Panic disorder happens when you experience recurring unexpected panic attacks. The DSM-5 explains panic attacks as abrupt surges of intense fear or discomfort that peak within minutes. People with the disorder live in fear of having a panic attack. You may be having a panic attack when you feel sudden, overwhelming terror that has no obvious reason and or cause. You may notice physical symptoms, such as a racing heart, breathing difficulties, and sweating.
Most people have a panic attack once or twice in their lives. The American Psychological Association says that 1 out of every 75 people might experience a panic disorder. Panic disorder is characterized by persistent fear of having another panic attack after you have had at least one month (or more) of persistent concern or worry about additional panic attacks (or their consequences) recurring.
Even though the signs and symptoms of this disorder can be quite overwhelming and frightening, they can be managed and improved with treatment. Seeking treatment is the most vital part of reducing symptoms and improving your quality of life.
What are the symptoms of panic disorder?
Symptoms of panic disorder often starts to appear in teens and young adults under the age of 25. If you have experienced four or more panic attacks, or you live in fear of having another panic attack after experiencing one, you may have a panic disorder.
Panic attacks creates intense fear that begins suddenly, often with no warning. An attack typically lasts for 10 to 20 minutes, but in extreme cases, signs may last for more than an hour. The experience is different for everyone, and symptoms often vary.
Common symptoms linked with a panic attack include:
- racing heartbeat or palpitations
- shortness of breath
- feeling like you are choking
- dizziness (vertigo)
- sweating or chills
- shaking or trembling
- changes in mental state, including a feeling of derealization (feeling of unreality) or depersonalization (being detached from oneself)
- numbness or tingling in your hands or feet
- chest pain or tightness
- fear that you might die
The symptoms of a panic attack often happen for no clear reason. Typically, the symptoms are not equal to the level of danger that exists in the environment. Because these attacks can’t be predicted, they can greatly affect your functioning.
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Fear of a panic attack or recalling a panic attack can result in another attack.
What a panic attack feels like
Hear from real people who have had a panic attack.
What causes panic disorder?
The real causes of panic disorder are not clearly understood. Research has indicated that panic disorder may be genetically linked. Panic disorder is also linked with significant transitions that happen in life. Leaving for college, getting married, or having your first child are all major life transitions that may generate stress and lead to the development of panic disorder.
Who is at risk for developing panic disorder?
Although the causes of panic disorder are not clearly known, information about the disease does show that certain groups are more likely to develop the disorder. In particular, women are twice as likely as men to develop the condition, according to the National Institute of Mental Health.
How is panic disorder diagnosed?
If you notice symptoms of a panic attack, you may seek emergency medical care. Most people who have a panic attack for the first time believe that they are having a heart attack.
While at the emergency department, the emergency provider will carry out several tests to see if your signs are caused by a heart attack. They may run blood tests to rule out other conditions that can create similar symptoms, or an electrocardiogram (ECG) to check heart function. If there is no emergency basis to your signs, you will be referred back to your primary care provider.
Your primary care provider may carry out a mental health examination and ask you about your symptoms. All other medical disorders will be ruled out before your primary care provider makes a diagnosis of panic disorder.
How is panic disorder treated?
Treatment for panic disorder focuses on reducing or eliminating your signs. This is achieved through therapy with a qualified professional and in some cases, medication. Therapy typically involves cognitive-behavioral therapy (CBT). This therapy helps you to change your thoughts and actions so that you can understand your attacks and manage your fear.
Medications used to treat panic disorder can be inclusive of selective serotonin reuptake inhibitors (SSRIs), a class of antidepressant. SSRIs prescribed for panic disorder may include:
Other medications often used to treat panic disorder include:
- serotonin-norepinephrine reuptake inhibitors (SNRIs), another class of antidepressant
- antiseizure drugs
- benzodiazepines (commonly used as tranquilizers), including diazepam or clonazepam
- monoamine oxidase inhibitors (MAOIs), another type of antidepressant that is prescribed infrequently due to rare but serious side effects
In addition to these treatments, there are a number of steps that you can take at home to reduce your symptoms and signs. Examples include:
- maintaining a regular schedule
- exercising on a regular basis
- getting enough sleep
- avoiding the use of stimulants such as caffeine
What is the long-term outlook?
Panic disorder is most times a chronic (long-term) condition that can be hard to treat. Some people with this disorder do not respond well to treatment. Others may have intervals when they have no symptoms and periods when their symptoms are quite intense. Most people with panic disorder will notice some symptom relief through treatment.
How can panic disorder be prevented?
It may not be possible to keep panic disorder. However, you can work to reduce your symptoms by avoiding alcohol and stimulants such as caffeine as well as illicit drugs. It is also helpful to notice if you are having symptoms of anxiety following a distressing life event. If you are bothered by something that you experienced or were exposed to, discuss the situation with your primary care provider