Fear and anxiety (intense nervousness) are normal reactions to stressful events in our lives. Panic disorder, however, is different. Panic disorder is a serious condition that strikes without reason, causing sudden attacks of fear and anxiety, as well as physical symptoms such as sweating and a racing heart.
When a person has a panic disorder, these attacks—called panic attacks—continue to occur without warning. Over time, the person develops a constant fear of having another 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.
Panic disorder affects 2 to 3 percent of adult Americans. Panic disorder most often begins during late adolescence and early adulthood. It is two times more common in women than men.
Although the exact cause of panic disorder is not fully understood, studies have shown that a combination of factors, including biology and environmental stresses, might be involved. These factors include the following:
People with panic disorder have repeated panic attacks. A panic attack is a period of intense fear that occurs in response to ordinary situations. During a panic attack, the fear response is out of proportion for the situation, which often is non-threatening. Panic attacks occur suddenly and without warning, and cannot be stopped. They can occur at any time and generally do not last long, usually reaching their peak of intensity within 10 minutes of onset.
Symptoms of a panic attack include:
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 might occur.
Panic disorder can be difficult for health care providers to recognize. Physical symptoms can be very strong, so much so that many people with panic disorder believe they have a physical illness, such as heart disease.
If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose panic disorder, the doctor might use various diagnostic tests to rule out physical illness as the cause of the symptoms.
If no physical illness is found, the person might be referred to a psychiatrist or psychologist, health care professionals who are 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 the patient’s report of the 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 patient’s symptoms and degree of dysfunction suggest panic disorder. The standard reference manual used for the diagnosis of recognized mental illnesses in the United States is the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
A combination of the following therapies often is used to treat panic disorder:
Some people will respond well to treatment only to experience panic attacks later in life. When panic attacks continue after treatment has stopped, additional treatment might still help to control and reduce panic attacks. In addition, relaxation techniques—such as breathing retraining and positive visualization—might help a person get through a panic attack.
Panic disorder is highly treatable and, once treated, does not lead to any permanent problems. Without treatment, however, panic disorder can have serious consequences and can severely impair quality of life. Complications of untreated panic disorder include the following:
Panic disorder cannot be prevented. However, there are some things you can do to reduce stress and decrease symptoms:
Panic disorder can be successfully treated, and patients can go on to lead full and satisfying lives. With appropriate treatment, nearly 90 percent of people with panic disorder can find relief. Unfortunately, many people with panic disorder do not seek treatment.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 02/01/2018