Panic disorder is a mental illness known for its sudden, sometimes dread-filled episodes, called panic attacks. A person in the grips of such an attack experiences a rush of overwhelming fear and intense physical discomfort. Some people feel as though they’re going crazy or they’re on the brink of death.
You might be diagnosed with panic disorder if you are having recurrent panic attacks and you worry about having future episodes or you fear the physical or mental toll of your next attack.
“It’s not actually about the frequency of the panic attacks but, instead, how the panic attacks change one’s behavior,” explains Lily Brown, PhD, director of research with the Center for the Treatment and Study of Anxiety at the University of Pennsylvania’s Perelman School of Medicine.
People with panic disorder often avoid certain places or activities they believe might trigger a panic attack. Someone might skip exercise, for example, “because it stirs up these physiological sensations that resemble a panic attack,” Brown explains.
While panic attack symptoms (such as anxious thoughts, racing heart, and shortness of breath) usually subside within minutes, panic disorder can be a chronic condition. But treatment can help reduce symptom severity and frequency and improve people’s quality of life.
What is panic disorder?
Panic disorder is considered an anxiety disorder. It’s in a category of mental illnesses that includes generalized anxiety disorder, social anxiety disorder, and other phobias. According to the Diagnostic and Statistical Manual of Mental Disorders, panic disorder may be diagnosed if a person is having recurrent panic attacks (two or more) followed by one month or more of:
- Persistent worry about additional panic attacks or their consequences, and/or
- A significant change in behavior due to these attacks, such as avoidance of certain situations seen as potential triggers.
Panic disorder symptoms
Panic disorder, by definition, affects people who have recurring panic attacks. These episodes seem to arise out of the blue. They’re not due to substance use, a medical condition, or some other psychiatric disorder. Suddenly, the person is mired in fear or physical discomfort before symptoms abate minutes later.
During a panic episode, a litany of symptoms can arise. These include heart palpitations, sweating, trembling, shortness of breath, a feeling of choking, lightheadedness, chest pain, nausea, a feeling of detachment, fear of losing control, numbness or tingling, chills or hot flushes, and a fear of dying.
Panic disorder symptoms are connected to these troubling episodes. A defining symptom of panic disorder is panic-related worry. Put another way, people with panic disorder either fret about having panic attacks or they avoid places or activities that might trigger an attack, or both. As a result, panic disorder can interfere with people’s livelihoods and relationships.
Some people with panic disorder also develop agoraphobia, a fear of situations or places that might cause them to feel trapped and helpless. These folks fear being stuck in a crowd or in a confined space and having a panic attack.
Panic disorder causes
No one knows exactly what causes panic disorder, according to the National Institute of Mental Health (NIMH). It sometimes runs in families, but that doesn’t explain why some members have it and others do not.
Studies also suggest a possible link with brain structure and biology. Could it be that some people misinterpret harmless bodily sensations? That’s one theory, according to the NIMH. Environmental factors and people’s unique responses to stress may also play a role.
Panic disorder treatment
Panic disorder treatment consists of psychotherapy (also known as talk therapy), with or without medication.
A particular type of psychotherapy, called cognitive behavioral therapy, is considered first-line treatment for panic disorder because it teaches people more productive ways to respond to panicked feelings that arise or fear of another episode.
Antidepressants, such as SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), are often used for the treatment of panic disorder.
Less commonly, there may be times when doctors prescribe beta blockers, which stifle the body’s fight-or-flight response, or a short-term course of a benzodiazepine, a powerful sedative medication.
Plus, don’t forget self-care. Getting plenty of sleep, eating a healthy diet, maintaining an exercise regimen, and getting worries off your chest by sharing with a trusted friend or family member can help you keep anxious feelings in check.
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