Panic Disorder

Panic disorder is different from the normal fear and anxiety reactions to stressful events. Panic disorder is a serious condition that strikes without reason or warning. Symptoms of panic disorder include sudden attacks of fear and nervousness, as well as physical symptoms such as sweating and a racing heart. During a panic attack, the fear response is out of proportion for the situation, which often is not threatening. Over time, a person with panic disorder develops a constant fear of having another panic attack, which can affect daily functioning and general quality of life.

Panic disorder often occurs along with other serious conditions, such as depression, alcoholism, or drug abuse.

What Are the Symptoms of Panic Disorder?

Symptoms of a panic attack, which often come on quickly and last about 10 minutes, include:

  • Difficulty breathing
  • Pounding heart or chest pain
  • Intense feeling of dread
  • Shortness of breath
  • Sensation of choking or smothering
  • Dizziness or feeling faint
  • Trembling or shaking
  • Sweating
  • Nausea or stomachache
  • Tingling or numbness in the fingers and toes
  • Chills or hot flashes
  • A fear that you are losing control or are about to die

Beyond the panic attacks themselves, a key symptom of panic disorder is the persistent fear of having future panic attacks. The fear of these attacks can cause the person to avoid places and situations where an attack has occurred or where they believe an attack may occur.

What Causes Panic Disorder?

Although the exact cause of panic disorder is not fully understood, studies have shown that a combination of factors, including biological and environmental, may be involved. These factors include.

  • Family history. Panic disorder has been shown to sometimes run in families. It may sometimes be passed on to people by one or both parents much like the risk for other complex diseases such as cancer or heart disease.
  • Abnormalities in the brain. Panic disorder may be caused by problems in regulating brain areas that control the "fight or flight" response.
  • Substance abuse. Abuse of drugs and alcohol can contribute to panic disorder.
  • Major life stress. Stressful events and major life transitions, such as the death of a loved one, can sometimes trigger panic attacks, which can potentially recur and go on to become panic disorder.

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How Common Is Panic Disorder?

Panic disorder affects about 2.4 million adult Americans. Panic disorder most often begins during late adolescence and early adulthood. It is twice as common in women as in men.

How Is Panic Disorder Diagnosed?

If symptoms of panic disorder are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose panic disorder, the doctor may use various tests to look for physical illness as the cause of symptoms.

If no physical illness is found, you may be referred to a psychiatrist, psychologist, or other mental health professional who is specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for panic disorder.

The doctor bases his or her diagnosis on reported intensity and duration of symptoms, including the frequency of panic attacks, and the doctor's observation of the patient's attitude and behavior. The doctor then determines if the symptoms and degree of dysfunction suggest panic disorder.

How Is Panic Disorder Treated?

A combination of the following therapies is often used to treat panic disorder.

  • Psychotherapy . Psychotherapy (a type of counseling) addresses the emotional response to mental illness. It is a process in which trained mental health professionals help people by talking through strategies for understanding and dealing with their disorder.
  • Cognitive behavioral therapy . A type of psychotherapy that helps a person learn to recognize and change thought patterns and behaviors that lead to troublesome feelings. Therapy also aims to identify possibly triggers for panic attacks.
  • Medication . There are several anti-depressant medications used to treat panic disorder. These are generally selective serotonin reuptake inhibitors (SSRI) such as Paxil and Zoloft. Anti-anxiety medications such as Xanax, Ativan, or Klonopin are also used to treat panic disorder. Sometimes, heart medications such as beta-blockers are used to help with situational anxiety.
  • Relaxation techniques.

Some people will respond well to treatment but experience panic attacks later in life. When panic attacks continue after treatment has stopped, additional treatment may still help control and reduce panic attacks. In addition, relaxation techniques, such as breathing retraining and positive visualization, may help a person during an attack.

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What Is the Outlook for People With Panic Disorder?

Panic disorder can be successfully treated, and sufferers can go on to lead full and satisfying lives. With appropriate treatment, nearly 90% of people with panic disorder can find relief. Unfortunately, many people with panic disorder do not seek treatment. Without treatment, panic disorder can have serious consequences and can severely impair quality of life. Complications of untreated panic disorder include.

  • Avoidance. A person may discontinue any activities that seem to trigger a panic attack. This can make a normal work and home life nearly impossible.
  • Anticipatory anxiety. This refers to anxiety that is triggered merely by thinking about the possibility of having an anxiety attack.
  • Agoraphobia. This is the fear of being in places or situations in which an attack may occur, or from which escape would be difficult or highly embarrassing. This fear can drive people to avoid public places and crowds, and may even progress to the point that the person will not leave his or her home. About one-third of people with panic disorder develop agoraphobia.
  • Claustrophobia. The person fears enclosed spaces.

Can Panic Disorder Be Prevented?

Panic disorder cannot be prevented; however, there are some things you can do to reduce overall stress which may decrease the intensity or frequency of symptoms, including:

  • Stop or reduce consumption of products that contain caffeine, such as coffee, tea, cola, and chocolate.
  • Ask your doctor or pharmacist before taking any over-the-counter drugs or herbal remedies. Many contain chemicals that can increase anxiety symptoms.
  • Exercise daily and eat a healthy, balanced diet.

WebMD Medical Reference Reviewed by Smitha Bhandari, MD on February 24, 2016

Sources

SOURCE:

National Institute of Mental Health.

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