Panic disorder can take many forms, and panic attacks vary in intensity and frequency.

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Typical symptoms of severe panic disorder are expressed by our clients as follows: 'It came out of the blue and I suddenly felt sick. I don't think I had any depression before. But at that moment I thought I was having a heart attack or suffocating. I was afraid I was going to die or go crazy. I'm pretty good now, but I'm very scared that it will come back."

However, the client (let's call him Mr. Petr) lives in a happy marriage, is a relatively successful businessman and an active sportsman. He often works overtime but does not observe any symptoms of burnout. One day after work, however, he suddenly feels sick, feels a strong pounding heartbeat, can't catch his breath and feels faint. Fortunately, a colleague is at work and he immediately takes him to the doctor.

However, the results of the ECG and other examinations do not show any physiological cause and even show that Peter is as healthy as a fish. A week later, however, the same, perhaps even worse, seizure recurs in the middle of the night. Fearing for his life, Peter calls an ambulance.

All examinations will confirm the initial negative findings and the doctor will recommend a visit to a psychologist or psychiatrist. Mr. Peter refuses to believe the doctors' findings, seeks more and more specialists, but the results remain normal. But the seizures continue...

However, a similar story is also told by an elderly lady enjoying a well-deserved retirement, a student preparing for a state exam or a mother on maternity leave.

All have experienced the panic attacks that accompany one of the most serious anxiety disorders - panic disorder. Individual attacks vary in severity, frequency and physical manifestations. The most typical manifestations are heart palpitations, increased blood pressure, tightness of the throat, inability to breathe. Feeling of suffocation, tingling of the limbs, loss of sensation and mobility of the limbs. Feeling of paralysis of various parts of the body.

A panic attack (panic attack) is also accompanied by massive anxiety, even terror. The typical thoughts that run through the sufferer's head during a panic attack can be formulated in the following terms: I will suffocate, have a heart attack, faint, go crazy, need immediate help, can't cope, go mad.

No wonder, a panic attack is a real ordeal. The sufferer is not fooling himself, he feels real pain and sometimes even an immediate fear of death. As the anxiety sets in, his breathing changes and with it the ratio of oxygen and carbon dioxide in our blood.

This disparity causes a number of other physiological reactions in the body that we experience on a conscious level as the symptoms mentioned above. So there is no hypochondria, only the cause of the pain is not somatic but psychological.

Every panic attack experienced is a deep trauma for a person. In quiet periods, the sufferer is therefore plagued by anticipatory anxiety, that is, the fear of when, where and how hard the next attack will strike. Intuitively, he or she begins to avoid situations and spaces where he or she does not feel safe and is unsure of the possibility of immediate help. Typically this is traveling, visiting areas where there are too many people, riding in vehicles, etc. Panic disorder is then often superimposed on another anxiety disorder, so-called agoraphobia.

Sufferers often look for a specific reason or trigger for a panic attack. However, this is not important because panic disorder is a much more complex problem. It is not that the attack itself must always be preceded by any particular anxious thought or emotional trauma. The mind of a panic disorder sufferer is psychologically overwhelmed for a long time for various reasons.

This may be due to a persistent lack of mental rest as a result of excessive work performance, excessive self-control or self-criticism, anxious-fearful thinking patterns, perfectionistic tendencies, and many other factors.

The exhausted mind can be compared to a pitcher filled to the brim with water. The trigger for a panic attack is usually the proverbial "last drop", which is usually mild physical stress or mental stress. Typically this is the case when the blood sugar level drops, physical exhaustion occurs due to lack of sleep, after alcohol excess, at night when the brain goes from NON-REM sleep to REM sleep.

The sufferer may not be aware of this stress (especially at night) and therefore experience the seizure as completely surprising and unpredictable. So-called nocturnal panic attacks are a specific type of panic attacks that are very challenging for patients because they also cause sleep disturbances.

Successful treatment of panic disorder must always rest on at least two pillars, and in more severe cases on three.