What Is Panic Disorder?
Panic disorder is a mental health condition characterized by recurrent, unexpected panic attacks—sudden surges of intense fear or discomfort that peak within minutes.
Panic attacks can happen without warning and often create ongoing fear of future episodes, leading to avoidance of situations where a person fears another attack might occur.
According to the National Institute of Mental Health (NIMH), around 2–3% of adults in the U.S. experience panic disorder in a given year. It often begins in late adolescence or early adulthood and can significantly impact daily functioning if untreated.
What Does a Panic Attack Feel Like?
A panic attack is intense and physical. People experiencing a panic attack often report:
- Racing or pounding heart
- Sweating
- Trembling or shaking
- Shortness of breath
- Feelings of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Dizziness or lightheadedness
- Chills or hot flashes
- Numbness or tingling sensations
- Feelings of unreality or detachment
- Fear of losing control or “going crazy”
- Fear of dying
These symptoms peak within 10 minutes, but the aftereffects can linger for hours.
Causes and Risk Factors of Panic Disorder
Panic disorder results from a complex interplay of biological, psychological, and environmental factors:
Biological Factors
- Genetic predisposition (family history increases risk)
- Brain chemistry involving neurotransmitters like serotonin and norepinephrine
- Heightened sensitivity in brain regions regulating fear and stress responses
Psychological Factors
- High sensitivity to stress
- Catastrophic misinterpretation of physical sensations (e.g., “I’m having a heart attack”)
Environmental Triggers
- Major life changes or stressors
- History of trauma or abuse
- Substance use (caffeine, drugs, alcohol can trigger panic symptoms)
Not everyone with risk factors develops panic disorder, suggesting multiple factors must converge for symptoms to emerge.
Panic Disorder vs. Everyday Anxiety
It’s common to feel anxious occasionally, but panic disorder is different:
- Everyday anxiety: Linked to specific worries (e.g., exams, work deadlines). Usually manageable.
- Panic disorder: Involves repeated panic attacks often without obvious triggers. Fear of future attacks causes significant distress and avoidance.
Some people develop agoraphobia, avoiding places or situations where escape might be difficult if panic symptoms arise.
Diagnosis and Assessment
Panic disorder is diagnosed based on criteria in the DSM-5-TR (2022):
- Recurrent, unexpected panic attacks
- At least one month of:
- Persistent worry about future attacks
- Maladaptive behavior changes (e.g., avoiding exercise or social situations)
Diagnosis includes:
- Clinical interview
- Medical evaluation to rule out physical causes (e.g., heart conditions, thyroid issues)
- Psychological questionnaires (e.g., Panic Disorder Severity Scale)
Important: Many people visit emergency rooms during their first panic attack, fearing a heart attack.
Treatment Options for Panic Disorder
Panic disorder is highly treatable, with several effective options:
Cognitive Behavioral Therapy (CBT)
- Gold standard treatment
- Helps challenge catastrophic thoughts
- Includes exposure techniques to reduce fear of physical sensations
Medications
- SSRIs (e.g., sertraline, fluoxetine): First-line for panic disorder
- SNRIs (e.g., venlafaxine)
- Benzodiazepines (e.g., clonazepam): Effective short-term but risk dependency
Lifestyle Strategies
- Regular exercise
- Limiting caffeine and alcohol
- Mindfulness and relaxation techniques
Early treatment can prevent panic disorder from worsening and improve quality of life.
Living with Panic Disorder
Living with panic disorder can be challenging but recovery is possible. Helpful strategies include:
- Following treatment consistently
- Educating loved ones about panic disorder
- Learning relaxation techniques
- Practicing gradual exposure to feared situations
- Joining support groups
With proper help, many people live full, satisfying lives despite panic disorder.
