventilation), which intensifies symptoms. Try breathing in slowly through your nose for a count of 4, holding for 4, and breathing out through your mouth for 4-6. This calms your nervous system. Practise this when calm so it’s available when you need it.
- Understand your fight-or-flight response. Learn how the fight-or-flight response works and recognise that your body is trying to protect you from a threat it perceives but that isn’t real. This understanding helps you respond with curiosity rather than terror.
- Use grounding techniques to manage unreality. If you feel detached from your body or surroundings, ground yourself in the present by naming 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell, and 1 you can taste. This anchors you to the here-and-now and reduces dissociation.
- Don’t fight the panic or try to escape. Attempting to stop or escape panic often intensifies it. Instead, practise accepting the panic: “This is happening, and I can handle it. It won’t hurt me.” Paradoxically, acceptance reduces panic faster than fighting it.
- Gradually return to situations you’ve been avoiding. Avoidance feels protective in the moment but strengthens panic long-term. Work with a therapist to gradually and safely re-enter situations (shops, public transport, being alone). Each time you do, your brain learns the situation is safe, and panic weakens.
- Reduce caffeine and prioritise sleep. Caffeine is a stimulant that can trigger panic attacks or make them worse. Sleep deprivation also increases anxiety. Reducing caffeine and aiming for 7-9 hours of sleep per night reduces your overall panic sensitivity.
- Tell someone you trust. Sharing what you’re experiencing with a trusted friend, family member, or therapist reduces shame and isolation. You don’t need to manage panic alone. Support makes recovery easier.
What to Expect
During your first session with a Mind Health psychologist, we’ll spend 50–60 minutes getting to know you, understanding your panic history, and discussing what brought you in. We’ll explore when your panic started, what situations trigger it, and how it’s affected your life. We’ll also explain how panic develops and the evidence-based treatments that help. Most people with Panic Disorder attend weekly sessions initially, gradually moving to fortnightly as they progress. A typical treatment course is 8–16 sessions, though this varies depending on your needs and goals. Throughout treatment, we’ll teach you practical skills, help you gradually face avoided situations, and work with you to reclaim your confidence and freedom.
Accessing Treatment
Get Started
If you or someone you care about is struggling with panic attacks or Panic Disorder, our experienced psychologists at Mind Health in Parramatta and Sydney are here to help.
1300 084 200Book AppointmentMake a Referral
Frequently Asked Questions
What’s the difference between a panic attack and a heart attack?
A panic attack can feel very much like a heart attack—racing heart, chest pain, shortness of breath—but a heart attack involves actual damage to heart tissue, while a panic attack is a false alarm. During a panic attack, your heart may beat faster and irregularly, but it’s working normally. If you’re unsure whether you’re having a panic attack or a heart attack, it’s always best to seek immediate medical evaluation. Once your doctor has ruled out a heart condition, you can be reassured that the physical symptoms, though very real and frightening, are not dangerous.
Are panic attacks dangerous?
Panic attacks, while extremely distressing, are not medically dangerous. Your body is not in actual danger, even though it feels that way. You won’t faint, lose control, or die during a panic attack. The panic will naturally rise and fall. However, Panic Disorder can significantly impact quality of life through avoidance and restriction, which is why treatment is important—not because panic is dangerous, but because it can become disabling if left untreated.
How long do panic attacks last?
Most panic attacks peak within 5–10 minutes and typically last between 5–20 minutes, though some may extend longer. The uncertainty is part of why they feel so frightening—you don’t know when it will end. However, knowing that panic naturally subsides can help you get through an attack. The key is not to fight it or try to escape, as these actions can prolong or intensify the panic.
Can children have panic attacks?
Yes, children and adolescents can experience panic attacks and Panic Disorder. In young people, panic may present slightly differently—sometimes as school refusal, fear of being away from parents, or reluctance to attend certain places. If your child shows signs of panic, it’s important to seek professional help early, as early intervention can prevent the development of avoidance patterns and Panic Disorder.
Is medication needed for panic?
Panic Disorder can be effectively treated with therapy alone, without medication. CBT and exposure therapy are first-line treatments supported by strong evidence. However, some people benefit from short-term medication (such as SSRIs or short-acting anti-anxiety medications) alongside therapy, particularly if panic is severe or if there are co-occurring conditions like depression. This is a decision to make with your doctor and psychologist based on your individual situation.
Will panic attacks go away on their own?
Without treatment, Panic Disorder often persists or worsens over time because avoidance reinforces the fear cycle. However, with evidence-based treatment like CBT and exposure therapy, the vast majority of people (70–90%) experience significant improvement. Treatment teaches you to break the cycle and regain confidence. Early intervention generally leads to faster and more complete recovery.
Further Reading
References
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Australian Bureau of Statistics. (2022). National Mental Health and Wellbeing Survey. Canberra: ABS.
- Hofmann, S. G., & Hay, A. C. (2011). Cognitive-behavioral treatment of social anxiety disorder: Evidence-based and disorder-specific treatment approaches. Cognitive and Behavioral Practice, 18(4), 501–513.
- Gorman, J. M., Kent, J. M., Sullivan, G. M., & Coplan, J. D. (2000). Neuroanatomical hypothesis of panic disorder, revised. American Journal of Psychiatry, 157(4), 493–505.
- Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10–23.