Understanding Panic Disorder: Symptoms, Treatment & Help

Definition of Panic Disorder and Panic Attack

A panic attack is a sudden episode of overwhelming fear accompanied by a sense of losing control. It occurs even in the absence of any apparent danger. Panic attacks can occur unpredictably without any obvious trigger. 

Some people have sudden and repeated panic attacks — this is called a panic disorder. You can have several panic attacks a day or only a few panic attacks each year. Not everyone who has a panic attack will go on to develop panic disorder. 

Distinction Between Panic Disorder and Panic Anxiety Disorder

According to the Anxiety and Depression Association of America and the National Institute of Health, anxiety disorders are mental health conditions associated with excessive worry and fear. Panic disorder is a type of anxiety disorder. 

Other types of anxiety disorders include generalized anxiety disorder (GAD) and specific phobias, such as agoraphobia (fear of leaving places the person knows or considers to be safe). Social phobia, separation anxiety, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD) are also related conditions.

An anxiety attack is associated with intense worry. It is triggered by stress that builds up gradually over a period of time. Anxiety attacks can last for hours, days, or longer. In contrast, panic attacks occur suddenly, often without any apparent trigger. The symptoms typically peak within 10 minutes and last for 5-20 minutes.

Prevalence and Impact on Mental Health

Experts estimate that approximately 1 in 10 people experience a panic attack every year. About 2-3% of the U.S. population has a panic disorder. Women are twice as likely as men to have this mental health condition.

Panic attack symptoms include feelings of intense terror in the absence of any real danger. Repeated attacks and frequent symptoms of panic disorder can:

• Interfere with everyday life, including missed work

• Cause depression and disability

• Lead to constant fear and worry about when the next panic attack will occur

• Cause avoidance of situations or places that might trigger sudden attacks

• Cause physical symptoms

Panic disorder often interferes with a person’s daily life the most when it is accompanied by agoraphobia. This is a fear of certain public spaces. These situations are feared and avoided because the person believes that escape might be difficult or help might not be available if the person develops panic-like symptoms or other distressing symptoms such as incontinence.

For this reason, it is important to have panic disorder diagnosed and treated by a mental health professional.

Recognizing the Signs and Symptoms

Characteristics of Unexpected Panic Attacks

According to the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5), characteristics of unexpected panic attacks include:

• An abrupt episode of intense and overwhelming fear that occurs without warning and often without any specific trigger

• Perceived lack of control

• Feelings of impending doom

• Persistent concern about having more panic attacks

• Worry about the consequences of the panic attacks

• Avoidance of certain situations, activities, or places to prevent panic attacks

Read our blog to find out how to recover from a panic attack.

Physical Symptoms and Their Effects

Heart Rate Changes and Sensations of a Heart Attack

People experiencing panic attacks will often experience physical symptoms such as palpitations, a pounding heart rate, chest pain, or chest tightness. This can feel like you’re having a heart attack or you’re going to die.

Learn more about how to tell the difference between a panic attack vs heart attack.

Shortness of Breath, Trembling, and Nausea

Additional physical symptoms of panic disorder include trembling or shaking, shortness of breath, and smothering or choking sensations. These may be accompanied by nausea and stomach distress.

Other Sensory Symptoms: Tingling, Dizziness, Chills, and Sweating

Many people experience dizziness, unsteadiness, and lightheadedness. Chills, sweating, hot flashes, and numbness or tingling sensations are also common during panic attacks.

Psychological Impact: From Agoraphobia to Unreality

People with panic disorder also report derealization (feelings of losing touch with reality) and depersonalization (feelings of looking at oneself from outside their body). Some people feel like they’re losing control or going crazy. Agoraphobia (a fear of being in places or situations where you feel you may become trapped or helpless) sometimes accompanies panic disorders.

Causes and Aggravating Factors

Understanding the Root Causes of Panic Disorder

We don’t know what exactly causes panic disorders or why some people develop panic attacks. Researchers believe these mental illnesses occur due to chemical imbalances and changes in the amygdala, the part of the brain that handles fear, anxiety, and emotions. 

Learn more about how to live with anxiety.

Role of Genetics, Stress, and Other Mental Health Conditions

You are more likely to develop panic disorder if you have a family history of anxiety disorders. People with one or more close relatives (parents, siblings, or children) with panic disorder are at a 40% higher risk of developing this condition themselves.

Additionally, other mental illnesses, such as depression and anxiety, can increase your risk of developing panic attacks.

Identifying Aggravators: Life Stressors and Health Conditions

Childhood trauma, such as abuse, is a risk factor for panic disorders. This condition can occur in children but is usually diagnosed later in life, typically in the teens or early adulthood.

Other aggravating factors that can contribute to the development of panic attacks and panic disorder include stressful life experiences such as bereavement, traumatic events such as sexual assault, or major changes in life such as divorce.

When to Seek Medical Help: Identifying the Need for Professional Intervention

Difference Between Occasional Anxiety and Panic Disorder

Occasional anxiety occurs in response to stressors, such as money, health, or family problems. It is a normal part of life, and most people have experienced it a few times. Panic disorder is the occurrence of repeated panic attacks, which are sudden, intense episodes of overwhelming fear. 

Symptoms That Warrant a Visit to a Health Professional

If you are experiencing symptoms such as chest pain, trouble breathing, or loss of consciousness, seek emergency medical care. A heart attack can cause similar symptoms, and you should be evaluated as soon as possible.

Also, seek care from a mental health professional if you have frequent panic attacks that interfere with daily life. For example, if you worry about having another panic attack or have made changes to your behavior, such as avoiding certain places or situations to prevent panic attacks.

The Importance of Early Diagnosis

If left untreated, a panic disorder can affect your quality of life and cause difficulties at work or school. Having your panic disorder treated is therefore important. A mental health professional can make an accurate diagnosis and prescribe appropriate treatments to people with panic disorder. They will obtain a medical history, perform a physical exam, and rule out if the symptoms are caused by an unrelated physical problem. 

Treatment and Management Options for Panic Disorder

Overview of Available Treatments

Psychotherapy Options: Cognitive Behavioral Therapy (CBT) and Other Forms

Psychotherapy modalities such as cognitive behavioral therapy (CBT) are proven to be effective in helping people with panic disorder. This is a research-based talk therapy that teaches you how to modify your thought patterns, emotions, and behaviors before or during a panic attack.

Another type of therapy, called exposure therapy, is sometimes used to treat panic disorders. During a session, the therapist exposes you to your fears (things, places, activities, or situations) in a safe, controlled environment. This helps you confront your fears and develop resilience in handling them.

Medications: SSRIs, SNRIs, Antidepressants, and Benzodiazepines

Antidepressant medications, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs), are commonly prescribed to people with panic disorder. These drugs help to balance brain chemicals. They take 2-4 weeks to start working and also treat depression and related symptoms.

Anti-anxiety medicines called benzodiazepines are sometimes used for the short term. They can provide faster relief from overwhelming anxiety symptoms. Learn more: Benzodiazepines Vs. SSRIs: What’s A Better Treatment Option?

Self-Help Strategies

During a panic attack:

• Take slow, deep breaths.

• Focus on positive, relaxing, peaceful images.

• Remember, the panic attack will pass, and it is not life-threatening.

Living with Panic Disorder: Coping Strategies and Long-Term Management

Developing Personal Coping Mechanisms: Stress Management and Relaxation Techniques

• Read self-help books or online blogs or listen to audio guides on cognitive behavioral therapy.

• Try relaxing activities like meditation, yoga, and pilates.

• Learn deep breathing exercises to manage stress.

The Role of Lifestyle Changes in Managing Panic Disorder

A healthy lifestyle can help you cope with your symptoms better:

• Get regular physical exercise.

• Eat a balanced, healthy diet and avoid unhealthy foods.

• Get enough restful sleep every night.

• Limit alcohol intake.

• Stop smoking.

• Talk to family members, friends, or health professionals for support.

Empowerment Through Medical Education and Support

During a panic attack, fear overwhelms you, accompanied by physical sensations. These symptoms can be extremely distressing. However, many people suffer in silence because they are unaware that treatment is available or they are too embarrassed to seek help. However, effective treatments are available for panic attacks and panic disorders. By learning about these conditions, you have taken the first important step towards getting a handle on your mental health. 

Building a Support System: Family, Friends, and Support Groups

Panic disorder can impact your life in a big way, but support is available. Reach out to family members and friends. It may also help to connect with people who are struggling with the same condition through a support group such as No Panic.

Common Questions

What are the types of panic attacks?

There are different types of panic attacks:

• Spontaneous panic attacks that occur without any apparent trigger

• Cued panic attacks that occur in response to a specific trigger

• Situationally predisposed panic attacks that are more likely to occur (but do not always occur) in specific situations

Does panic disorder ever go away?

Panic disorder can go away with treatment consisting of talk therapy and medications. It is important to get professional help as soon as possible. Without treatment, a panic disorder can progress and become harder to treat. 

How does panic disorder affect life?

As a panic disorder gets worse, you may have more frequent or more severe panic attacks that last longer. It can become difficult to cope with daily life, your job, and to function socially. This can progress to a fear of going to places where you feel it may be hard to escape or that might leave you helpless or embarrassed (agoraphobia). It can also lead to depression and cause you to abuse alcohol or drugs in order to cope.

What is panic anxiety disorder?

Panic disorder is a type of anxiety disorder in which people have frequent and sudden panic attacks with feelings of overwhelming fear lasting 5-20 minutes.