What is the first treatment for panic disorder?

A clinician first checks the pattern of panic attacks, anticipatory fear, avoidance, sleep, mood, medicines and physical symptoms. This helps distinguish panic disorder from conditions that can feel similar, such as heart or thyroid problems. A GP Consultation can be a practical starting point.

Cognitive behavioural therapy teaches you to notice threat-focused thoughts, understand the body’s alarm response and gradually face avoided sensations or situations. The aim is to reduce fear of the next attack, rather than simply suppress every physical sensation. A Mental Health Assessment may help clarify the most suitable plan.

Arrange an appointment and write down when attacks happen, what you feel first, what you avoid and how long recovery takes. Bring a list of medicines, caffeine or stimulant use, alcohol intake and relevant medical history.

During an attack, move to a safe place, loosen restrictive clothing and breathe slowly without forcing deep breaths. Regular sleep, gentle activity and reducing caffeine may make the alarm response easier to manage. Do not stop prescribed medicine suddenly; discuss unwanted effects or doubts with the prescriber.

Seek urgent help for new or severe chest pain, fainting, severe breathlessness, confusion, one-sided weakness or thoughts of harming yourself. Panic symptoms can overlap with emergencies, so do not assume a new physical symptom is anxiety. Contact a clinician promptly if attacks are becoming more frequent, you are avoiding work or travel, or you cannot manage daily activities.

Ask what conditions should be ruled out, whether talking therapy or medicine fits your circumstances, how progress will be measured, and what to do if an attack occurs between appointments.