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Panic Disorder

Definition

Panic disorder is a type of anxiety disorder characterized by recurrent and unpredictable bursts of terror known as panic attacks. A panic attack is accompanied by physical symptoms that may feel similar to a heart attack or other life-threatening condition.

Intense anxiety often develops between episodes of panic. As panic attacks become more frequent, people begin avoiding situations that could trigger them. Panic attacks can lead to agoraphobia. This is a fear of being trapped in places or situations where escape could be difficult or impossible.

Causes

Panic disorder is likely to be an interaction of:

  • Genetics
  • Changes in brain function or metabolism
  • Psychosocial stressors that combine to influence the brain's fear networks

Risk Factors

Panic disorder is more common in women and young adults. Other factors that may increase your risk of developing panic disorder include:

  • Family history
  • Stressful life events
  • Increased sensitivity to physical sensations
  • History of another anxiety disorder or anxious temperament
  • Cigarette smoking during adolescence and young adulthood

Symptoms

Panic attacks usually occur unexpectedly and repeatedly. Panic attack symptoms may include:

  • Sudden and intense episodes of fear
  • Racing, pounding, or skipping heartbeat
  • Chest pain, pressure, or discomfort
  • Difficulty breathing
  • Choking sensation or lump in the throat
  • Excessive sweating
  • Lightheadedness
  • Nausea
  • Tingling or numbness in parts of the body
  • Chills or hot flashes
  • Shaking or trembling
  • Feelings of unreality or being detached from the body
  • An urge to flee
  • Fear of impending doom, such as death, a heart attack, suffocation, loss of control, or embarrassment
  • Stomach pain
Symptoms of Anxiety
Physiological effects of anxiety
Copyright © Nucleus Medical Media, Inc.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will also be done. The diagnosis can be made if you have had a panic attack with at least four of the symptoms listed above and persistent worries about the attack for more than one month.

Since some panic disorder symptoms are similar to heart, digestive, and/or thyroid problems, your doctor may recommend tests to rule out an underlying condition.

Tell your doctor about your physical symptoms and how the symptoms make you feel. Your doctor will want to know if the panic attacks interfere with your normal activities. You should also tell your doctor if you:

  • Have been feeling sad or hopeless
  • Have been drinking or using drugs to control symptoms

Treatment

The goal of treatment is to decrease the frequency and intensity of panic attacks. Studies support a combination of treatment methods to achieve success. Talk to your doctor about the best treatment plan for you.

Options include:

General Education

Education helps people to better understand what panic disorder is and how it can be treated. It focuses on the concepts that symptoms are not life-threatening and are very common. It also helps the person to understand the course of treatment and develop realistic goals for overcoming the disorder. People who undergo treatment have an improved quality of life.

In some people, learning about panic disorder is enough to help relieve symptoms.

Cognitive Behavioral Therapy

Cognitive-behavioral therapy can prepare you for situations that may trigger panic attacks. Therapy focuses on:

  • Learning how to recognize what causes your fears
  • Gradually forming healthier thinking patterns
  • Doing breathing exercises to increase relaxation
  • Reducing fear and feelings of terror

Medications

Your doctor may recommend:

  • Antidepressants
  • Anti-anxiety medications

Dietary Changes

Some people find that avoiding caffeine may help reduce panic attacks. Caffeine is found in many products, like coffee, tea, chocolate, and soft drinks.

Prevention

To help reduce your chance of developing panic disorder, take these steps:

  • Avoid drinks that contain caffeine
  • Avoiding abusing alcohol and drugs
  • Getting plenty of rest
  • Scheduling a regular quiet time for yourself at home
  • Participate in regular exercise—aim for at least 30 minutes per day most days of the week

Revision Information

  • Anxiety Disorders Association of America

    http://www.adaa.org

  • Mental Health America

    http://www.nmha.org

  • Canadian Psychiatric Association

    http://www.cpa-apc.org

  • Canadian Psychological Association

    http://www.cpa.ca

  • Answers to your questions about panic disorder. American Psychological Association website. Available at: http://www.apa.org/topics/anxiety/panic-disorder.aspx. Accessed November 26, 2013.

  • Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Updated August 12, 2010. Accessed November 26, 2013.

  • Panic disorder. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated February 28, 2013. Accessed November 26, 2013.

  • Panic disorder and agoraphobia. Anxiety and Depression Association of America website. Available at: http://www.adaa.org/understanding-anxiety/panic-disorder-agoraphobia. Accessed November 26, 2013.

  • 8/22/2006 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Furukawa TA, Watanabe N, Churchill R. Psychotherapy plus antidepressant for panic disorder with or without agoraphobia: systematic review. Br J Psychiatry. 2006;188:305-312.