Panic disorder is a kind of anxiety disorder that makes people have sudden and repeated panic attacks. A panic attack is a feeling of extreme fear or discomfort that happens very quickly and has physical and mental signs such as:
Fast or pounding heartbeat
Sweating
Shaking or trembling
Trouble breathing or feeling choked
Chest pain or tightness
Stomach upset or pain
Feeling dizzy, faint, or unsteady
Feeling cold or hot
Numbness or tingling in the body
Feeling unreal or detached from oneself
Fear of losing control or going crazy
Fear of dying
People with panic disorder may also be afraid of places or situations where they think they cannot escape or get help if they have a panic attack, such as crowds, public transport, open spaces, or being alone. This is called agoraphobia, and it can make people avoid things that may cause a panic attack.
The exact reasons why some people get panic disorder are not clear, but some possible factors are:
Genetics: Panic disorder may be passed down from parents or relatives and be affected by inherited traits.
Brain structure and function: Panic disorder may be linked to problems in the brain areas that control fear and anxiety reactions.
Stress and trauma: Panic disorder may start or get worse because of stressful or traumatic life events, such as abuse, violence, loss, or illness.
Personality and temperament: Panic disorder may be more common in people who have a negative outlook, are easily worried, or have low self-confidence.
Substance use: Panic disorder may be related to the use or stopping of certain substances, such as caffeine, alcohol, nicotine, or drugs.
To find out if someone has panic disorder, a doctor or mental health professional will:
Do a physical exam and check for any medical conditions that may cause or look like panic attacks, such as thyroid problems, heart disorders, or breathing issues.
Ask about how often, how strong, how long, and what causes the panic attacks, as well as how they affect daily life and happiness.
Use standard diagnostic rules, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), to see if the symptoms match the definition of panic disorder and/or agoraphobia.
Check for other mental health conditions that may happen with panic disorder, such as depression, bipolar disorder, obsessive-compulsive disorder, or post-traumatic stress disorder.
Panic disorder can be treated well with a mix of psychotherapy and medication. The main aims of treatment are to make the panic attacks less often and less strong, to reduce the fear of having panic attacks, and to improve the ability to deal with anxiety and stress.
Psychotherapy: The most common and effective type of psychotherapy for panic disorder is cognitive-behavioral therapy (CBT), which helps to find and change the negative thoughts and beliefs that lead to panic attacks, and to learn and practice relaxation and coping skills to handle anxiety and stress. CBT may also have exposure therapy, which means slowly facing the scary situations or feelings that cause panic attacks, in a safe and controlled way, until they become less scary and upsetting.
Medication: The most common and effective types of medication for panic disorder are antidepressants and anti-anxiety drugs, which help to balance the brain chemicals that affect mood and anxiety. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), may take a few weeks to show their full effects, but can also prevent or reduce the symptoms of depression that often happen with panic disorder. Anti-anxiety drugs, such as benzodiazepines, may
