Dr. Danielle McCarthy on the Psychology of Panic Disorder

PANIC DISORDER by Dr.Danielle McCarthy

Full story featured in July/Aug 2018 Issue of TOI Magazine


Panic disorder is an anxiety disorder characterized by experiencing recurring panic attacks. It is often accompanied by the individual worrying about experiencing future panic attacks, as well as the implications about these panic attacks (i.e. it is common for individuals to think there is something medically wrong with them). In addition, many individuals start to avoid certain places for fear of having a panic attack (e.g. public transport, shops). Panic disorder can vary in severity. Because panic attacks feel so physically horrible, the fear of having another one can be intense and become very disabling, and the avoidance of certain places and activities can take a serious toll on a person's well being.

A panic attack is the sudden onset of overwhelming fear and anxiety with intense physical symptoms (e.g., pounding heart, trembling, shortness of breath, chest pain). Due to the intensity of the physical symptoms experienced during a panic attack, it is not uncommon for individuals to believe they are having a heart attack or that something else is seriously medically wrong with them. Psychologically, the individual may experience a fear of dying or that they are going crazy. Panic attacks can be either expected (e.g., in response to a feared situation such as being on a high building), or unexpected where there is no apparent trigger.

Panic attacks do not only occur in relation to panic disorder. If you have recurring panic attacks you may meet criteria for panic disorder. However, an individual may experience panic attacks as part of another anxiety disorder such as the ones listed above. For example, someone with OCD who has a compulsion to wash their hands may experience a panic attack if they are in a situation where they are unable to wash their hands. Or someone with PTSD may experience a panic attack when they have a flashback to the traumatic event. Somebody can be diagnosed with panic disorder, as well as another anxiety disorder such as the ones listed above.

When working with an individual who experiences panic attacks, one of the first things I would do is help them understand what’s happening in their brain & body during a panic attack. In short, I would teach them about our natural survival mechanism called the “fight or flight” response (i.e. our biological drive to either fight off or flee from danger). The physical changes that occur during the fight or flight response assist an individual to survive. However, a panic attack is this fight or flight response being triggered when we are not faced with a life-threatening situation. It is essentially a false alarm. I believe that understanding this process is very useful for an individual as it takes the “crazy” out of it.

I would also ensure the person is aware that although their panic attacks feel horrible and like something is very wrong (like a heart attack), in actual fact a panic attack can’t physically hurt them...it just feels like it. I would then ensure the person is well versed at breathing from their abdomen, as this is very helpful for calming the fight or flight response down. This is because when an individual has a panic attack they tend to take short, shallow breaths from their chest. Another helpful tool for someone experiencing a panic attack in the moment is to ground themselves. I teach people with panic attacks to use their senses to ground themselves. For example, name 5 things you can see, hear, and touch. This helps a person to shift their focus from all the uncomfortable sensations they are experiencing, as well as the distressing thoughts they are likely having.

Because of the physical nature of panic attacks, it will be very hard for the individual to mask their distress. They will appear in a state of panic and may be experiencing difficulty breathing or appear uneasy on their feet. A loved one or co-worker can be useful in assisting to ground the individual. For example, they can hold the individuals hands, and instruct them to pay attention to the sensations of the clasped hands, as well as the sensations of their feet on the floor. They may even instruct the individual to tell them 5 things they can see, hear, and touch. Helpful phrases such as “this will pass”, and “I’m here” can also assist.

Seek support. You do not have to live with an anxiety disorder. There is treatment available that has great success rates. Speak to your GP and get a referral to a psychologist. If you have any questions, feel free to send me a private message on one of the social networks below and I will do everything I can to ensure you are linked in with the appropriate support.

There are absolutely natural ways of overcoming anxiety. If you’re experiencing panic attacks/panic disorder, or some other anxiety disorder, I highly recommend reaching out and seeking support from a health professional. There are evidence-based treatments available for all anxiety disorders. By learning strategies to assist with your specific concerns, you can get control over your anxiety and not have it hold you back from living a fulfilling life.



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