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Panic Disorder Fast Facts

Panic disorder affects an estimated 2.7% of adults in the United States at any given time. Women are approximately twice as likely as men to be affected by panic disorder.

Although panic disorder typically affects adults over the age of 20, approximately 2.3% of adolescents in the United States are estimated to be affected. As with adults, adolescent girls are more likely than adolescent boys to be affected.

Among adults diagnosed with panic disorder, about 45% report that the disorder causes serious impairment in their daily lives. About 30% report moderate impairment, and about 25% report mild impairment.

People with panic disorder also sometimes suffer from agoraphobia, which is a compulsion to avoid situations or places that cause anxiety. Panic disorder coupled with agoraphobia tends to cause the most severe impairment for sufferers.

Nearly 5% of all American adults will experience symptoms of panic disorder at some time during their lives.

What is Panic Disorder?

Panic attacks are periods of extreme fear that cause physical symptoms such as a racing heart rate, sweating, or trembling. Panic attacks are often also accompanied by a feeling of an impending threat of harm or even death, but usually, there is no actual danger or any clear trigger for the panic.

Panic disorder is diagnosed when someone experiences recurrent panic attacks over a period of time, the attacks occur unexpectedly without apparent cause, and anxiety over the possibility of an attack interferes with the sufferer’s daily life.

Symptoms of Panic Attacks

Symptoms of panic attacks are typically not harmful in themselves, but they can cause such profound emotional strain and anxiety that the fear of them has long-term, debilitating effects.

The most common symptoms of panic attacks include:

  • Rapid heart rate or heart palpitations
  • Shortness of breath or a feeling of choking
  • Chest pain
  • Headache
  • Chills
  • Sweating
  • Nausea
  • Trembling
  • Dizziness
  • Numbness or tingling
  • Fear of an impending, non-specific threat
  • Feeling of a loss of control
  • Feeling of emotional detachment

Panic attacks may vary in intensity and duration, but most often they come on suddenly and reach their peak intensity quickly.

Related Anxiety Disorders

Panic disorder is closely related to several other anxiety disorders, and sometimes it occurs in conjunction with these disorders. Other anxiety disorders include:

  • Generalized anxiety disorder. In this disorder, sufferers experience anxiety beyond the typical levels of worry, and their anxiety persists for at least six months without relief. The anxiety can have effects that result in significant impairment.
  • Social anxiety disorder. This disorder causes severe anxiety surrounding social situations and situations in which the sufferer is required to perform in public. As a result of the fear, sufferers often withdraw from social situations, and the anxiety can have detrimental effects at work or school.
  • Phobia disorders. The anxiety in this disorder comes from an extreme fear of specific situations or objects. A phobia that often occurs along with panic attacks is agoraphobia, an intense fear of being away from home, in open spaces, in crowded places, or in other specific situations.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

What Causes Panic Disorder?

Doctors and researchers have not yet determined exactly what causes panic attacks and panic disorder, but a lengthy list of risk factors seems to increase an individual’s likelihood of developing the disorder.

  • Genetic Predisposition. People with a family history of panic disorder are significantly more likely to develop the disorder than are people with no family history. Studies of identical twins have shown a heritability rate of as much as 40%, strongly suggesting that there’s a genetic component to the development of the disorder.
  • Major stress. Major life events that cause stress may cause an onset of panic attacks. These events may include a divorce, death of a loved one, the birth of a child, trauma or injury, or unemployment.
  • Sensitive temperament. Research suggests that those who are particularly sensitive to stressful situations are more likely to be susceptible to panic disorder.
  • Substance use. Excessive consumption of substances such as caffeine or tobacco may increase the risk of panic attacks.
  • History of abuse. People with a history of childhood of physical or sexual abuse are also at increased risk of developing panic disorder.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Is Panic Disorder Hereditary?

There is strong evidence to suggest that panic disorder has some degree of heritability, and a genetic component in the development of the disorder is very likely. Environmental factors also play a significant role, however, and a specific genetic mechanism that produces the disorder has not been identified.

  • In studies of families in which panic disorder is present, researchers have found a rate of development of the disorder of 10% among those with a first-degree relative (a parent, child, or sibling) with the disorder. In control groups, the rate was only 2.1%.
  • Studies of identical twins have shown a heritability rate of between 30% and 40%. Such a high rate suggests that a genetic link is extremely likely.
  • In general, research has not identified a single gene that is linked to the disorder.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is Panic Disorder Detected?

Panic disorder most often sets in during adulthood, with most people experiencing their first panic attacks after the age of 20. Panic attacks and panic disorder are not entirely uncommon in children and adolescents, however. The early signs of the disorder are often misdiagnosed, and adolescent sufferers sometimes don’t get appropriate treatment until the disorder has caused severe disruption to their lives. Given that treatment is very often successful at controlling panic attacks, early detection and proper diagnosis can prevent the disorder from having a severe impact.

Potential early signs of panic disorder in young people include:

  • Separation anxiety, or a fear of leaving home
  • Disinterest in or a fear of going to school
  • Decline in grades
  • Withdrawal from social activities
  • Depression or a persistent low mood
  • Panic attack symptoms (racing heart, sweating, etc.) with no discernible physical cause
  • Substance abuse

Panic disorder is generally easier to diagnose in adults, but recognition of early symptoms in conjunction with risk factors can help to speed the path to diagnosis, treatment, and recovery.

Early signs and risk factors for panic disorder in adults include:

  • Sudden, unexpected feelings of fear without an obvious cause
  • Physical symptoms such as elevated heart rate, sweating, trembling, dizziness, chills, etc.
  • A growing fear of specific situations such as crowded places
  • Persistent fear of having another panic attack
  • Avoidance of situations that might cause a panic attack
  • Problems at work or in school because of changes in behavior

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is Panic Disorder Diagnosed?

The process of diagnosing panic disorder begins with a physical assessment followed by a psychological assessment. Because the symptoms of panic attacks are often overtly physical, it is important to rule out other medical conditions that could be causing the symptoms. Only after these potential physical conditions have been ruled out will the diagnostic process move on to possible psychological causes.

Diagnostic steps may include:

  • A physical exam. This exam will be aimed at ruling out physical conditions that could be causing the symptoms.
  • Blood and laboratory tests. These tests will look at the patient’s blood chemistry for issues such as thyroid function, electrolyte imbalances, anemia, chronic infection, and cancer. Screenings for drugs and alcohol may also be conducted to rule out symptoms that may be caused by substance abuse. An electrocardiogram (ECG) may also be administered to check for problems with heart function.
  • Psychological assessments. These assessments may take the form of questionnaires or talk sessions with a mental health professional to assess the patient’s mood, mental state, and mental health history. Family members or caregivers may also be asked to participate in these assessments.

The results of the psychological assessments will be compared to the diagnostic criteria for panic disorder in the Diagnostic and Statistical Manual of Mental Disorders. A mental health professional will look for these indications of panic disorder:

  • Recurrent and unexpected panic attacks, followed by at least a month of one or more of the following:
  • Persistent worry about the occurrence of another attack
  • Worry about the consequences of an attack
  • Significant change in behavior as a result of the attacks

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is Panic Disorder Treated?

Given the proper treatment, many people who have been diagnosed with panic disorder are able to substantially control the occurrence of panic attacks or eliminate them entirely. Treatment of the disorder usually involves psychotherapy, medications, or both. The exact course of treatment prescribed in each case depends on factors such as the patient’s history and the severity and frequency of the panic attacks.

Medication

Several different medications may be used to treat and manage the symptoms of panic disorder. Individual medication plans are dependent on the preference of the patient, the patient’s responsiveness to treatments, the precise symptoms being experienced, and the severity of the symptoms.

  • Selective serotonin reuptake inhibitors (SSRIs). These drugs work by increasing the levels of serotonin, a neurotransmitter chemical in the brain. SSRIs used to treat panic disorder include fluoxetine, paroxetine, and sertraline.
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs). These drugs work similarly to SSRIs in that they increase serotonin levels, but they also increase the level of norepinephrine, another neurotransmitter. SNRI venlafaxine is approved for the treatment of a panic disorder.
  • Benzodiazepines. These drugs are used to treat anxiety, and they can be helpful in treating the symptoms of panic attacks. Benzodiazepines act more quickly than antidepressants, which typically take at least a week to have any effect, but patients may develop a resistance to benzodiazepines if they’re taken for a long period of time. Alprazolam and clonazepam are benzodiazepines commonly prescribed for panic disorder.
  • Beta-blockers. These drugs are commonly used to treat high blood pressure, but they can be effective at controlling the physical symptoms of panic attacks. They have the advantage of being fast-acting.

Psychotherapy

The most common therapeutic approach used to treat panic disorder is cognitive-behavioral therapy (CBT), an approach that focuses on helping the patient to identify a pattern of harmful thoughts and to construct strategies and solutions for dealing with them that don’t interfere with functionality.

In some cases, providers may try exposure therapy, in which patients are exposed to the triggers of their panic attacks in a controlled way. This therapy is aimed at addressing the fears underlying the panic attacks and allowing the patient to return to the activities or situations that they’ve avoided out of fear of an attack.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Does Panic Disorder Progress?

If left untreated, panic disorder can generate such persistent anxiety and fear that significant life-altering consequences develop, including:

  • Major depression
  • Other anxiety disorders
  • Specific phobias (e.g., fear of driving) or agoraphobia
  • Substance abuse
  • Relationship dysfunction
  • Dysfunction at work or school
  • Financial trouble
  • Suicide or suicidal thoughts

The good news, however, is that with proper diagnosis and treatment, almost 90% of people with panic disorder are able to lessen the severity of their symptoms.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is Panic Disorder Prevented?

Although treatment can help lessen, or even eliminate, the symptoms of panic disorder, there is no known definitive cure for the disorder or any way to prevent its onset. There are ways, however, to decrease the likelihood that a panic attack will occur, to prevent future attacks, or to decrease the severity of symptoms when an attack does occur.

  • Seek professional help as soon as possible. Getting help from medical and mental health professionals early on can help you to head off future attacks and their complications.
  • Follow the advice of the professionals. Once you’ve been given a treatment plan, stay on it in order to prevent future attacks or relapses.
  • Learn relaxation techniques. Strategies for relaxation and stress reduction have proven effective at lessening the severity of anxiety disorders, including panic disorder.
  • Take care of yourself. Being attentive to your physical health and being physically active has also been shown to help with anxiety.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Panic Disorder Caregiver Tips

Caring for someone with panic disorder or another anxiety disorder can be extremely difficult. The disorder’s symptoms not only cause stress for the sufferer, but they can cause high levels of stress in caregivers, loved ones, and the people close to the sufferer, as well. In fact, caregivers themselves are especially at risk of developing anxiety and depression as a result of their caregiving challenges.

Caregivers for someone with panic disorder should consider these tips to help the sufferer and themselves to deal with the disorder:

  • Learn as much as possible about the disorder.
  • Seek out appropriate professional treatment for the sufferer.
  • Do everything possible to support the sufferer in the pursuit of treatment and help them to stay on their treatment plan.
  • Learn how to help manage a panic attack when it occurs. Know how to guide the sufferer through relaxation techniques, and know who to call if you need help.
  • Find a support group for caregivers.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Panic Disorder Brain Science

Research into the neurobiology of panic disorder is focused on finding out what happens in the brain when a panic attack occurs, with the ultimate goal of developing more effective diagnostics and treatments. Genetic research, too, is looking for the root causes of the panic disorder so that, with a better understanding of the mechanism of the disorder, doctors will be better able to treat it.

Recent research into the nature of panic disorder includes:

  • Researchers at the University of Cincinnati have been looking at a possible link between panic disorder and a particular gene. Previous studies have suggested that panic attacks are sometimes associated with a pH imbalance in the body, and the UC researchers are exploring the possibility that an acid-sensing gene (TDAG8) may play a role in creating such an imbalance.
  • Imaging studies have found real physical differences in the way that the brains of people with panic disorder work. These studies have identified changes in the function of certain areas of the brain, including the amygdala and the midbrain, when patients are experiencing a panic attack as compared to when they are relaxed.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Panic Disorder Research

Scientists are working on several research projects to expand on what is known about Panic Disorder.  The research will improve knowledge about the factors that increase the risk for Panic Disorder, as well as the causes, and best treatments, and will aid people living with Panic Disorder and their caregivers.

We are currently gathering the information required to support projects.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

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