Panic Disorder And Relaxation Techniques


Panic disorder (PD) is a severe type of anxiety disorder that is characterised by arapid onset of intense fear and discomfort. These feelings are recurrent, unexpected, usually peak within minutes and are called panic attacks. Fear of having panic attacks may make a person avoid triggers such as places or situations, eventually leading to fundamental impairment in their quality of life and functioning. If you are suffering from panic disorder, it is  essential for you to know how to tacklethese feelings and handle certain panic inducing situations. Research shows practicing relaxation techniques can be an effective way to manage these feelings.1,2

Understanding panic disorder

Symptoms and characteristics of panic disorder

Panic attacks are characterised by a series of physical symptoms thatcan appear at any time even when there is no apparent danger. Panic attack symptoms typically peak within a few minutes. Some common panic attack physical symptoms are:2,3,4

  • Chest pain
  • Rapid heart rate
  • Trembling
  • Sense of danger
  • Numbness
  • Lightheadedness
  • Shortness of breath
  • Feeling detached
  • Ringing in your ears

After a panic attack, you may feel worn out and fatigued. You may also have an intense fear of having another panic attack and for that reason actively avoid certain situations or places.2,3,4

Causes and risk factors

Similar to several mental health conditions, the exact causes of panic disorder are not known. Instead, panic disorder is thought to be associated with many things, such as:

  • Genetics: Research has demonstrated that a family history of panic disorder may play a role in the manifestation of the disorder:certain genetic variations that may act as risk factors for developing panic disorder4,5
  • Biological factors: There might be an intricate relationship between panic disorder and other medical illnesses. Illnesses that cause autonomic (affecting your nervous system) and metabolic abnormalities such as hyperthyroidism or arrhythmia may result in anxiety disorders6,7 
  • Brain chemistry: Brain circuits are pathways are controlled by several chemicals known as neurotransmittershe three major neurotransmitters that have been extensively studied in panic and anxiety disorders are serotonin, norepinephrine, and dopamine. The majority of effective therapies target and affect one or more of these neurotransmitters6
  • Environmental factors: An important environmental factor that has to be considered when looking into the causes of panic disorder is stress or trauma. Stressful life events related to panic disorder development may include neglect, loss, or abuse. Individuals with panic or anxiety disorders often relate the disorder onset with a stressful event that happened or a continuous stressor.6 Some studies have also found that stress can subsequently cause biological alterations in certain structures of the brain8

Effects on mental and physical health

Panic disorder can severely impact both your mental and physical health. People with panic disorder may experience feelings of fear, anxiety, avoidance, social isolation, and overall impairment in their daily functioning and quality of life. Additionally, panic disorder can contribute to the development of other mental health conditions including substance abuse, depression, or even lead to suicide.9,10

Moreover, panic attacks can present as a range of physical symptoms that may require medical attention and emergency visits to the doctor. Panic disorder can increase the risk of other medical conditions such as irritable bowel syndrome and cardiovascular disease.11,12

Role of relaxation techniques

Panic disorder can be managed by the use of relaxation techniques. Relaxation techniques work by activating the part of the nervous system responsible for rest and relaxation, called the  parasympathetic system.10 Relaxation techniques can decrease the intensity and frequency of panic attacks.13 Apart from the benefits of relaxation techniques in managing panic disorder, they may also act as a way to improve your overall well-being by reducing symptoms of other disorders, improving sleep quality, and increasing the feelings of calmness.14 Finally, relaxation techniques can be used together with other treatments for pain disorder such as psychotherapy and medications boosting the overall effectiveness of the treatment.10

Types of relaxation techniques

There are multiple types of relaxation techniques that have been proven to be effective in reducing the symptoms of panic disorder15,16,17,18,19,20,21

These include:

  • Deep breathing exercises: These involve slow and deep inhalations followed by slow exhalations.·    Progressive muscle relaxation: This involves tensing and relaxing different body muscle groups and is known as a grounding technique
  • Visualization and guided imagery: This technique involves visualizing calming and peaceful situations or images
  • Mindfulness meditation: This is a mental training practice that teaches you how to let negative feelings go, calm your body and mind, and slow down your thoughts. It helps you focus on the present so you can embrace your feelings, thoughts, and sensations without the fear of judgement
  • Yoga: This technique combines relaxation techniques and deep breathing with different physical postures
  • Tai Chi: This is a type of martial arts that uses deep breathing in combination with flowing and slow movements

How to practice relaxation techniques for panic disorder

Symptoms of panic disorder can be effectively managed by practicing relaxation techniques. Here are some tips for how to practice relaxation techniques:16,22

  1. You should schedule a specific time of day for your regular practice so that you can easily build a routine
  2. You should find a comfortable and quiet place with no distractions
  3. You should sit comfortably or lie down
  4. You should wear clothes that allow you to breathe and move freely
  5. You should clear your thoughts and focus on your breathing as this is a key part of most relaxation techniques
  6. You should aim to practice at least 10 minutes every day
  7. Remember to be patient as it takes time to learn how to effectively use these techniques to manage your symptoms

Additional strategies to enhance relaxation

Sometimes it may be difficult to relax when practicing relaxation techniques. Here are some additional strategies that may help enhance your relaxation:4,16

  • You can make certain lifestyle changes that reduce your stress levels and support your relaxation such as following a healthy diet, reducing alcohol consumption, sleeping, and exercising
  • You can combine relaxation techniques with other therapies such as CBT (cognitive behavioral therapy)
  • You should seek professional guidance and support if you are struggling with incorporating relaxation techniques into your life
  • You can use audio programs and relaxation apps if you are having trouble staying focused

Precautions and considerations

Panic disorder may be managed by practicing relaxation techniques, which are usually safe, but it is important to know the precautions of using these techniques, including:16,23,24

  • Specific medical conditions such ascardiovascular disease Remember to check with your doctor before you start practicing
  • Not all relaxation techniques are suitable for all individuals. For example, for some people deep breathing may cause hyperventilation or dizziness
  • It is important to tailor relaxation techniques to the preferences and needs of an individual. You should do what is more helpful for you. After all it is your practice. It may take some time to find the best relaxation technique for you


Panic disorder is characterised by sudden and recurrent panic attacks. Panic attacks can cause sweating, shaking, shortness of breath, and a rapid heart rate. A way to manage the symptoms of panic disorder is by practicing relaxation techniques. Relaxation techniques include deep breathing, progressive muscle relaxation, mindful meditation, and guided imagery. These techniques have been shown to reduce the levels of stress and anxiety and improve one’s overall quality of life. It is important for relaxation techniques to be individualised and customised to meet the yourneeds and preferences. You should seek professional support and guidance especially as dditional strategies such as psychotherapy can enhance the effectiveness of relaxation techniques.. You should also be aware of the potential limitations of relaxation techniques and consult with your doctor if you are in any doubt.


  1. Locke AB, Kirst N, Shultz CG. Diagnosis and management of generalized anxiety disorder and panic disorder in adults. American Family Physician; 2015. 91(9): 617-624.
  2. National Health Service (NHS). 2023. Panic Disorder.
  3. Mayo Clinic. 2023. Panic attacks and panic disorder.
  4. National Institute of Mental Health (NIMH). 2023. Panic Disorder: when fear overwhelms.
  5. Smoller JW, Andreassen OA, Edenberg HJ, Faraone SV, Glatt SJ, Kendler KS. Psychiatric genetics and the structure of psychopathology. Mol Psychiatry; 2019. 24(3): 409-420.
  6. Bystritsky A, Khalsa SS, Cameron ME, Schiffman J. Current diagnosis and treatment of anxiety disorders. P T; 2013. 38(1): 30-38, 41-44, 57.
  7. Wittchen HU, Hoyer J. Generalized anxiety disorder: nature and course. J Clin Psychiatry; 2001. 11: 15-19.
  8. Bremner JD. Functional neuroanatomical correlates of traumatic stress revisited 7 years later, this time with data. Psychopharmacol Bull; 2003. 37(2): 6-25.
  9. Rapee RM, Oar EL, Johnco CJ, Forbes MK, Fardouly J, Magson NR, Richardson CE. Adolescent development and risk for the onset of social-emotional disorders: a review and conceptual model. Behav Res Ther; 2019. 123: 103501.
  10. Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disorders. Dialogues Clin Neurosci; 2017. 19(2): 93-107. 
  11. Pollack MH, Smoller JW. The longitudinal course and outcome of panic disorder. Psychiatr Clin North Am; 1995. 18(4): 785-801.
  12. Scott KM, Lim C, Al-Hamzawi A, Alonso J, Bruffaerts R, Caldas-de-Almeida JM, Florescu S, de Girolamo G, Hu C, de Jonge P, Kawakami N, Medina-Mora ME, Moskalewicz J, Navarro-Mateu F, O’Neill S, Piazza M, Posada-Villa J, Torres Y, Kessler RC. Association of mental disorders with subsequent chronic physical conditions: world mental health surveys from 17 countries. JAMA Psychiatry; 2016. 73(2): 150-158.
  13. Manzoni GM, Pagnini F, Castelnuovo G, Molinari E. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry; 2008. 8: 41.
  14. Hoge EA, Bui E, Marques L, Metcalf CA, Morris LK, Robinaugh DJ, Worthington JJ, Pollack MH, Simon NM. Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. J Clin Psychiatry; 2013. 74(8): 786-792.
  15. Medical News Today. 2023. How can you stop a panic attack?
  16. 2023. Relaxation Techniques for Stress Relief.
  17. YoungMinds. 2023. How I use Progressive Muscle Relaxation for anxiety.
  18. Clum GA, Watkins PL, Borden JW, Broyles SE, Hayes J. A comparison of guided imaging coping and imaginal exposure in the treatment of panic disorder. Journal of Rational-Emotive and Cognitive-Behavior Therapy; 1993. 11: 179-193.
  19. erywellmind. 20223. What is mindfulness meditation?
  20. Cramer H, Lauche R, Langhorst J, Dobos G. Yoga for depression: a systematic review and meta-analysis. Depress Anxiety; 2013. 30(11): 1068-1083.
  21. Li F, Harmer P, Fitzgerald K, Eckstrom E, Stock R, Galver J, Maddalozzo G, Batya SS. Tai chi and postural stability in patients with Parkinson’s disease. N Engl J Med; 2012. 366(6): 511-519.
  22. NHS Inform. 2023. Relaxation techniques to help prevent falls.
  23. National Center for Complementary and Integrative Health. 2023. Relaxation Techniques: What You Need To Know.
  24. University of Michigan Health. 2023. Stress Management: Breathing Exercises for Relaxation.
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Athina Servi

Research Assistant at Imperial College London, Department of Brain Sciences

My name is Athina Servi, and I am a young professional with a strong academic background
and a passion for neuroscience and mental health. I graduated from the University College
London with a degree in Biomedical Sciences BSc and then I pursued a Translational
Neuroscience MSc at Imperial College London where I currently work as a Research
Assistant. My academic and professional journey so far has provided me with extensive
experience in various healthcare settings. I believe in making medical information accessible
to everyone, not just those with a medical background. Through my writing, I want to help
people better understand their health, make informed decisions about their care, and
ultimately, live healthier, happier lives. I hope you enjoy my article!

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