Have you ever experienced a sudden rush of fear? Like you suddenly can’t catch your breath, everything feels out of control, and you’re convinced you might die there and then, even though you’re perfectly safe?
For some, these episodes are rare. But for others, they can strike unexpectedly and repeatedly, turning daily life into a series of anxious what-ifs.
This is what living with Panic Disorder can feel like. It’s more than stress or everyday anxiety, it’s a mental health condition that can affect your ability to work, travel, or even step outside your home without fear. The good news? Panic Disorder is treatable, and recovery is possible with the right support and care.
What is Panic Disorder?
Panic Disorder is a type of anxiety disorder characterised by recurrent and unexpected panic attacks, which are sudden episodes of intense fear accompanied by physical symptoms such as a racing heart, shortness of breath, and dizziness.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Panic Disorder involves:
- Repeated panic attacks that are not tied to any specific situation
- Worrying about when the next attack will happen (worries are related to having a heart attack or losing control)
- Avoiding places or situations out of fear of another attack (e.g. avoidance of exercise)
The symptoms experienced must not be attributable to a medical condition, other mental health conditions or the effects of a substance.
Panic attacks vs Panic Disorder
At least 20% of adults will experience a panic attack at some point in their lives. Panic attacks can occur in response to extreme stress, trauma, or even caffeine. They’re also often seen across a range of mental health conditions, including most anxiety disorders, PTSD, depression, and substance misuse disorders.
Panic Disorder, however, is diagnosed when these panic attacks are frequent and unexpected, and they make you live in fear of another attack to the point of distress or avoidance.
In short, panic attacks are a symptom while Panic Disorder is the diagnosis of a condition which involves panic attacks.
Panic Disorder vs Anxiety Disorder
Although both Panic Disorder and Generalised Anxiety Disorder (GAD) fall under the same umbrella, they tend to manifest differently.
A key difference is their symptoms. For Panic Disorder, this is more physical: heart racing, dizziness, choking. For GAD, on the other hand, it is more cognitive: constant worrying or restlessness. Someone with GAD might worry constantly about work or family, while someone with Panic Disorder might be laughing one minute and gasping for breath the next.
Panic Disorder vs Agoraphobia
Panic Disorder and Agoraphobia, an anxiety disorder, often overlap, but they are not the same.
Panic Disorder is primarily about the panic attacks themselves—the fear of the symptoms and what they might mean (e.g., “I’m going to die” or “I’m losing control”). Agoraphobia, in contrast, is the fear of having a panic attack or another incapacitating or embarrassing situation (e.g. incontinence or falling down) in a specific setting where escape might be difficult or help may not be available. Individuals with agoraphobia may avoid places like public transport, shopping centres, or even leaving the house altogether.
In short, Panic Disorder is driven by fear of the symptoms of a panic attack, while Agoraphobia is driven by fear of the perceived consequences of having those symptoms in certain places or situations. It is possible to have both Panic Disorder and Agoraphobia diagnoses.
What causes Panic Disorder
There is no specific cause of Panic Disorder. However, there are several risk factors, including genetics, major life changes, trauma, or prolonged stress.
Panic Disorder symptoms
The main symptom of Panic Disorder is panic attacks. According to DSM-5, a panic attack involves four (or more) of the following symptoms, peaking within minutes:
- Palpitations or pounding heart
- Sweating
- Trembling or shaking
- Sensations of shortness of breath or smothering
- Feelings of choking
- Chest pain or discomfort
- Nausea
- Feeling dizzy, unsteady, lightheaded, or faint
- Chills or hot flushes
- Numbness or tingling
- Feelings of unreality (derealisation) or detachment from self (depersonalisation)
- Fear of losing control or “going crazy”
- Fear of dying
However, not all panic attacks are the same. Some people report having “silent” panic attacks, mainly involving a strong internal feeling of dread. There are also some other symptoms of panic attacks that vary across different cultures, such as: Tinnitus, neck soreness, headache, and uncontrollable screaming or crying.
How is Panic Disorder diagnosed?
Diagnosis generally starts with a clinical interview, where your clinician will:
- Ask about your medical and psychological history
- Explore the onset, course, frequency, triggers, experience and consequences of your panic attacks
- Rule out other medical causes (e.g., heart issues or hyperthyroidism) and mental health conditions
Panic Disorder tests
Beyond the clinical interview, your clinician may also use standardised questionnaires to assess the severity of symptoms and how much they interfere with your life. Some example questionnaires include:
- Panic Disorder Severity Scale (PDSS): Measures how much panic attacks disrupt daily life
- Beck Anxiety Inventory (BAI): Assesses the overall level of anxiety
Panic Disorder treatments
Psychotherapy
Panic Disorder is highly treatable. Research has shown that 85-90% of individuals respond well to evidence-based interventions such as Cognitive Behavioural Therapy (CBT). There are a few different psychotherapy options available to treat Panic Disorder.
Cognitive Behavioural Therapy
CBT, which focuses on identifying and challenging unhelpful thoughts, is the gold standard treatment for Panic Disorder.
As individuals with Panic Disorder often misinterpret symptoms of a panic attack as signs of danger, like mistaking heart palpitations for the onset of heart attack, CBT encourages them to replace catastrophic thoughts with more balanced ones.
CBT also involves behavioural experiments, which are activities carefully designed to test beliefs that drive panic. For example, if you believe, “If my heart starts beating quickly on the train, I’ll collapse,” a therapist may guide you to take a short ride on public transport during a quieter time of day while using coping strategies. After the experiment, you’ll review what actually happened (e.g., you felt uncomfortable, but nothing dangerous occurred) and “update” your brain’s understanding of the symptoms.
Over time, these experiments build confidence, reduce fear of bodily sensations, and help you regain control in situations you previously avoided, such as engaging in exercise, going out alone or speaking in meetings.
Acceptance and Commitment Therapy
While CBT focuses on challenging and changing anxious thoughts, Acceptance and Commitment Therapy (ACT) offers a different approach: learning to live well even when discomfort is present.
ACT recognises that trying to suppress or control panic symptoms often backfire. The more you try to avoid panic, the more your life “narrows”, leading you to steer clear of things like public transport or spending time with friends in social settings.
ACT reduces the impact of anxiety by shifting your focus to what truly matters to you. For example, your therapist might help you identify personal values—such as being an engaged colleague or a caring friend—which can serve as motivation to take meaningful action, even when panic shows up. You may also learn mindfulness and grounding techniques that enable you to tolerate discomfort while still staying true to your values.
Medication
Medication can also be useful for treating Panic Disorder, especially for moderate to severe cases. These may include:
- SSRIs (e.g., sertraline, fluoxetine): Reduce anxiety over time
- SNRIs (e.g., venlafaxine): Also effective for anxiety and panic
- Benzodiazepines (e.g., lorazepam): Fast-acting relief, but not recommended for long-term use due to dependency risk
Your therapist may refer you to a psychiatrist within Intellect Clinic’s network if medication is appropriate for you.
Healing Panic Disorder at Intellect Clinic
At Intellect Clinic, we believe recovery is not just possible but probable with the right support. Our therapists offer a personalised care plan that will include psychoeducation, therapy, lifestyle guidance and referrals to psychiatrists if medication is required.
You’ll have the option of seeing a counsellor ($160) or a clinical psychologist ($240) for 50-minute sessions. We offer appointments across our clinics in Marina One, Tanjong Pagar, Woodleigh, and Tembeling.
