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How Does Panic Disorder Start?

Updated on April 3, 2015

A man at work one day suddenly begins to feel ill. He didn't slept well the night before so hasn’t felt great all morning anyway. At first he feels very weak and shaky but soon this is accompanied by a feeling that his heart is racing too. He feels alarmed by this. He sits down and notices he had started to feel very hot and his mouth is very dry. He is finding it a bit hard to swallow and that is frightening him even more. He starts to gasp for breath and then the dizziness begins along with some chest pains. He shouts over to a work colleague for help who in turn, seeing this man is in some distress, calmly calls for a first aider to attend to the scene and then leaves the room.

The first aider lays the man in the recovery position on the floor and decides it is best to call a paramedic.The paramedics arrive, take his blood pressure and pulse and say best to get checked out at the hospital. In the ambulance they say just as a precaution with anyone who has chest pain they will put him on a monitor.


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An hour later this same man, after seeing a doctor at hospital is given the all clear and told he has just had a panic attack. The relief is enormous. He really did think he was having a heart attack and that he may have died. When he leaves the hospital and goes home for the rest of the day he has a spring in his step and feels glad to be alive.

It was only a panic attack. He’d panicked. He’d probably felt a bit weak and shaky because he’d had little sleep but it had shocked him and taken him by surprise. He recognizes he had become very fearful and after explanation about the effects adrenaline can have on the body by the doctor, he readily accepts the logic of what has happened. The following day he has pushed the experience to the back of his mind and thereafter he didn’t have another panic attack. It soon becomes history.

This man avoided panic disorder. How? What makes a panic attack become panic disorder? There are many people who have had or will have an isolated panic attack in their lives. For others panic attacks can occur every day, sometimes several times a day. Repeated and regular panic attacks over the course of time will take on the diagnosis of panic disorder which comes under the umbrella of anxiety disorders. Sounds a whole lot worse doesn’t it? It is! It can be extremely debilitating and lead to conditions such as agoraphobia and depression.

What happens when that initial panic attack takes place is all important. How you react to it and, if a medical professionals are involved, how they handle your panic attack will all play a part in what happens next.

A first panic attack may be checked out as a heart problem
A first panic attack may be checked out as a heart problem | Source

So! Let’s take a look at a different scenario but using the same man as an example. The man has called over the colleague but this time the colleague panics. He runs off saying he will get help and the man instantly gets the message reinforced that something is indeed very wrong when he has seen the panic on the colleague’s face. The symptoms get worse as he adds more fear.

The first aider arrives along with the supervisor and the colleague. This makes the man more nervous as he sees himself as a spectacle. When he checks the man out he asks if he has any heart problems. The man thinks that his suspicions might be right, this could be his heart and this is serious. He replies to the negative but the fear is now greater. The paramedics arrive and the first thing they do is place him on a heart monitor with no explanation. As soon as he is placed on that heart monitor he is sure now that he is having a heart attack. They also give him an aspirin. He has lots of tests in the hospital and is told the same thing. It’s a panic attack. The doctor doesn’t give an explanation about what a panic attack is and assumes the man must know.

Questions add confusion to a panic attack
Questions add confusion to a panic attack | Source

In the second scenario the man the man goes home rather confused. How can a first aider and a paramedic think it’s his heart when it’s a panic attack? What if they made a mistake with those tests because those pains sure felt real? He knows what panic is but wonders why he should have had a panic attack; everything felt very physical not mental. He doesn’t trust what happens and keeps reliving it all in his mind for the rest of that day. He sleeps badly again but this time he is pacing the floor. What if it happens again? What if they got it wrong? What if it happens at work again and he can’t stop it. The embarrassment would be too much. Will he keep having them and lose his job?

By the time the man sets off for work the next day he is extremely anxious. By the afternoon he is so anxious that he begins to feel a little strange. He recognises some of yesterday’s sensations starting up and thinks oh no, it’s going to happen again, I can’t deal with this, why is this happening to me?


A full blown panic attack happens again. He suffers this in the restroom to avoid embarrassment and when he feels a little better he asks if he can go home as he’s not feeling too well. In the following weeks, although he may have some days when he doesn’t have a panic attack he has experienced quite a few more. Not only are they happening at work but also on the way to work and some happen in his home. He is now afraid he can have a panic attack at any time in any place. He has fearful anticipation of the next one, has lost an amount of confidence, still isn’t sure there isn’t something physically wrong with him and has panic disorder.

You may argue that there are other factors involved in why some people get panic disorder and some don’t but the bottom line will always be how much residual fear and confusion from that first panic attack lays the path down for more to follow.

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