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Panic disorder occurs when you experience recurring, unexpected panic attacks.
You may be having a panic attack when you feel sudden, overwhelming terror that has no obvious cause. There may be physical symptoms too, such as a racing heart, breathing difficulties, and sweating.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines a panic attack as “an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes.”
Most people experience a panic attack once or twice in their lives. According to a 2019 study, 2 to 4 percent of people have a panic disorder.
Panic disorder is defined by at least 1 month of persistent fear about panic attacks (or their effects) reoccurring.
Symptoms of panic disorder often begin to appear in young adults between 20 and 24 years old. You may have a panic disorder if you’ve had four or more panic attacks, or you live in fear of having another panic attack after experiencing one.
Even though the symptoms of panic disorder can be overwhelming and frightening, they can be managed and improved with treatment. Seeking treatment is the most important part of reducing symptoms and improving your quality of life.
What a panic attack feels like
Panic attacks produce intense fear that begins suddenly, often with no warning. An attack typically lasts for 5 to 20 minutes. In extreme cases, symptoms may last for more than 1 hour. The experience is different for everyone, and symptoms often vary.
Common symptoms associated with a panic attack include:
- • racing heart rate or palpitations
- • shortness of breath
- • feeling like you’re choking
- • dizziness or vertigo
- • lightheadedness
- • nausea
- • sweating or chills
- • shaking or trembling
- • changes in your mental state, such as a feeling of derealization (feeling of unreality) or depersonalization (being detached from oneself)
- • numbness or tingling in your hands or feet
- • chest pain or tightness
- • fear that you might die
The symptoms of a panic attack often occur for no clear reason. Typically, the symptoms are not proportionate to the level of danger that exists in your environment.
Because these attacks cannot be predicted, they can significantly affect your everyday life.
Causes of panic disorder
The causes of panic disorder are not clearly understood.
Some research has shown that panic disorder may be genetically linked, while other studies have not found a strong connection between panic disorder and a person’s genetics.
Panic disorder is also associated with significant life changes. Leaving for college, getting married, or having your first child are all major life transitions that may create stress and lead to the development of panic disorder.
Fear of a panic attack or recalling a panic attack can result in another attack.
Treatment options
Treatment for panic disorder focuses on reducing or eliminating your symptoms. This is achieved through therapy with a qualified professional and, in some cases, medication.
Therapy typically involves cognitive behavioral therapy (CBT). This therapy teaches you to change your thoughts and actions so you can understand your panic attacks and manage your fear.
Medications used to treat panic disorder can include selective serotonin reuptake inhibitors (SSRIs), which are a class of antidepressants. SSRIs prescribed for panic disorder may include:
- • fluoxetine (Prozac)
- • paroxetine (Paxil)
- • sertraline (Zoloft)
Other medications sometimes used to treat panic disorder include:
- • serotonin-norepinephrine reuptake inhibitors (SNRIs), which are also antidepressants
- • monoamine oxidase inhibitors (MAOIs), which are antidepressants that are used infrequently because of rare but serious side effects
- • antiseizure drugs
- • benzodiazepines (commonly used as tranquilizers), including alprazolam (Xanax) or clonazepam (Klonopin)
In addition to these treatments, there are a number of steps you can take at home to reduce your symptoms. Examples include:
- • maintaining a regular schedule
- • exercising on a regular basis
- • getting enough sleep
- • avoiding stimulants such as caffeine
Risk factors for panic disorder
Although the causes of panic disorder are not clearly understood, information about the condition does indicate that certain groups are more likely to develop it.
In particular, women are more likely than men to develop the condition, according to the National Institute of Mental Health. In general, research shows that anxiety disorders such as panic disorder are more common in women than in men.
Panic disorder is also more common in teens and young adults than in other age groups.
Complications of panic disorder
If left untreated, panic disorder can have a significant effect on your daily life. Complications include:
- • suicidal ideation
- • depression
- • agoraphobia
- • delayed development in children and teens, as fear of having a panic attack may make it difficult to attend school or maintain relationships
Rates of substance use disorder and alcohol use disorder are high among people with anxiety disorders. More research is needed to determine if anxiety disorders cause substance and alcohol use disorder or vice versa.
How to get a diagnosis
If you experience symptoms of a panic attack for the first time, you may want to seek emergency medical care. Most people who have a panic attack for the first time believe they’re having a heart attack. It can be hard to differentiate the symptoms without the help of a medical professional.
While at the emergency care facility, a healthcare professional will perform several tests to see if your symptoms are caused by a heart attack. They may run blood tests to rule out other conditions that can cause similar symptoms, or an electrocardiogram (ECG or EKG) to check your heart function.
If they determine you do not need emergency care, you’ll be referred back to your primary care provider, if you have one.
Your primary care provider may perform a mental health examination and ask about your symptoms. All other medical disorders will be ruled out before your primary care provider makes a diagnosis of panic disorder.
A mental health professional can also diagnose panic disorder.
Can it be prevented?
Panic disorder is often a long-term condition that can be difficult to treat.
Some people with this disorder do not respond well to treatment. Others may have periods when they have no symptoms and periods when their symptoms are quite intense. Most people with panic disorder will experience some symptom relief through treatment.
It may not be possible to prevent panic disorder. However, you can work to reduce your symptoms by using substances only as prescribed and avoiding alcohol and stimulants.
It’s also helpful to notice if you’re having symptoms of anxiety following a distressing life event. If you’re bothered by something that you experienced or were exposed to, discuss the situation with your primary care provider or a mental health professional.