Panic Disorder

Panic disorder is characterized by multiple, unanticipated panic attacks, which are episodes of overwhelming fear of being in danger without any specific cause for the fear. Panic attacks can be both distressing and disabling. In the period between panic attacks, persons with panic disorder worry excessively about when and where the next attack may occur. Panic disorder often occurs in late adolescence or early adulthood, but may also begin in childhood.
Panic disorder affects approximately six million American adults, according to the National Institute of Mental Health, with twice as many women as men affected. About one-third of all people with panic disorder develop agoraphobia, an illness in which they become afraid of being in any place or situation where escape might be difficult or help unavailable in the event of a panic attack. Persons with panic disorders are more likely to abuse alcohol or drugs.

Causes of Panic Disorder
The causes of panic disorder are not known, although potentially causative factors include family history, brain abnormalities, substance abuse and major life stress.
Symptoms of Panic Disorder
Panic disorder is characterized by panic attacks, which can occur at any time of the day or night, even during sleep. An attack usually peaks within 10 minutes, but some symptoms may persist for longer.
Each person may experience different symptoms of a panic attack. Common symptoms include:
  • Pounding heart
  • Sweating
  • Trembling or shaking
  • Shortness of breath
  • Sensation of choking
  • Nausea or abdominal pain
  • Dizziness or lightheadedness
  • Feeling unreal or disconnected from oneself
  • Fear of losing control
  • Fear of "going crazy" or dying
  • Numbness
  • Chills or hot flashes
  • Physical symptoms (suggestive of a cardiac or thyroid problem)

The symptoms of a panic attack may resemble those of other psychiatric conditions, including other types of anxiety disorder.

Diagnosing Panic Disorder
Not everyone who experiences panic attacks will develop panic disorder. To diagnose panic disorder, your doctor will first perform a thorough physical exam and obtain a medical and social history. Information about your symptoms, situations that cause the attacks, personal relationships that may be difficult, and your overall fears and concerns may be obtained with use of self-assessment tools and questionnaires. You may also be asked about your use of alcohol or other substances because panic disorder often coexists with drug abuse or alcoholism, as well as depression. Because certain cardiac and thyroid disorders may cause symptoms that resemble those of panic disorder, blood tests or other tests may be needed to rule them out as a cause of the panic attacks.

Treating Panic Disorder
If you are experiencing the symptoms of panic disorder, it is critical to seek help early because of the risk that ongoing panic episodes may restrict your normal activities and might lead to agoraphobia.
Panic disorder is one of the most treatable of all anxiety disorders, responding well in most cases to different treatments that can alter the thought patterns that cause fear and anxiety.

Specific treatment for panic disorder will be determined by your individual circumstances, and takes into account the following:
  • Your age, overall health and medical history
  • The severity and extent of your disease
  • Your tolerance for specific medications, procedures or therapies
  • Your expectations for the course of the disease
  • Your opinion or preference

Two main types of treatment prescribed for patients with panic disorder include:
  • Medications such as antidepressants or mild sedatives are commonly used to treat panic disorder.
  • Psychotherapy (or ‘talk’ therapy) may help you overcome the fears or issues that cause panic attacks and learn how to cope with or stop them.