Panic Disorder: Breaking the Fear-of-Fear Cycle

Sudden surge of fear with palpitations, chest tightness, breathlessness, dizziness, tingling, fear of losing control or dying. Peaks within 10 minutes.

Avoid the avoidance trap

Avoiding places where attacks occurred leads to agoraphobia and progressive isolation.

Treatment

• CBT with interoceptive exposure is the gold standard
• SSRIs are highly effective
• Avoid long-term benzodiazepines

During an attack

Slow breathing (4 in, 6 out), grounding techniques, remind yourself the symptoms are physiologically harmless and self-limited.

Panic disorder responds remarkably well to treatment: 70-90% improve substantially with CBT.