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“I was sitting in my car, stuck in heavy traffic. Suddenly my heart started to race, I felt my hands and feet go numb and I felt like I couldn’t breathe. Everything around me suddenly seemed unreal and I wondered if I was somehow going crazy. My hands started shaking so badly on the steering wheel. I felt like I needed to get out of the car as fast as I could and run. It was absolutely terrifying.”

Panic attacks are intense episodes of fear that often occur out of the blue and will peak within ten minutes and often even quicker. They take place when the body’s built-in alarm system gets activated and your body gets ready to fight or run for your life through a survival mechanism called the ‘Fight or Flight’ response. When this alarm system gets triggered you are likely to experience a series of physical and cognitive symptoms which can be overwhelming.

A Panic Attack is diagnosed when four or more of the following symptoms appear together. These symptoms include:

  1. Shortness of breath or smothering sensations
  2. Dizziness, unsteady feelings, or faintness
  3. Palpitations or accelerated heart rate
  4. Trembling or shaking
  5. Sweating
  6. Choking
  7. Nausea or abdominal distress
  8. Depersonalization- feeling that your own body is unreal- or derealization- feeling that your environment is not real
  9. Numbness or tingling sensations in one or more parts of your body
  10. Hot flashes or chills
  11. Chest pain or discomfort
  12. Fear of dying
  13. Fear of going crazy or losing self- control
  14. Feeling a need to escape
  15. Having a feeling of imminent doom or danger

What is panic disorder?

Panic disorder is a disorder that people experience when, after their first ‘out of the blue’ panic attack, they begin to have periods of worrying about having other and/or repeated attacks. As well, they begin to have concerns about what the panic attacks could do to them (fearing they will die, or lose control). As a result, they will experience significant changes in their behaviour due to the attacks (e.g. starting to avoid things that might make them anxious)

Some people have panic attacks but never develop Panic Disorder. Others, however, have many attacks. There are many different explanations for this including a combination of genetic predisposition, childhood experiences and later life challenges faced by the individual.


Often when people have Panic Attacks, the episodes are so overwhelming that they will do anything that they can to avoid having the experience again. This avoidance behaviour is called Agoraphobia. People often think agoraphobia means fear of crowds or open spaces but it is actually a fear of having a panic attack in a situation where you feel you won’t be able to escape.

It is easy to see how this avoidance cycle can develop. For instance, if a person has a panic attack at a grocery store then they might be fearful of going shopping again. If they have another panic attack at the grocery store then they might simply avoid going grocery shopping in the future. Instead they may start ordering their food via the internet or they may avoid going to the grocery store during crowded times of the day. If another person has a panic attack in their car, then they might start avoiding driving and start taking the bus instead. These are all understandable attempts at solutions to avoid having a panic attack because the experiences can be so overwhelming and frightening. However, over time, these avoidance behaviours can become very limiting and have a detrimental impact on your self-esteem, your relationships, your job or your general happiness in life.

If you think you may have Panic Disorder with or without agoraphobia, speak to your family physician, psychologist or psychiatrist.



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