Panic states can occur as part of panic disorder or, to a lesser degree, be present in other anxiety disorders as well. A panic state is characterized by sensory hyper-alertness and body reactions that can include hyperventilation, increased heart rate, tension, agitated restlessness and, occasionally, a sense of derealisation as the person has the impression that they are observing the situation from the outside. It is a fully blown fight-flight-freeze reaction. Many panic sufferers believe that they are losing their mind or are at brink of becoming seriously ill and possibly dying. Because of similarity in physical symptoms, many confuse panic attack with a heart attack or a stroke. The experience is sufficiently terrifying that persons with a panic disorder will develop a “fear of fear” and end up by avoiding all situations (e.g., going out) and tasks (e.g., aerobic exercise) that might produce physical sensations that are similar to those that were experienced during the panic attack. With excessive avoidance and self-monitoring, the very thought of a possibility of a panic attack can produce the very body response that the person tries to protect themselves against.
Cognitive behaviour therapy targets panic by teaching the affected persons how to decatostrophize their predictions, learn to tolerate body reactions through exposure exercises and to eliminate avoidant behaviours that limit their lives. If necessary, therapy will also include practice of relaxation strategies.