Panic and anxiety
Panic Attacks and Panic Disorder in Kathmandu: Symptoms, Causes and Treatment
A sudden wave of fear with a pounding heart, breathlessness, shaking and a feeling that something terrible is about to happen: this is a panic attack. It feels dangerous, and many people rush to hospital fearing a heart attack. Panic attacks are frightening but not harmful, and panic disorder responds very well to treatment.
Key takeaways
- A panic attack peaks within about ten minutes and usually settles within half an hour. It is not dangerous in itself.
- New chest pain should be checked by a doctor, because heart and other problems can look similar.
- Avoiding places or situations keeps panic going. Facing them gradually, with CBT, breaks the cycle.
- CBT and antidepressant-type medicines are effective treatments.
What a panic attack feels like
- Pounding or racing heart, chest tightness or pain.
- Shortness of breath, choking feeling, dizziness or light-headedness.
- Sweating, trembling, tingling or numbness in hands, legs or face.
- Nausea, a hot or cold feeling, and fear of losing control, fainting or dying.
In Nepali: प्यानिक अट्याक, डर तथा आत्तिने समस्या. See our guide to physical anxiety symptoms.
Why panic attacks happen
Panic is the body's alarm system firing when there is no real danger. Adrenaline speeds the heart and breathing, and fast breathing causes tingling and dizziness. A sharp fear of these sensations can feed the attack. Stress, caffeine, poor sleep and a tendency to worry make attacks more likely.
Panic attack or panic disorder?
One or two attacks can happen to anyone. Panic disorder means repeated unexpected attacks together with ongoing worry about having another or changing behaviour to avoid them, for example not travelling alone or avoiding crowds (agoraphobia). It is very treatable.
What to do during an attack
- Remind yourself it is a panic attack, it will pass and it is not dangerous.
- Breathe in slowly through the nose for four counts and out for six.
- Ground yourself: name five things you see, four you feel, three you hear.
- Stay where you are if you can, rather than running, so you learn the fear fades.
Chest pain that is new, severe or spreading to the arm or jaw, fainting, or breathlessness at rest needs urgent medical care. Call 102 or go to an emergency department.
Getting checked
The first time, it is sensible to see a doctor to rule out heart, thyroid, blood sugar or other causes. Once panic is confirmed, you do not need repeated emergency visits.
Treatment
- CBT teaches you to understand panic and gradually face feared sensations and places. It is the treatment with the strongest evidence, and its benefits last.
- Medicine: antidepressant-type medicines (SSRIs) reduce attacks over weeks. Short-term sedatives can cause dependence and are used with great care.
- Habits: less caffeine, alcohol and nicotine, regular sleep, exercise and slow-breathing practice.
Read more about anxiety treatment and medicine.
How we help
Our consultant psychiatrists diagnose panic disorder, teach CBT skills and prescribe medicine where needed. See anxiety and panic attack therapy or book a consultation, in person or online.
Frequently asked questions
Can a panic attack cause a heart attack?
No. Panic attacks feel like a heart attack but do not damage the heart. Because the symptoms overlap, new chest pain should still be checked by a doctor.
How long does a panic attack last?
Most peak within about ten minutes and settle within twenty to thirty minutes, though you may feel drained afterwards.
Can panic disorder be cured?
Most people improve a great deal or recover with CBT, medicine or both. Skills learnt in therapy help you manage any future attacks.
Should I avoid places where I had an attack?
Avoiding them tends to make fear stronger. A therapist helps you return step by step at a pace you can manage.
Further reading
Independent sources on this topic. They did not write this page and do not endorse this clinic.
- Panic disorderNHS (UK)
- Panic disorder: what you need to knowNational Institute of Mental Health (US)
- Anxiety disordersWorld Health Organization
This guide is general information and does not replace advice from a doctor. If you are worried about your health or someone's safety, seek medical help.
In an emergency: Nepal Police 100 · Ambulance 102 · Suicide prevention helpline 1166. Outside Nepal, call your local emergency number.