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FAQs:

What is Panic Disorder?

Panic disorder is an anxiety disorder that involves multiple unexpected panic attacks. A main feature of panic disorder is that the attacks usually happen without warning and aren’t due to another mental health or physical condition. There’s often no specific trigger for them. Not everyone who experiences a panic attack develops panic disorder.

How Common is Panic Disorder?

The one-year prevalence for panic disorder is 2 to 3 percent in the United States and European countries. Asian, African, and Latin American countries have lower prevalence rates, ranging from 0.1 to 0.8 percent. Females are twice as likely to be affected as males, and the gender difference is observed as early as adolescence. The median age of onset for panic disorder in the United States is 20-24 years. A small percentage of cases first occur in childhood or later adulthood.

Who is Affected by Panic Disorder?

Panic disorder typically first occurs in late adolescence or early adulthood, but may also begin in childhood. Women are twice as likely as men to experience this disorder, and some people may be genetically predisposed to the disorder. About 1 to 2 percent of Americans suffer from panic disorder.

How is Panic Disorder Diagnosed?

Medical or mental health providers can diagnose panic disorder based on criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Your provider may diagnose panic disorder when you have repeated, unexpected panic attacks as well as one month or more of:

1. Persistently worrying about having more panic attacks or their consequences.

2. Changing your behaviors to avoid situations that may trigger an attack.

In addition, the attacks can’t be due to the direct effects of a substance or general medical condition. And they can’t be better accounted for by another mental health condition, like a phobia or PTSD.

What is the Difference Between a Panic Attack and Panic Disorder?

It is important to note that the mere presence of panic attacks is not sufficient to meet the criteria for diagnosing panic disorder. A panic attack is an anxiety reaction that can occur in other anxiety disorders or anxiety-provoking situations for people without anxiety disorders.

Panic disorder infrequently occurs in the absence of other mental disorders. People with panic disorder often have other anxiety disorders, major depression, bipolar disorder, and mild alcohol use disorder. Reported lifetime rates of co-occurrence between major depression and panic disorder range from 10 to 65 percent. Panic disorder also frequently co-occurs with other medical conditions, such as dizziness, cardiac arrhythmias, hyperthyroidism, asthma, chronic obstructive pulmonary disease, and irritable bowel syndrome.

Is Panic Disorder an Anxiety Disorder?

Yes, panic disorder falls under the category of anxiety disorders. Anxiety disorders are characterized by excessive fear, worry, or anxiety and associated behavioral disturbances. Panic disorder is a specific type of anxiety disorder distinguished by the occurrence of panic attacks and the persistent fear of having additional attacks. While it shares common features with other anxiety disorders, its defining feature is the sudden and intense nature of panic attacks.

How are Phobias and Agoraphobia Related to Panic Disorder?

Phobias and agoraphobia are related to panic disorder because they share symptoms and contribute to anxiety. Phobias involve intense fears of specific objects or situations. Individuals with panic disorder develop phobias when they associate certain environments with past panic attacks. For instance, a panic attack while driving leads to a fear of driving, reinforcing anxiety and increasing the likelihood of future attacks.

Agoraphobia refers to the fear of being in situations where escape is difficult during a panic attack. It develops as a consequence of panic disorder, with individuals avoiding places where previous attacks occurred. This avoidance severely limits activities and leads to confinement at home. Approximately 30-50% of individuals with panic disorder may also develop agoraphobia, according to 2020 research published in Medical News Today titled “What you need to know about agoraphobia.”

The relationship between these conditions is cyclical: panic disorder triggers phobias and agoraphobia, while existing phobias exacerbate panic symptoms. Effective treatment involves understanding these connections. Cognitive-behavioral therapy (CBT) is commonly used to address avoidance behaviors and cognitive distortions, with exposure therapy helping individuals confront their fears. Pharmacological treatments, like selective serotonin reuptake inhibitors (SSRIs), also aid in managing symptoms.

Is Panic Disorder a Disability?

Panic disorder is considered a disability under certain conditions, particularly when it impairs a person’s ability to perform daily activities or work. In the United States, the Americans with Disabilities Act (ADA) defines a disability as a physical or mental impairment that substantially limits one or more major life activities. For panic disorder to qualify as a disability, it must be severe enough to interfere with essential functions, such as the ability to work, socialize, or care for oneself. 

Documentation from psychiatrists, including a diagnosis of how the disorder affects functioning, is required to support claims for disability benefits. Individuals also need to demonstrate that they have sought treatment and that their symptoms persist despite these efforts. Legal considerations vary by jurisdiction, so individuals should consult with an attorney or a disability advocate to understand their rights and the specific criteria applicable to their situation.

Can Panic Disorder Be Cured?

Panic disorder can be effectively managed and treated, but it may not always be completely cured. The goal of treatment is to reduce the frequency and intensity of panic attacks, alleviate anticipatory anxiety, and help individuals regain control over their lives. Many people with panic disorder can achieve significant improvements and lead fulfilling lives with the right treatment and support.

Is Panic Disorder Genetic?

There is evidence to suggest that panic disorder may have a genetic component. Individuals with a family history of anxiety disorders, including panic disorder, may be at a higher risk of developing the condition themselves. While genetics can play a role, it is essential to recognize that panic disorder is a complex condition influenced by a combination of genetic, biological, psychological, and environmental factors.

What is the Difference Between Panic Disorder and Generalized Anxiety Disorder (GAD)?

Panic Disorder is characterized by recurrent and unexpected panic attacks. These panic attacks are intense, sudden episodes of fear and anxiety that can include symptoms like a racing heart, shortness of breath, and a fear of losing control. Individuals with Panic Disorder often live in fear of when the next attack might occur and may even change their behavior to avoid potential triggers. Panic Disorder is not characterized by constant worry about various life events but rather by the presence of these acute panic attacks.

Generalized Anxiety Disorder, on the other hand, involves chronic and excessive worry and anxiety about various aspects of life. Individuals with GAD experience persistent and often uncontrollable worrying about everyday situations, such as work, relationships, and health. Unlike Panic Disorder, GAD does not typically involve sudden, intense panic attacks. While individuals with GAD may experience physical symptoms of anxiety, they do not experience the same acute and overwhelming panic attacks seen in Panic Disorder.

Can Exercise Help Panic Disorder?

Yes, exercise helps in managing panic disorder by reducing panic symptoms. Regular physical activity is known to have numerous mental health benefits, including the reduction of anxiety and stress levels. Exercise promotes the release of endorphins, which are natural mood lifters, and helps mitigate feelings of anxiety and panic. It also improves sleep quality and increases overall energy levels, contributing to better emotional regulation.

Aerobic exercise, such as running, swimming, or cycling, is particularly effective in reducing anxiety symptoms. People who engage in regular exercise experience fewer panic attacks and reduced anxiety sensitivity. Additionally, exercise serves as a positive coping mechanism, providing a healthy outlet for stress and tension.

Incorporating exercise into a daily routine not only helps manage panic symptoms but also enhances overall physical health, making it a valuable component of a comprehensive treatment plan for panic disorder.

Panic Disorder Symptoms

Panic attacks can happen in other types of anxiety disorders, too. Generally, if you have 4 or more panic attacks and if you always worry about having another, you have panic disorder. Symptoms of a panic attack may include:

- Pounding heart

- Sweating

- Trembling or shaking

- Shortness of breath

- Sense of choking

- Nausea or belly pain

- Dizziness or lightheadedness

- Feeling unreal or disconnected from oneself

- Fear of losing control

- Fear of "going crazy" or dying

- Numbness

- Chills or hot flashes

- Chest pain and other symptoms that mimic a heart attack

Panic disorder can be upsetting and disabling. An attack can last from a few minutes to an hour or sometimes longer. The symptoms of a panic attack may look like other mental health conditions. Always see your healthcare provider for a diagnosis.

What Causes Panic Disorder?

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

1. Genetics - panic disorder sometimes runs in families. But no one knows for sure why some family members have it while others don't.

2. Brain biology and chemistry.

3. Your environment.

4. Major stress.

Risk Factors of Panic Disorder

Symptoms of panic disorder often start in the late teens or early adulthood and affect more women than men.

Factors that may increase the risk of developing panic attacks or panic disorder include:

1. Family history of panic attacks or panic disorder

2. Major life stress, such as the death or serious illness of a loved one

3. A traumatic event, such as sexual assault or a serious accident

4. Major changes in your life, such as a divorce or the addition of a baby

5. Smoking or excessive caffeine intake

6. History of childhood physical or sexual abuse

Complications of Panic Disorder

Left untreated, panic attacks and panic disorder can affect almost every area of your life. You may be so afraid of having more panic attacks that you live in a constant state of fear, ruining your quality of life.

Complications that panic attack disorder may cause or be linked to include:

1. Development of specific phobias, such as fear of driving or leaving your home

2. Frequent medical care for health concerns and other medical conditions

3. Avoidance of social situations

4. Problems at work or school

5. Depression, anxiety disorders, and other psychiatric disorders

6. Increased risk of suicide or suicidal thoughts

7. Alcohol or other substance misuse

8. Financial problems

For some people, panic disorder may include agoraphobia — avoiding places or situations that cause you anxiety because you fear being unable to escape or get help if you have a panic attack. Or you may become reliant on others to be with you to leave your home.

Disorders that are Comorbid with Panic Disorder

Panic disorder is frequently comorbid with several other mental health conditions. These comorbidities can complicate diagnosis and treatment, but are important to recognize for a comprehensive care plan. Here are the most common disorders that are comorbid with panic disorder:

1. Major depressive disorder (MDD): This is a mood disorder marked by persistent feelings of sadness and loss of interest in activities. Panic disorder leads to increased feelings of hopelessness and despair, contributing to the onset of depression. About 7.1% of U.S. adults had at least one major depressive episode in the past year, according to Wikipedia. 

2. Social anxiety disorder (SAD): Social anxiety disorder involves intense fear of social situations and being judged by others. The fear of experiencing panic attacks in social settings exacerbates social anxiety, leading individuals to avoid these situations. Half of all individuals with Social Anxiety Disorder (SAD) experience panic attacks (PAs), which are frequently triggered by specific social situations, per research by Mark V. et al published in the Journal of Experimental Psychopathology in 2016 titled “Socially-relevant Panic Symptoms in Social Anxiety Disorder.”

3. Agoraphobia: This is the fear of being in situations where escape might be difficult or help unavailable. Many individuals with panic disorder develop agoraphobia as they begin to avoid places where they previously experienced panic attacks. An estimated 0.9% of U.S. adults had agoraphobia in the past year, according to data from the National Institute of Mental Health.

4. Post-traumatic stress disorder (PTSD): PTSD is a condition triggered by experiencing or witnessing a traumatic event. Those with PTSD  have panic attacks as a response to trauma-related triggers, leading to a comorbid relationship.

5. Obsessive-compulsive disorder (OCD): OCD is characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). Panic attacks occur in individuals with OCD, particularly when anxiety levels rise due to obsessions. Approximately 1.2% of U.S. adults had OCD in the past year, according to the National Institute of Health. This translates to about 2.2 million adults in the United States.

How to Treat Panic Disorder

Your doctor may refer you to a specialist called a psychotherapist. They might recommend a panic disorder treatment:

1. A type of talk therapy called cognitive behavioral therapy that helps you learn how to change unhealthy thoughts and behaviors that bring on panic attacks.

2. Antidepressants, like selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs).

3. Benzodiazepines are sedatives that affect your central nervous system. (These aren’t used for long because you can get dependent on them.)

4. Anti-anxiety medications (Like benzodiazepines, these work better in the short term).

5. Cutting back on caffeine

6. Regular exercise

7. Limiting alcohol

8. Deep breathing exercises

How to Manage Panic Disorder in the Long Term

To manage panic disorder in the long term, you have to engage in continued therapy, manage your medications, practice mindfulness, and adopt several other strategies that promote overall well-being. The ways to manage panic disorder in the long term are listed below:

1. Regular sessions with a therapist, particularly one experienced in cognitive behavioral therapy (CBT), help reinforce coping strategies and address any emerging issues.

2. Maintaining an open dialogue with a healthcare provider about medication helps optimize treatment and manage any side effects.

3. Incorporating mindfulness, meditation, and deep breathing exercises into daily routines helps reduce anxiety and enhance emotional regulation.

4. Engaging in consistent physical activity improves mood, reduces stress, and contributes to overall well-being. Aim for at least 30 minutes of exercise most days.

5. Eating a balanced diet, staying hydrated, getting adequate sleep, and limiting alcohol and caffeine positively affect mental health.

Different Lifestyle Changes to Manage Panic Disorder

Managing panic disorder often involves a combination of professional treatment and lifestyle changes that support mental and physical health. Here are some practical lifestyle changes that can help:

1. Healthy diet: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins supports overall mental health. Reducing caffeine and sugar intake also helps minimize anxiety.

2. Regular exercise: Engaging in regular physical activity reduces stress and anxiety levels, improves mood, and promotes better sleep. Aim for at least 30 minutes of moderate exercise most days of the week.

3. Stress management techniques: Practices such as mindfulness meditation, deep breathing exercises, and yoga help manage stress and reduce anxiety symptoms. Incorporating these techniques into daily routines is beneficial.

4. Adequate sleep: Prioritizing quality sleep is essential for mental health. Aim for 7-9 hours of sleep per night and establish a consistent sleep schedule to promote better rest.

5. Limit alcohol and avoid drugs: Reducing or eliminating alcohol and recreational drug use helps prevent exacerbation of panic symptoms and improve overall mental health.

6. Social support: Maintaining strong social connections with friends and family provides emotional support and reduces feelings of isolation, which helps alleviate anxiety.

Implementing these lifestyle changes complements other treatments for panic disorder and enhances overall well-being.

How to Help Someone with Panic Disorder

To help someone with panic disorder, you should educate yourself, listen and validate their feelings, encourage healthy habits, offer reassurance, etc. 

Helping someone with panic disorder includes the following:

1. Educate yourself: Learn about panic disorder to better understand what your loved one is experiencing and how to provide effective support.

2. Listen and validate: Offer a non-judgmental ear and validate their feelings. Let them know it’s okay to feel anxious and that you’re there to support them.

3. Encourage healthy habits: Support them in adopting healthy lifestyle choices, such as regular exercise, a balanced diet, and good sleep hygiene, which help reduce anxiety.

4. Offer reassurance: Remind them that they are safe and that panic attacks are not life-threatening. Reassurance helps reduce feelings of fear during an attack.

5. Respect their space: Understand that they need space or time alone to cope. Respect their boundaries while also letting them know you’re available when they need support.

6. Stay calm yourself: Maintain a calm demeanor during their panic attacks. Your composure helps provide a sense of safety and stability for them.

How to Find Panic Disorder Support Near Me

If you're looking for support for panic disorder, there are several helpful options depending on the type of care and connection you’re seeking. Here’s a breakdown of where you can find support:

1. Support Groups: Many organizations offer peer-led support groups where individuals share their experiences and coping strategies. These groups provide a sense of community and understanding among those facing similar challenges. For example, Mental Health America has a directory of helpful support groups.

2. Online Communities: Online communities are another valuable resource. The Anxiety and Depression Association of America (ADAA) offers free online peer-to-peer communities where people connect with others experiencing anxiety and depression, including panic disorder. These communities provide a safe space to share experiences and find support. Mental Health America also hosts an online support community through Inspire, allowing individuals to connect on various mental health topics.

3. Professional Resources: Seeking professional help is crucial for managing panic disorder. You can find a panic disorder specialist near me who specializes in anxiety disorders through resources like the ADAA’s guide to finding a therapist. They also provide information on how to access professional help if you are in crisis. Additionally, local mental health clinics and hospitals have resources and programs specifically designed for individuals dealing with panic disorder.

Sources:

Sofia Health

Cleveland Clinic

Hopkins Medicine

Mayo Clinic

WebMD

Medline Plus

Nexus Nursing Institute

Mental Health

Bright Path BH

JGH Delhi

The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 (in the United States) immediately.