Panic Disorder and Panic Attacks

Panic Disorder and Panic Attacks


 Panic disorder occurs when you experience recurring, unexpected panic attacks and have a constant fear of panic attacks.

You may be having a panic attack when you feel sudden, overwhelming fear or dread that has no obvious cause. There may be physical symptoms too, like a racing heart, breathing difficulties, and sweating.

Most people experience a panic attack once or twice in their lives. Other people experience panic attacks more regularly, sometimes with no clear cause. Panic disorder is defined by at least 1 month of persistent fear about panic attacks (or their effects) reoccurring.

Even though the symptoms of panic disorder can be overwhelming and frightening, they can be managed and improved with treatment. Seeking help is the most important part of reducing symptoms and improving your quality of life.

SENSITIVE MENTAL HEALTH TOPIC

This article includes topics that may be distressing to some readers. In covering panic attacks and panic disorder, we also touch on anxiety, depression, trauma, and suicidal ideation.

Please proceed with care. Remember: your well-being comes first.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5)Trusted Source defines a panic attack as “an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes.”

Panic attacks produce intense fear that begins suddenly, often with no warning. An attack typically lasts for 5 to 20 minutes. In extreme cases, symptoms may last for more than 1 hour. The experience is different for everyone, and symptoms often vary.

Common symptoms associated with a panic attack include:

  • racing heart rate or palpitations
  • shortness of breath
  • feeling like you’re choking
  • dizziness or vertigo
  • lightheadedness
  • nausea
  • sweating or chills
  • shaking or trembling
  • changes in your mental state, like a feeling of derealization (feeling of unreality) or depersonalization (being detached from oneself)
  • numbness or tingling in your hands, feet, or face
  • chest pain or tightness
  • fear that you might die

Sometimes a panic attack is triggered by a specific event or external stimulus. Other times, the symptoms of a panic attack occur for no clear reason. Typically, the symptoms are not proportionate to the level of danger that exists in your environment.

Because of their unpredictable nature, panic attacks can significantly affect your everyday life. Some people experience panic attacks at work, in public with friends, or even at home.

You may have a panic disorder if you’ve had four or more panic attacks, or you live in fear of having another panic attack after experiencing one. In order to meet the diagnostic criteria for panic disorder, you must experience unexpected panic attacks.

The causes of panic disorder are not fully understood, and research is ongoing.

Let’s examine several key possibilities for developing panic disorder.

Genetics

Research on whether your genes can make you more likely to develop panic disorder is mixed.

2020 study has suggested that panic disorder may have a genetic component. Researchers claimed to have found 40 different genes that were linked to panic disorder, most of which were connected to our body’s system of neurotransmitters (which regulate communications between our nerve cells). They argued testing for biomarkers may be a helpful tool in diagnosing panic disorder.

2018 study noted research on panic disorder and genetics is very inconsistent, and larger studies are needed before any conclusions are possible. Researchers emphasized that life stress, trauma, and anxiety sensitivity are all important social and psychological factors contributing to the condition.

Both the 2020 and the 2018 studies noted that changes in the “COMT” gene show the most evidence for being connected to panic disorder. This gene is responsible for an important enzyme (protein), which affects our cognitive abilities and behavioral control.

Additionally, a 2019 studyTrusted Source reported finding a “significant genetic correlation” between panic disorder and other conditions, including major depressive disorder and neuroticism.

Life changes

Panic disorder is associated with significant life changes and stressful life events, like arguing with family. And even when life changes are exciting and positive, they can create new challenges and daily stressors.

For example, such changes and events may include:

  • leaving home for college
  • moving
  • the death of a loved one
  • getting married
  • having your first child
  • starting a new job

It’s important to take care of your mental and physical health during transitional periods in life. You also deserve support when going through periods of high stress, and managing difficulties or trauma.

Consider reaching out to trusted loved ones for emotional support. Set boundaries, and communicate when you’re feeling overwhelmed. A therapist or mental health professional can also be your ally by listening, providing resources, and helping you develop coping tactics.

Anxiety

A tendency to be anxious and having an anxiety disorder is also connected to panic attacks and panic disorder. In the DSM-5, panic attacks are listed under the umbrella of anxiety disorders. Both anxiety and panic disorder can be long-term conditions.

Anxiety usually manifests as being worried, nervous, or overwhelmed. For example, social anxiety may occur when you’re nervous about performing in social situations or environments with a lot of people. You may feel particularly self-conscious and even have physical symptoms like sweating or trembling.

It’s natural for human beings to be anxious sometimes. But being anxious all the time is a cause for concern, and could indicate generalized anxiety disorder (GAD).

The DSM-5 diagnostic criteria for GAD are met when someone has “excessive anxiety and worry” more often than not for at least 6 months. These feelings could be about a number of different events or activities (such as work or school performance).

You shouldn’t have to live in a constant state of worry and stress. If you frequently experience anxiety, it’s important to reach out for help. Therapy, lifestyle adjustments, or medications can all help get anxiety under control.

Panic disorder always includes panic attacks. But having a panic attack doesn’t necessarily mean you have panic disorder.

In making a panic disorder diagnosis, doctors will look at the amount and frequency of any panic attacks. They’ll also take into consideration your feelings surrounding them.

Many people experience a panic attack at some point in their lives. But when you have multiple panic attacks and live in fear of their reoccurrence, this can indicate panic disorder.

Treatment for panic disorder focuses on reducing or eliminating your symptoms. Similar to anxiety approaches, this can be achieved through therapy, lifestyle changes, in some cases, medication.

Therapy typically involves cognitive behavioral therapy (CBT). CBT teaches you to change your thoughts and actions so you can understand your panic attacks and manage your fear.

Therapy options

Therapy can help you work through problems and feel more in control of your life. It can also be a safe space to talk about anything you need to express.

Learn more:

Medications used to treat panic disorder can include selective serotonin reuptake inhibitors (SSRIs), which are a class of antidepressants. SSRIs prescribed for panic disorder may include:

Other medications sometimes used to treat panic disorder include:

  • serotonin-norepinephrine reuptake inhibitors (SNRIs), which are also antidepressants
  • monoamine oxidase inhibitors (MAOIs), which are antidepressants that are used infrequently because of rare but serious side effects
  • benzodiazepines (commonly used as tranquilizers), including alprazolam (Xanax) or clonazepam (Klonopin)

In addition to these treatments, there are a number of steps you can take at home to reduce your symptoms. Examples include:

  • maintaining a regular schedule
  • exercising on a regular basis
  • getting enough sleep
  • avoiding stimulants like caffeine

Although the causes of panic disorder are not clearly understood, information about the condition does indicate that certain people are more likely to develop it.

The most-cited statistics on panic disorder come from the 2001-2003 National Comorbidity Survey ReplicationTrusted Source. The NCS-R is a representative survey of mental health conditions in the United States and included over 9,000 participants.

The NCS-R reported 2.7 percent of people reported having panic disorder within the past year. The condition had a lifetime prevalence of 4.7 percent.

The NCS-R and other data cited below categorized participants according to their sex and gender assigned at birth.

Here’s what we know about risk factors:

  • According to NCS-R, female people are more likelyTrusted Source to have panic disorder than male people. In the NCS-R, 3.8 percent of women reported having panic disorder within the past year, compared to 1.6 percent of men.
  • Overall, research shows that anxiety disorders, including panic disorder, are more common in women than in men.
  • Panic disorder is also more common in young adults than in other age groups. Symptoms of panic disorder often begin to appear between 20 and 24 years old.

Sex and gender terms

In research and in life, gender and sex are often used interchangeably. But they are not the same.

Sex is assigned at birth in one of two categories — female or male. Each is associated with specific genitalia, chromosomes, primary and secondary sex characteristics. Intersex people are those who have characteristics of more than one sex.

Gender is also often divided into a binary — women and men. But your sex assigned at birth does not determine your gender. Gender is so much more than a binary.

If left untreated, panic disorder can have a significant effect on your daily life and overall well-being.

Adverse health effects of untreated panic disorder include:

  • agoraphobia (fear of going places and seeing people)
  • developing a substance use disorder to cope
  • depression
  • suicidal ideation

Panic attacks and panic disorder may also impact social development for children and teens. Fear of having a panic attack can make it difficult to attend school, leave the home, or maintain relationships.

If you experience symptoms of a panic attack for the first time, you may want to seek emergency medical care. Many people who have a panic attack for the first time believe they’re having a heart attack. It can be hard to differentiate the symptoms without the help of a medical professional.

While at the emergency care facility, a healthcare professional will perform several tests to see if your symptoms are caused by a heart attack.

These include:

If they determine you do not need emergency care, you’ll likely be referred back to your primary care physician if you have one.

Your primary care physician will likely:

  • review any earlier lab results
  • ask about your symptoms
  • perform a mental health examination

Your primary care doctor or a mental health specialist (like a psychiatrist or psychologist) can diagnose panic attacks and panic disorder.

Panic disorder is often a long-term condition that can be difficult to treat. You may have panic disorder if you’ve experienced multiple panic attacks and have a persistent fear of them reoccurring.

It may not be possible to fully “cure” your panic disorder, but treatment can help. Therapy, including CBT, working to lessen life stressors, and taking medication are all potential options.

The onset of panic disorder is often in the early twenties, and statistics show it affects women more than men. A preexisting anxiety condition can increase your risks of panic attacks and panic disorder.

Try to be mindful of any symptoms of anxiety following a major life event. If you’re distressed by something that you experienced or were exposed to, consider discussing it with your primary care physician or a mental health professional.

Panic disorder can be treated and managed. Help is available, and you’re not alone.

JPeei Clinic