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Common conditions

Panic Disorder

What is panic disorder?

What is panic disorder?

Panic attacks are episodes of sudden and intense fear when there is no real threat of danger. Physical symptoms like a racing heart, fast breathing, and sweating often occur alongside panicked thoughts. 

Panic disorder is a type of anxiety disorder. You may be diagnosed with panic disorder if you’ve had at least two panic attacks and worry constantly about having another one. Although panic attacks can feel scary, treatment can be very effective and help reduce worry and fear in your daily life.

Signs & symptoms of panic disorder

Symptoms

Panic attacks are experienced differently by everyone, but symptoms usually peak within minutes and then subside. Afterward, you might feel worn out or tired.

Physical symptoms of a panic attack include:

  • Chest pain
  • Dizziness
  • Nausea
  • Racing heart
  • Hyperventilation (difficulty breathing)
  • Shaking or trembling
  • Chills
  • Tingling (or numbness in the fingers or toes)
  • Cramping
  • Headache
  • Sweating
  • A choking sensation

Psychological symptoms of a panic attack include:

  • Intense fear
  • Fear of dying
  • Derealization (feeling detached from reality)
  • Depersonalization (feeling detached from yourself)
  • A fear of losing control
  • Fear of approaching danger

What causes panic disorder?

Causes

Your brain and nervous system control, interpret, and handle feelings of fear and anxiety. Some experts think that if you have panic disorder, your amygdala (the part of your brain that processes emotions) may be especially sensitive in responding to fear. Research has shown that there is a connection between panic attacks and phobias.

Factors that may put you at higher risk for developing panic disorder:

  • Stress and traumatic events. Trauma and stressful events can trigger panic disorder. Physical or emotional abuse, sudden death in the family, divorce, or changing your environment (new job or school) may contribute to panic attacks.
  • Mental health conditions: Other mental health conditions like anxiety disorders and depression can make you more prone to panic attacks.
  • Genes. Research suggests that your family history may affect your chances of having panic disorder. No genes have been identified, but families may pass down a likelihood of developing panic disorder through lifestyle or environment.
  • Smoking or excessive caffeine intake. Nicotine causes the release of chemicals that increase your heart rate and blood pressure. In high amounts, nicotine can even produce the same mental and physical symptoms as panic attacks. Similarly, taking in more than 400 mg of caffeine has also been shown to increase the likelihood of anxiety and panic attacks.

How is panic disorder diagnosed?

Diagnosis

Mental health providers, including psychologists and psychiatrists, can use the criteria within the Diagnostic and Statistical Manual of Mental Disorders to diagnose panic disorder. Your health provider may also run tests to rule out medical conditions that can cause similar physical symptoms, such as heart disease, thyroid disease, and breathing problems.

You may be diagnosed with panic disorder if no other condition is causing your symptoms and you’ve had two or more panic attacks. Panic disorder may also come with the constant worry of having more panic attacks or changing your everyday behaviors to avoid anything you think may trigger a panic attack.

Some tests you may undergo are:

  • A physical exam
  • Blood tests (to check your thyroid)
  • Heart tests such as an electrocardiogram
  • A psychological evaluation to better get to know you, your family history, and your symptoms

How is panic disorder treated?

Treatment

After you are diagnosed with panic disorder, you could be treated with psychotherapy (talk therapy), medication, or both, depending on your specific needs.

Treatment may include:

  • Medication (benzodiazepines or antidepressants)
  • Counseling (cognitive behavioral therapy or psychotherapy)
  • Learning relaxation techniques
  • Strategies to help with coping skills
  • Making lifestyle changes to reduce stress
  • Quitting smoking or drug use

Your health provider may recommend lifestyle changes such as getting more sleep, reducing your consumption of alcohol and caffeine, or exercising more frequently, which can help lower stress.

FAQs

FAQ

How can I stop a panic attack?

If you’re experiencing a panic attack, you can breathe deeply to prevent hyperventilation (difficulty breathing). Try to remember that the attack is temporary and will soon be over; relax your muscles and ground yourself to stay present.

How can I help someone else experiencing a panic attack?

If someone you are with starts having a panic attack, you can help them by remaining calm, asking what they need, counting slowly with them to regulate their inhales and exhales, and reassuring them that the panic attack is temporary and will soon be over.