Panic Disorder Guides & Articles

Catrina Cowart

Last updated: Jul. 07, 2023

Brindusa Vanta, MD, DHMHS

Medical Editor

What Is Panic Disorder?

Panic disorder is a type of anxiety disorder that causes regular, recurring panic attacks. ¹ Often, these attacks have no recognizable trigger (an act, thought, or item that causes panic). While most people experience panic at some point in their lives, those living with a panic disorder have a specific set of symptoms. These symptoms are severe enough to decrease their quality of life. ¹

Panic disorders have many causes, but the mechanisms behind them aren't completely understood. These disorders can lead to regular panic attacks and may cause serious disruptions to a person's life. Panic attacks have a sudden onset and cause intense physical and psychological symptoms. These symptoms include heart palpitations, nausea, trembling, sweating, shaking, breathlessness, fear of losing control, and/or a sense of impending doom.

No two people experience these attacks exactly alike, but they do share common symptoms. ²

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What Causes a Panic Disorder?

Panic disorders and attacks have several potential underlying causes. Factors such as major stress, trauma, genetics, temperament, and changes in the way the brain functions can all affect the likelihood of developing a panic disorder. ²

Research suggests that the body's fight-or-flight response triggers during a panic attack, but it's unclear why these attacks occur when no there's no danger present.

Some potential risk factors for developing a panic disorder include: ²

A family history of panic attacks
Significant life changes, such as having a new baby or getting a divorce
A history of sexual or childhood abuse
Living through or witnessing a traumatic event
Major life stress, such as an illness or the death of a loved one

Unfortunately, complications of a panic disorder can occur. Complications can include the development of specific phobias, problems at work or school, financial issues, depression and anxiety, suicidal thoughts, and others. Some people may also develop agoraphobia, which is an avoidance of places or situations they fear they can't escape. With agoraphobia, the person may no longer be able to leave home or may need support to do so. ²

What Are Symptoms of Panic Disorder?

Panic attacks present differently for each person, but they often share some common symptoms. Panic disorder symptoms may include: ²

Sweating
Hot flashes
Nausea
A sense of impending doom
Headaches
Dizziness or faintness
Detachment
Chest pain
Fear of loss of control
Fear of death
Heart palpitations (or a sensation of a pounding heart)
Abdominal cramping
Shaking or trembling
Shortness of breath
Chills
Intense fear

After a panic attack, individuals may feel exhausted or weak from the energy used. They may also develop anxiety or depression in response to the risk of having a panic attack unexpectedly in the future.

How Is a Panic Disorder Diagnosed?

A panic disorder diagnosis starts with a visit to a primary care physician. They perform a full physical exam and run blood tests to check for physical problems that might present as panic attacks, such as issues with the heart or thyroid. ³

Next, the patient goes through a psychological evaluation.

According to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), patients must have symptoms that meet specific criteria to receive a diagnosis. ⁴
For a panic attack diagnosis, a patient must experience a period of intense fear or discomfort. They must also have four or more symptoms, such as palpitations, trembling, nausea, dizziness, or sweating, that peak within minutes. ⁴

For agoraphobia, there must be fear or anxiety about one of the following five situations: ⁴

Being in open spaces
Being in enclosed spaces
Being outside alone
Standing in line/in a crowd
Using public transportation

For a panic disorder with or without agoraphobia, the patient has to have recurrent and unexpected panic attacks. Those attacks must come with at least 1 month of concern about additional attacks or maladaptive changes in behavior in response to the attack. ⁴

Best Treatment for Panic Disorder

Two primary panic disorder treatment options include psychotherapy and medications. Psychotherapy, also known as talk therapy, helps patients understand their panic attacks and learn to cope with them. They may try cognitive behavioral therapy (CBT), which helps patients learn that panic attack symptoms aren't dangerous. Then, with gradual recreation of those symptoms in a safe environment, they slowly overcome fears and see the attacks lessen. ³

Medications can also support recovery or reduce symptoms. Commonly used medications include: ³

Selective serotonin reuptake inhibitors (SSRIs)
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
Benzodiazepines

Find help for treating a panic disorder today.

How to Cope With a Panic Disorder Diagnosis

To cope with panic attacks, people can start by recognizing the symptoms. Once a person learns to recognize the symptoms, their fear of dying may decrease. ⁵

More ways to cope with a panic attack include: ⁵

Closing the eyes to reduce stimulation
Taking deep breaths to reduce the risk of hyperventilation
Using a focus object to take attention away from the symptoms
Challenging negative thoughts with rational ones
Trying progressive muscle relaxation, which relaxes one muscle at a time throughout the body

Those on medications should take them as prescribed. People who experience an increase in panic activity should reach out to their healthcare providers.

How to Help Someone Diagnosed With a Panic Disorder

Someone with a panic disorder may state that they're dealing with an attack. In that case, those around them can help by asking if they want someone to remain with them. If possible, the person should go to a quiet place, and someone should stay there to help them focus or stay present.

Other things a person can do to help include: ⁶

Helping to slow down the person's breathing by counting with them
Speaking in short sentences
Staying calm
Providing support with positive mantras or assisting them in getting what they need

Panic vs Anxiety Disorder

Panic and other anxiety disorders have some overlapping symptoms but aren't exactly the same. Anxiety often has clear triggers, but panic disorders can cause panic attacks suddenly and without cause. ⁷

Anxiety, which may have an obvious trigger, can lead to an anxiety attack with symptoms such as nausea, numbness, dizziness, or other functional impairments. Panic attacks, which may not have an obvious trigger, can do the same.