Last reviewed:
Nov 22nd 2022
PharmD, BCPS
Panic disorder is a diagnosis of repeated, unexpected panic attacks and a persistent worry about having more attacks. It can be treated with medication, therapy, or a combination.
Panic disorder is a type of anxiety disorder. It is diagnosed in people who have recurring panic attacks and who live with a constant worry that another attack will occur. It can significantly impact a person’s quality of life, particularly if they look to avoid circumstances that may trigger a panic attack or situations where having a panic attack would be particularly problematic. For example, people with panic disorder may avoid stressful situations and crowded spaces. Some may develop agoraphobia, other specific phobias, or alcohol and drug problems.[1]
A panic attack is a sudden, intense feeling of fear that lasts a few minutes. They usually occur when awake, but some people are succeptible to nocturnal panic attacks too. Someone having a panic attack may experience some or all of the following symptoms:[2]
As so many panic attack symptoms are physical sensations, it can feel as though you are having a medical emergency such as a heart attack.[3]
Just over one in ten people a year will have a panic attack, but only a small number will develop panic disorder.[2]
Panic attacks come on very quickly and can last up to 20 minutes. Symptoms usually peak at around 10 minutes.[4] A panic attack can be a terrifying experience. If you have a panic attack, try to:
The terms ‘panic attack’ and ‘anxiety attack’ are often used interchangeably, but they are different experiences. Some of the symptoms – such as increased heart rate, shaking, and sweating – are similar, but there are some key differences:
Diagnosing panic disorder is not always straightforward.
According to the Diagnostic and Statistical Manual of Mental Disorders [5], used by mental health professionals in the US to diagnose mental health problems, diagnosis starts with an assessment of the panic attacks a person has been experiencing. They must satisfy the following criteria:
In addition to recurring, unexpected panic attacks, a person with panic disorder will also be very worried about having another attack and may go to some lengths to avoid certain circumstances as a result. This may include avoiding situations that may trigger an attack, such as stressful or crowded environments. It can also include avoiding situations where having a panic attack would be particularly distressing, such as in public.
Before panic disorder can be diagnosed, a doctor or mental health professional must also rule out other possible causes of the physical symptoms of a panic attack, such as heart problems or adverse effects from medication. You may be sent for medical tests as part of your assessment.
Patients with panic disorder often have other mental health conditions as well, including:[5]
They may also have co-existing physical health problems, including:[5]
The causes of panic disorder are not well understood, but there are some known links, including [6]
There are several ways you can lessen the risk of having a panic attack:[7]
The main treatments for panic disorder are medication and therapy.
Your doctor may prescribe:[3]
Cognitive behavioral therapy (CBT) is the most common therapy for panic disorder. It helps by identifying triggers for anxiety and panic attacks and teaching coping skills.
The American Psychiatric Association also recommends panic-focused psychodynamic psychotherapy (PFPP) [8] to uncover the underlying reasons for a person’s panic attacks.
Living with someone who has a mental illness can be challenging. Panic attacks can be as frightening to observe as they are to experience, while living with someone anxious about leaving the house and being in public can affect your daily life too.
There are many things you can do to support your loved one:
If left untreated, panic disorder can develop into more complex problems such as anxiety and phobias. Agoraphobia is a particular risk, as people with panic disorder seek to avoid situations that might trigger or worsen a panic attack.
However, most people with panic disorder can and do recover with effective treatment plans and self-care.
Not necessarily. Panic attacks are relatively common, and only a small number of people develop panic disorder.
Just over one in ten people a year will have a panic attack. While frightening, most are one-off events that aren’t a cause for serious concern.
Panic disorder affects around 2-3 percent of Americans. Women are more likely to be diagnosed with panic disorder than men.[9]
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