Panic Disorder

Panic attacks can happen anytime, anywhere, and without warning. You may live in fear of another attack and may avoid places where you have had an attack. For some people, fear takes over their lives and they cannot leave their homes.

Panic disorder is more common in women than men. It usually starts when people are young adults. Sometimes it starts when a person is under a lot of stress. Most people get better with treatment. Therapy can show you how to recognize and change your thinking patterns before they lead to panic. Medicines can also help.

Causes

The cause is unknown. Genes may play a role. Other family members may have the disorder. But panic disorder often occurs when there is no family history.

Panic disorder is twice as common in women as it is in men. Symptoms often begin before age 25, but may occur in the mid-30s. Children can also have panic disorder, but it is often not diagnosed until they are older.

Symptoms

A panic attack begins suddenly, and most often peaks within 10 to 20 minutes. Some symptoms continue for an hour or more. A panic attack may be mistaken for a heart attack.

A person with panic disorder often lives in fear of another attack, and may be afraid to be alone or far from medical help.

People with panic disorder have at least 4 of the following symptoms during an attack:

• Chest pain or discomfort
• Dizziness or feeling faint
• Fear of dying
• Fear of losing control or impending doom
• Feeling of choking
• Feelings of detachment
• Feelings of unreality
• Nausea or upset stomach
• Numbness or tingling in the hands, feet, or face
• Palpitations, fast heart rate, or pounding heart
• Sensation of shortness of breath or smothering
• Sweating, chills, or hot flashes
• Trembling or shaking

Panic attacks may change behavior and function at home, school, or work. People with the disorder often worry about the effects of their panic attacks.

People with panic disorder may abuse alcohol or other drugs. They may feel sad or depressed.

Panic attacks cannot be predicted. At least in the early stages of the disorder, there is no trigger that starts the attack. Recalling a past attack may trigger panic attacks.

Diagnosis

Panic disorders may be long-lasting and hard to treat. Some people with this disorder may not be cured. But most persons get better when treated correctly.

People with panic disorder are more likely to:

• Abuse alcohol or illegal drugs
• Be unemployed or less productive at work
• Have difficult personal relationships, including marriage problems
• Become isolated by limiting where they go or who they are around

Treatment

The goal of treatment is to help you function well during everyday life. Using both medicines and talk therapy works best.

Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe.

Talk therapy (cognitive-behavioral therapy, or CBT) helps you understand your behaviors and how to change them. During therapy you will learn how to:

• Understand and control distorted views of life stressors, such as other people’s behavior or life events.
• Recognize and replace thoughts that cause panic and decrease the sense of helplessness.
• Manage stress and relax when symptoms occur.
• Imagine the things that cause the anxiety, starting with the least fearful. Practice in real-life situations to help you overcome your fears.

The following may also help reduce the number or severity of panic attacks:

• Not drinking alcohol
• Eating at regular times
• Getting plenty of exercise
• Getting enough sleep
• Reducing or avoiding caffeine, certain cold medicines, and stimulants