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How long do panic disorders last


Panic disorder - NHS

Panic disorder is an anxiety disorder where you regularly have sudden attacks of panic or fear.

Everyone experiences feelings of anxiety and panic at certain times. It's a natural response to stressful or dangerous situations.

But someone with panic disorder has feelings of anxiety, stress and panic regularly and at any time, often for no apparent reason.

Symptoms of panic disorder

Anxiety

Anxiety is a feeling of unease. It can range from mild to severe, and can include feelings of worry and fear. Panic is the most severe form of anxiety.

You may start to avoid certain situations because you fear they'll trigger another attack.

This can create a cycle of living "in fear of fear". It can add to your sense of panic and may cause you to have more attacks.

Panic attacks

During a panic attack you get a rush of intense mental and physical symptoms. It can come on very quickly and for no apparent reason.

A panic attack can be very frightening and distressing.

Symptoms include:

  • a racing heartbeat
  • feeling faint
  • sweating
  • nausea
  • chest pain
  • shortness of breath
  • trembling
  • hot flushes
  • chills
  • shaky limbs
  • a choking sensation
  • dizziness
  • numbness or pins and needles
  • dry mouth
  • a need to go to the toilet
  • ringing in your ears
  • a feeling of dread or a fear of dying
  • a churning stomach
  • a tingling in your fingers
  • feeling like you're not connected to your body

Most panic attacks last between 5 and 20 minutes. Some have been reported to last up to an hour.

The number of attacks you have will depend on how severe your condition is. Some people have attacks once or twice a month, while others have them several times a week.

Although panic attacks are frightening, they're not dangerous. An attack will not cause you any physical harm, and it's unlikely you'll be admitted to hospital if you have one.

Be aware that most of these symptoms can also be symptoms of other conditions or problems, so you may not always be experiencing a panic attack.

For example, you may have a racing heartbeat if you have very low blood pressure.

When to get help

See a GP if you've been experiencing symptoms of panic disorder.

They'll ask you to describe your symptoms, how often you get them, and how long you have had them.

They may also carry out a physical examination to rule out other conditions that could be causing your symptoms.

It can sometimes be difficult to talk about your feelings, emotions and personal life, but try not to feel anxious or embarrassed.

You may be diagnosed with panic disorder if you have regular and unexpected panic attacks followed by at least a month of continuous worry or concern about having further attacks.

Treatments for panic disorder

Treatment aims to reduce the number of panic attacks you have and ease your symptoms.

Talking therapies and medicine are the main treatments for panic disorder. Your treatment will depend on your symptoms.

Psychological therapies

You can refer yourself directly to a psychological therapies service for treatment based on cognitive behavioural therapy (CBT).

If you prefer, you can see a GP and they can refer you.

Your therapist may discuss with you how you react when you have a panic attack and what you think about.

They can teach you ways of changing your behaviour to help you keep calm during an attack.

You may need to see your GP regularly while you're having CBT so they can assess your progress.

Medicine

If you and your doctor think it might be helpful, you may be prescribed:

  • a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI) or, if SSRIs are not suitable, a tricyclic antidepressant (usually imipramine or clomipramine)
  • an anti-epilepsy medicine such as pregabalin or, if your anxiety is severe, clonazepam (these medicines are also beneficial for treating anxiety)

Antidepressants can take 2 to 4 weeks before they start to work, and up to 8 weeks to work fully.

Keep taking your medicines, even if you feel they're not working, and only stop taking them if your GP advises you to do so.

Referral to a specialist

If your symptoms do not improve after CBT, medicine and connecting with a support group, your GP may refer you to a mental health specialist such as a psychiatrist or clinical psychologist.

The specialist will carry out an assessment and devise a treatment plan to help you manage your symptoms.

Video: Psychological therapies for stress, anxiety and depression

Animated video explaining self-referral to psychological therapies services for stress, anxiety or depression.

Media last reviewed: 14 March 2022
Media review due: 14 March 2025

Things you can try yourself

What to do during a panic attack

The next time you feel a panic attack coming on:

  • do not fight it
  • stay where you are, if possible
  • breathe slowly and deeply
  • remind yourself that the attack will pass
  • focus on positive, peaceful and relaxing images
  • remember it's not life threatening

Preventing a further attack

It may help to:

  • read a self-help book for anxiety based on the principles of cognitive behavioural therapy (CBT) – ask your GP to recommend one
  • try complementary therapies such as massage and aromatherapy, or activities like yoga and pilates, to help you relax
  • learn breathing techniques to help ease symptoms
  • do regular physical exercise to reduce stress and tension
  • avoid sugary food and drinks, caffeine and alcohol, and stop smoking, as all they can all make attacks worse

For more help, read how to deal with panic attacks.

Support groups

Panic disorder can have a big impact on your life, but support is available. It might help to speak to other people with the same condition, or to connect with a charity.

You may find the following links useful:

  • Anxiety UK
  • Mind: understanding anxiety and panic attacks
  • No Panic
  • Triumph Over Phobia (TOP UK)

Ask your GP about support groups for panic disorder near you.

Find anxiety services in your area

Complications of panic disorder

Panic disorder is treatable and you can make a full recovery. But it's best to get medical help as soon as you can.

If you do not get medical help, panic disorder can escalate and become very difficult to cope with.

You're more at risk of developing other mental health conditions, such as agoraphobia or other phobias, or an alcohol or drug problem.

Having panic disorder may affect your ability to drive. The law requires you to inform the Driver and Vehicle Licensing Agency (DVLA) about a medical condition that could impact your driving ability.

Visit GOV.UK for further information about driving with a disability or health condition.

Causes

As with many mental health conditions, the exact cause of panic disorder is not fully understood.

But it's thought to be linked to a combination of things, including:

  • a traumatic or very stressful life experience, such as bereavement
  • having a close family member with panic disorder
  • an imbalance of neurotransmitters (chemical messengers) in the brain

Panic disorder in children

Panic disorder is more common in teenagers than in younger children.

Panic attacks can be particularly hard for children and young people to deal with. Severe panic disorder may affect their development and learning.

If your child has the signs and symptoms of panic disorder, they should see a GP.

After taking a detailed medical history the GP will carry out a thorough physical examination to rule out any physical causes for the symptoms.

They may refer your child to a specialist for further assessment and treatment. The specialist may recommend a course of CBT for your child.

Screening for other anxiety disorders may also be needed to help find the cause of your child's panic attacks.

Read more about anxiety disorders in children or find out about mental health services for children and young people.

How Long Do Panic Attacks Last: Duration, Coping, and More

Panic attacks are abrupt attacks where you feel fear, discomfort, and like you’re losing control even when there’s no danger. These attacks occur out of the blue with no warning and some symptoms can feel like a heart attack.

Panic attacks are typically short, reaching their peak in less than 10 minutes. An attack usually lasts anywhere from a few minutes up to 30, though repeated attacks can recur for hours.

Here’s what you need to know about the length of a panic attack, and how you can cope or prevent it from occurring.

Most panic attacks last only a few minutes — though they often feel like a lifetime when you’re experiencing one. Symptoms typically peak within 10 minutes and then begin to fade away.

It’s possible to have a panic attack that’s especially long or short. Some attacks can peak in a few seconds, with the entire attack lasting just minutes, while others may last longer.

Most research has described single panic attacks lasting up to 30 minutes. Some reports by individuals have described attacks lasting hours or even days.

According to some experts, if symptoms don’t peak within 10 minutes, it’s not considered a panic attack (which has a sudden onset of panic). Instead, it’s considered high anxiety. While this is still incredibly uncomfortable and unpleasant, it may not be diagnosed as a panic attack.

It’s also possible to experience multiple panic attacks that occur in waves for an hour or longer.

While symptoms of panic attacks can vary, they often include:

  • racing heart
  • sweating or chills
  • trembling
  • shortness of breath
  • chest pain or discomfort
  • dizziness
  • fear of losing control or of dying
  • nausea and other stomach discomfort

In a panic attack, symptoms come on suddenly, peak, and then gradually fade away.

Physical symptoms are often the first to subside, though depending on your anxiety levels, you may continue to hyperventilate and experience chest and abdominal discomfort. After the comedown of the attack, you may also feel tired or tension in your muscles.

The main symptoms that can linger are behavioral or cognitive symptoms. General anxiety may persist after the attack. People often continue to worry about their lack of control. If you experience pain, a fear of death may persist until you see a doctor.

If you have panic disorder, you may worry or obsess about having another panic attack. This can cause day-to-day anxiety, affecting your quality of life.

First things first: Breathe. You’re probably hyperventilating, but stabilizing your breathing can quickly calm your body’s fight-or-flight response.

Try counting your breaths. One deep breath in, one deep breath out. Count up to 10 and then start again until your breathing is back to normal.

Other quick coping strategies include:

  • recognizing that what you’re experiencing is a panic attack
  • finding an object to focus on
  • practicing muscle relaxation
  • repeating a mantra
  • exercising

Here’s a detailed list of how to stop a panic attack, along with some grounding techniques that may help.

You don’t have to live your life in fear of panic attacks. There are several tools and techniques you can use to help manage your attacks and even prevent them.

A good way to prevent panic attacks is to create a plan that will help you feel more in control. If you have a plan worked out for when an attack comes on, you can potentially shorten the duration and frequency of attacks.

Your plan might include:

  • practicing a deep breathing exercise or doing progressive muscle relaxation
  • focusing a grounding technique like the 5-4-3-2-1 technique
  • reading a sheet of paper describing panic attacks, to help rationalize the fear of dying
  • having a short list of mantras either on a sticky note or in your phone to open, saying something like “I am going to be OK, these are just symptoms of panic.”

You may want to seek support and let your family, friends, or coworkers in on your plans for when you’re in specific situations.

For instance:

  • At home, you can teach your partner or roommate a relaxation technique that they can do with you when you’re in the midst of an attack. Breathing together may help you feel more grounded and focused.
  • At work, you may want to simply give a trusted coworker or boss a heads up that you experience panic attacks. Sharing this information can feel scary, but it can also make your office feel like a safer space.

Other ways to prevent future attacks include:

Learn about panic attacks and anxiety

Knowledge is power. With more information about panic attacks, you can be aware of your symptoms, feel more in control, and shorten your attacks.

While many people experience a panic attack just once or a few times, others experience them as part of an existing anxiety disorder. Learning about anxiety can help you better manage it.

Practice relaxation techniques

Meditation, breathing exercises, and muscle relaxation can all help in the moment of a panic attack. But learning and practicing these techniques beforehand is essential so that you’re ready when one happens.

Exercise regularly

Regular exercise has shown a number of benefits for both mental and physical health.

Exercising, especially high intensity or cardio workouts, can even mimic symptoms of panic attacks. By exercising regularly, you can train your body and mind to realize that those symptoms — racing heart, sweating, breathing hard — don’t always indicate panic.

You may also reduce your stress, which can trigger panic attacks.

Avoid smoking, alcohol, and caffeine

Certain substances are known to trigger anxiety and sometimes panic attacks. If you notice that your panic attacks occur around the time you’ve consumed a stimulant such as coffee or another substance, it may be helpful to limit or avoid them and see if your attack frequency changes.

These substances may also increase the intensity of an attack, so avoiding them could help ease symptoms.

Get enough sleep

Sleep deprivation can make coping with stress more difficult and increase your anxiety levels. That’s why it’s important to maintain good sleep hygiene.

Panic attacks can feel very scary, especially when experiencing one for the first time. But it doesn’t mean you automatically have an anxiety disorder — you can have panic attacks without a mental illness.

Seek help if:

  • you have several panic attacks or experience them chronically
  • your anxiety is affecting your daily life
  • you’re having difficulties coping

There are so many options available to you, and your doctor can even help you set up plans, share literature, or check your vital signs to ease your mind.

If you often experience a fear of dying or worry that something is truly wrong with your health, see a doctor. They can run tests to check your overall health, or specifically the health of your heart.

Having a clean bill of health can give you peace of mind. You can even keep a printout of the results. This sheet of paper can be part of your plan to pull out during an attack to remind you that you’re going to be all right.

Panic attacks may come without warning and feel uncomfortable, but they won’t last forever. In fact, while they may feel longer, most panic attacks only last around 10 minutes.

If you begin to experience anxiety symptoms that affect your daily life, your attacks increase in intensity or duration, or you just need extra help with coping, reach out to a mental health professional.

For those who seek treatment from a mental health professional, two-thirds reportedly achieve remission within 6 months.

Panic attacks

Panic attacks (episodic paroxysmal anxiety) - attacks of severe anxiety (panic) or fear (most often - fear of death, less often - fear of losing consciousness, loss of control, helplessness or fear of "going crazy"), accompanied by a rapid heartbeat and a feeling of " suffocation, shortness of breath. Sometimes there are additional symptoms such as increased blood pressure, a feeling of "internal trembling", trembling in the limbs, a feeling of "hot flashes" of heat or cold, numbness of the extremities, increased sweating, a feeling of "unstability" or dizziness, nausea, derealization or depersonalization, etc.

Panic attacks last on average 5 to 30 minutes. However, sometimes they can last several hours, and in rare cases - up to several days.

I must say that even 30 years ago this disease was extremely rare. But now the incidence of panic attacks is increasing exponentially every year! Especially in big cities. Alas, panic attacks are considered a “disease of megacities”. And they suffer, most often, people with increased anxiety and the so-called perfectionists.

Earlier, in Soviet medicine, this disorder was called " sympathoadrenal crises ". This name, more than the modern one, reflected the essence of the processes occurring in the body during panic attacks. Nevertheless, I will not bother readers with a description of biochemical processes and a list of the hormones and neurotransmitters involved in these reactions. Knowing this practically does not affect the fact of the occurrence of seizures. Because biochemical processes are just an "intermediate link" in the chain of cause and effect relationships occurrence of panic attacks . What then is the "primary link", so to speak, the root cause?

Panic attacks occur suddenly, and, as it often seems, without any external causes or under the influence of minor unpleasant factors (an ordinary quarrel in the family, another trouble at work, overcrowding and stuffiness in a subway or train car, a long “traffic jam” on the road, etc.). etc.). In fact, panic attacks always occur against the background of an already long-term depression (most common), or after repeated or severe stress (or rather, distress). Don't be surprised by this, because it is quite difficult for an ordinary person, not a specialist, to diagnose depression. Especially, at himself. Moreover, its mild or atypical forms. Especially if it lasts a year or several years (and for some people - since childhood!). In this case, they may not even remember how they felt without depression. In this variant, the body functions “with the last of its strength”, works “at the limit of its capabilities”; and some minor unpleasant event can be the “last straw” for him! Figuratively speaking, a panic attack is “hysteria of the body”, its “desperate cry: “I can’t do this anymore !!!”

Well, in the question "Who is to blame?" figured it out. Now let's move on to the equally important question "What to do?" The fact that no one in the world has yet died from panic attacks is little consolation for those suffering from this excruciating disorder. To say that panic attacks are an unpleasant state is an understatement! These are unbearable sensations, and in the most severe cases, a real feeling of approaching death, which a person is sometimes forced to experience daily! And most importantly, he does not understand what is happening to him, and how to stop it!

Panic attacks sharply reduce the quality of a person's life, subordinating her entire expectation of the next attack. And, accordingly, they affect social activity, sometimes making a person completely incapacitated.

When panic attacks first appeared in the clinical practice of physicians, they were treated empirically with various sedatives and tranquilizers. However, after their cancellation, the seizures reappeared, and with prolonged use of these drugs, tolerance (insensitivity) inevitably and rather quickly set in. Therefore, in order to stop panic attacks, it was necessary to constantly increase doses or resort to more “strong” tranquilizers. But everywhere there is a limit: the number of tranquilizers is not unlimited, especially their doses. It was necessary to remember another very important aspect: long-term use of these drugs causes dependence on them. And after the abolition of tranquilizers, the symptoms of mental and physical withdrawal joined the renewed panic attacks, which further worsened the patient's condition.

Then the tactics of treatment were somewhat changed: antidepressants were added to "light" or small doses of "medium-powered" tranquilizers. And it was a "breakthrough" in the treatment of panic attacks! Because antidepressants do not just "relieve" the symptoms, but they affect the foundation on which these attacks are based - depression itself! Of course, in modern medicine there are a huge number of antidepressants, and the effectiveness of their effect on panic attacks is very different. But an experienced psychotherapist or psychiatrist can quite accurately select a drug that is suitable for a particular person. It is important to note that antidepressants have a cumulative effect, so their therapeutic effect does not appear immediately after the appointment, but after a certain time (on average, after a month). And, here, the full duration of treatment with antidepressants is, at best, from 6 to 12 months, and sometimes up to several years.

At the same time, there are cases of especially severe courses of panic attacks, when the appointment of even "powerful" antidepressants for a sufficiently long time does not bring the desired effect, i.e. panic attacks do not stop completely, but only become less pronounced or occur less frequently. In this version, a person, anyway, does not feel healthy and constantly lives in fear of the next attack. In this case, doctors are forced to launch "heavy artillery" - to add NEUROLEPTICS to the treatment, which patients have to take for quite a long time. Antipsychotics have a large number of unpleasant side effects, which is why many patients refuse them.

However, there is another way to treat panic attacks. He is not a drug! That is, there is a REAL METHOD OF COMPLETE CURING FROM PANIC ATTACKS, ABSOLUTELY WITHOUT RESORTING TO ANY KIND OF MEDICINES !!! This method is PSYCHOTHERAPEUTIC.

In the modern world there are a lot of different types and directions of psychotherapy. But, it must be said bluntly that with panic attacks, most of them are not effective without medical support.

However, the method that I use in my psychotherapeutic work is unique. It often allows you to completely eliminate panic attacks in 1 session! One or two more sessions are required to eliminate the FEAR of the appearance of seizures (or their expectation).

But in order to begin the direct elimination of panic attacks, a certain “intellectual” preparation of the patient is necessary. It requires from 8 to 12 sessions (depending on the severity of the disease and the personal characteristics of the patient) with a frequency of 1-2 sessions per week.

After eliminating panic attacks and the fear of their occurrence, it is extremely important to “develop” the underlying causes that led to their appearance. This will be a kind of "insurance" against the occurrence of panic attacks in the future. This requires 3-4 months on average (with the frequency of classes 1 time per week). But, having worked through these “deep roots”, a person not only completely gets rid of panic attacks, but also depression, solves many personal problems and begins to live a full life!

Panic Disorder (Paroxysmal Episodic Anxiety): Causes, Symptoms, Treatment

Panic disorder is a fairly common disorder affecting about 4% of the general population. Women are six times more likely to suffer from this disease than men. The disorder usually develops during adolescence and early adulthood.

Attention!

Here you can choose a doctor who specializes in the treatment of Panic Disorder (Episodic Paroxysmal Anxiety) If you are not sure about the diagnosis, make an appointment with a general practitioner or general practitioner to clarify the diagnosis.

Causes

No reliable causes of panic disorder have been found, however, changes in the central nervous system (CNS) associated with the exchange of serotonin and norepinephrine are observed during the disease. One of the causes of the disease is hereditary predisposition. This disease is often accompanied by stress or changes in life: be it a divorce, a change of housing, graduation from a university.

Intense episodes are one of the causes of a panic attack. They are accompanied by a feeling of horror, palpitations, sweating, dizziness, often there are sensations of suffocation.

There is also a frequent connection between the onset of panic disorder and negative emotions experienced in childhood. For example, approximately half of children who suffer from school phobias experience panic disorders as adults.

Sometimes patients experience derealization - the feeling that the world around them has changed and is unreal (one of the most frightening symptoms of a panic attack).

Symptoms

The symptoms of a panic attack reach their maximum intensity within 5-10 minutes, after which they disappear just as quickly. The entire panic attack can last up to half an hour and passes on its own, without posing a threat to human life. Some patients have such conditions regularly (every day or weekly).

Panic attacks cause anxiety reactions for no apparent reason. The disease can overtake a person in ordinary situations that do not predispose to the development of anxiety, sometimes this happens in a dream. However, panic disorder does not pose a health hazard: no complications are observed, insanity and loss of self-control, too.

However, the fact that patients do not know the cause of their condition remains frightening. After all, attacks often occur out of nowhere, for no apparent reason. But there is a theory accepted in cognitive behavioral therapy that explains the root cause of these seizures. Panic is caused by sudden bodily discomfort or unusual bodily sensations. Following this, a person asks himself a question like "What is happening to me?", and he himself finds a terrible explanation for his question. As a rule, panic is perceived by him as a heart attack, insanity, bronchial asthma. If a person is prone to panic attacks, it is important to constantly remind yourself of a few things:

  • the panic attack definitely goes away, it doesn't last long;
  • people don't die during a panic attack;
  • The physical symptoms are not signs of a serious illness, but are the result of a reaction of the sympathetic nervous system.

So, the symptoms of panic disorder are:

  • sudden palpitations;
  • labored breathing;
  • chest pain;
  • nausea;
  • dizziness;
  • trembling, fever or chills;
  • fear of going crazy.

Diagnosis

Before treating an anxiety disorder, it should be diagnosed in a patient by a psychotherapist. The disease can be diagnosed as the main diagnosis only if all types of phobias are absent, and the panic attack resulting from the established phobic situation is considered an expression of the severity of the phobia, which should be taken into account in the diagnosis in the first place.

In order to make the diagnosis more reliable, it is necessary to trace the frequency of severe attacks. If during the month they occur several times, then panic disorder is diagnosed. At the same time, it is necessary to take into account:

  • that the circumstances accompanying the attack should not be associated with an objective threat;
  • that attacks should not be limited to predictable situations;
  • that the state between attacks should be relatively free of anxiety symptoms.

Treatment

The treatment of panic attacks, if all procedures are followed correctly, can help up to 80% of patients. The goal of treatment is to eliminate the patient's panic attacks, normalize mood and restore a person's full life. The most effective results are obtained by complex treatment (a combination of drug treatment with psychotherapy). Treatment includes antidepressants, behavioral therapy, tranquilizers, psychoanalysis, and family therapy. The treatment of panic disorder lasts from a couple of months to several years, depending on the severity of the disease.

In the event of a sudden onset of a panic attack, it is advisable for the patient to start breathing into a paper bag, which is excellent for preventing hyperventilation, which is accompanied by alkalosis.

Panic disorders can be treated in several ways:

  • stopping the panic attack itself;
  • Prevention of panic attacks and secondary to panic syndromes.

Medications and psychophysiological techniques are used to stop a panic attack. Benzodiazepines are considered the most effective drugs, preference is given to fast-acting drugs (diazepam, lorazepam), medium therapeutic doses are used. Relief of the attack is achieved after the administration of the drug in 15-30 minutes. However, the frequent use of drugs leads to addiction, because of which they cease to act in the usual dosages.

Stabilization therapy is aimed at consolidating the results, restoring the level of social adaptation, overcoming various anxieties and preventing relapses.

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