Panic Disorder

What is panic disorder?

From: MedlinePlus, National Library of Medicine

Panic disorder is a type of anxiety disorder. It causes repeated panic attacks, which are sudden periods of intense fear, discomfort, or a sense of losing control. These attacks happen even though there is no real danger. They often cause physical symptoms. For example, you may have a rapid or pounding heartbeat and feel like you are having a heart attack.

If you have panic attacks, it doesn't mean you will develop a panic disorder. Many people only have one or two panic attacks in their lifetime and get better without treatment.

But some of the people who have panic attacks do develop panic disorder. They have repeated panic attacks. The attacks can happen as often as several times a day or as rarely as a few times a year. People with panic disorder often worry about having another attack. It may cause them to avoid places and situations where they had panic attacks in the past.

Panic disorder is not life-threatening, but it can be upsetting and affect your quality of life. And if it is not treated, it can sometimes lead to other health conditions, including depression and substance use disorders.

What causes panic disorder?

From: MedlinePlus, National Library of Medicine

The cause of panic disorder is unknown. Researchers think that certain factors may play a role:

• Genetics - panic disorder sometimes runs in families. But no one knows for sure why some family members have it while others don't.
• Brain biology and chemistry.
• Your environment.
• Major stress.

Who is more likely to develop panic disorder?

From: MedlinePlus, National Library of Medicine

Panic disorder is more common in women than men. It often starts in the late teens or early adulthood. Sometimes it starts when a person is under a lot of stress. People who have had trauma, especially in childhood, are more likely to develop panic disorder.

What are the symptoms of panic disorder?

From: MedlinePlus, National Library of Medicine

People with panic disorder may have:

• Sudden and repeated panic attacks of overwhelming anxiety and fear
• A feeling of being out of control or a fear of death during a panic attack
• An intense worry about another panic attack
• A fear or avoidance of places and situations where they had panic attacks in the past
• Physical symptoms during a panic attack, such as: Pounding or racing heart Sweating or chills Trembling or shaking Trouble breathing The feeling that they are choking Weakness or dizziness Chest pain Stomach pain or nausea

Panic attacks can happen anytime, without warning. They can last anywhere from a few minutes to over an hour.

How is panic disorder diagnosed?

From: MedlinePlus, National Library of Medicine

To find out if you have panic disorder, your health care provider:

• Will ask about your medical history and symptoms
• May check if an unrelated physical problem is causing your symptoms, for example with: A physical exam Blood tests to check for thyroid problems and other possible conditions Heart health tests
• May do a panic disorder test
• May refer you to a mental health provider for the panic disorder test or other types of psychological evaluations

What are the treatments for panic disorder?

From: MedlinePlus, National Library of Medicine

Treatment for panic disorder usually includes one or more of the following:

Your provider may also suggest that you follow a healthy lifestyle, which may help with panic disorder. It may include:

Joining a support group may also be helpful. Support groups can make you feel like you are not alone, and you may learn some new tips on how to cope.

• Talk therapy, also called psychotherapy or counseling, which can help you understand your feelings. It may include cognitive-behavioral therapy (CBT), a type of talk therapy that helps you change your negative thoughts and how you react to things that cause you to feel anxiety.
• Medicines, including: Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) Anti-anxiety medicines
• Avoiding alcohol
• Reducing caffeine
• Eating regular meals
• Getting enough sleep
• Getting regular exercise

Which doctor should you see?

The suggested department for discussing Panic Disorder is Psychiatry, with a psychiatrist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• How are symptoms affecting safety, sleep, relationships and everyday function?
• What roles could psychological treatment, medicines or support services have?
• Who should be contacted if safety or functioning deteriorates?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.