An Introduction to Panic Disorder
People with panic disorder have recurrent, unexpected feelings of extreme fear and dread that strike for no apparent reason, causing their heart to race, rapid breathing, sweating, and shakiness. These "attacks" can send people to the hospital believing they are having a
heart attack. A
panic attack may even occur when the person is not in a situation that would normally create stress,
anxiety, or fear.
People with panic disorder often avoid places where they've had
panic attacks and, in severe cases, may become housebound. Two to four percent of the people in America suffer from panic disorder.
Symptoms of Panic Disorder
People with panic disorder can't predict when a panic attack will occur, and many develop intense anxiety between episodes, worrying about when and where the next one will strike.
Common symptoms of panic disorder include:
- Pounding heart
- Feeling sweaty, weak, faint, or dizzy
- Shortness of breath
- Chest pain or smothering sensations
- A sense of unreality
- Hot flashes or chills
- Hands may tingle or feel numb
- Feeling flushed or chilled
- Nausea
- Fear of impending doom or loss of control.
You may genuinely believe you're having a heart attack or losing your mind, or that you're on the verge of death.
Panic attacks can occur at any time, even during sleep. A panic attack generally peaks within 10 minutes, but some symptoms may last much longer.
Diagnosing Panic Disorder
People who have multiple
panic attacks may have a medical condition called panic disorder. Panic disorder is diagnosed either after four
panic attacks within four weeks or after one or more panic attacks followed by at least a month of persistent fear of having another panic attack. A minimum of four of the symptoms listed previously must have developed during at least one of the panic attacks.
Many people with panic attacks and panic disorder visit the emergency room repeatedly or see several doctors before they obtain a correct diagnosis. Some people with the condition may go for years without learning that they have a real, treatable illness.
The risk of developing panic disorder appears to be inherited. Not everyone who experiences a panic attack will develop panic disorder. For example, many people have one panic attack but never have another one. For those who do have panic disorder, however, it's important to seek treatment. When left untreated, panic disorder can become disabling.
Panic Disorder and Other Medical Conditions
Panic disorder is often accompanied by other serious conditions, such as
depression, drug abuse, or alcoholism, and may lead to a pattern of avoiding places or situations where panic attacks have occurred. For example, if a panic attack strikes while you're riding in an elevator, you may develop a fear of elevators. If you start avoiding elevators, it could then affect your choice of a job or apartment, and greatly restrict other parts of your life as well.
Some people's lives become so restricted that they avoid normal, everyday activities, such as grocery shopping or driving. In some cases, they become housebound. Or, they may be able to confront a feared situation only if accompanied by a spouse or other trusted person.
Basically, these people avoid any situation in which they would feel helpless if a panic attack were to occur. When people's lives become so restricted, as happens in about one-third of people with panic disorder, the condition is called
agoraphobia. Early treatment of panic disorder can often prevent agoraphobia from developing.
Medication can include high-potency anti-
anxiety drugs like
alprazolam. Several classes of
antidepressants (such as
paroxetine, one of the newer selective serotonin reuptake inhibitors) and the older tricyclics and monoamine oxidase inhibitors (MAO inhibitors) are considered "gold standards" for treating panic disorder. Sometimes, a combination of therapy and medication is the most effective approach to helping people manage their symptoms.
Proper treatment helps 70 to 90 percent of people with panic disorder, usually within six to eight weeks.
Statistics on Panic Disorder
Approximately 2.4 million American adults ages 18 to 54, or about 1.7 percent of people in this age group, have panic disorder in a given year.
Panic disorder typically develops in late adolescence or early adulthood.
About one in three people with panic disorder develop
agoraphobia, a condition in which they become afraid of being in any place or situation where escape might be difficult or help unavailable in the event of a
panic attack.
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