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Panic Disorder : Anxiety Disorder, Symptoms & Causes

Team AckoJul 4, 2024

Panic Disorder (PD), a severe psychiatric condition impacting approximately 5% of the population, refers to recurrent panic attacks characterised by sudden, overwhelming fear or discomfort lasting minutes. 

These episodes can induce significant terror, disrupting daily functioning. Common symptoms include palpitations, sweating, trembling, and feelings of impending doom. 

PD often leads to behaviours aimed at preventing future attacks, worsening social and occupational impairment. Treatment typically involves psychotherapy, medication, or a combination aimed at managing symptoms and improving the quality of life for those affected by this critical disorder.





What is Panic Disorder ?

PD and Panic Attacks (PA) are distinct. The former is characterised by sudden, frequent, and intense episodes of anxiety or fear without prior warning, while the latter is understood as a sudden surge of intense fear or discomfort that peaks instantly. Most individuals have one or two PAs in their lifetime. However, PD occurs when frequent, unexpected PAs have no apparent cause.

PD is known to be a benign disease that can lead to depression and disability. In addition, these patients have a higher chance of developing alcoholism and substance abuse than the general population. This condition can affect your quality of life so miserably that it will be difficult for you to concentrate. However, the good news is that Panic Disorder is treatable. 

Distinguishing Panic Attacks from Anxiety Attacks

The distinction between panic attacks and anxiety attacks lies in their triggers, intensity, and duration. Anxiety attacks often stem from identifiable stressors and may manifest gradually, while panic attacks arise suddenly and unexpectedly. While both can involve physical symptoms such as rapid heartbeat and stomach discomfort, anxiety attacks typically exhibit less intensity and have longer-lasting effects compared to the intense but brief symptoms of panic attacks. 

Anxiety attacks may also involve worrying thoughts and a sense of impending doom, while panic attacks often induce a feeling of overwhelming fear or impending danger. 

Understanding these differences can aid in recognising and managing these experiences effectively, whether through relaxation techniques, therapy, or medication. Seeking professional guidance is crucial for accurate diagnosis and personalised treatment approaches tailored to each individual's needs.

Exploring the Types of Panic Attacks

Panic attacks are distressing episodes characterised by sudden and intense feelings of fear or discomfort, accompanied by a variety of physical symptoms. Understanding the different types of panic attacks is crucial for effective management and treatment strategies.

Unexpected Panic Attacks

Unexpected panic attacks are those that occur seemingly out of nowhere without any identifiable triggers or warning signs. Individuals experiencing unexpected panic attacks may be going about their day feeling relatively calm when suddenly, they are overcome by intense fear or anxiety. These attacks can happen during periods of relaxation or even during sleep, catching the person off guard. 

The lack of apparent triggers can contribute to increased feelings of confusion and helplessness during these episodes. For individuals with panic disorder, unexpected panic attacks are often a hallmark feature of the condition.

Expected Panic Attacks

On the other hand, expected panic attacks are triggered by specific situations or stimuli that evoke fear or anxiety in the individual. These situations can vary widely and may include things like public speaking, being in crowded places, or experiencing intense physical sensations such as during take-off on a plane. 

The anticipation of these feared situations can lead to heightened anxiety, culminating in a panic attack when the person is exposed to the trigger. 

Unlike unexpected panic attacks, which seemingly come out of nowhere, expected or anticipated panic attacks are more predictable and can often be traced back to a particular trigger or source of anxiety. 

Both types of panic attacks can be distressing and disruptive to daily life, but understanding their differences can inform tailored treatment approaches aimed at managing symptoms and reducing the frequency and severity of future attacks. 

Understanding Panic Attack Triggers

Panic attacks can be triggered by a variety of factors, though in many cases, there may not be a specific identifiable trigger. However, individuals with certain phobias may experience panic attacks in response to phobia-related triggers. For instance, someone with a fear of heights may have a panic attack when they see tall buildings or cliffs. Similarly, individuals with social anxiety disorder may experience panic attacks in social situations where they feel exposed or judged.

Moreover, the fear of having a panic attack itself can become a trigger for future episodes. This anticipatory anxiety can create a cycle of fear and avoidance behaviours, thus worsening the frequency and intensity of panic attacks.

Panic Attacks Without Known Trigger

It's worth noting that one of the defining criteria for panic disorder is the occurrence of panic attacks without a known trigger. In these cases, the attacks seem to arise spontaneously, without any obvious external cue. This can contribute to feelings of confusion and distress for individuals experiencing panic disorder, as the unpredictability of the attacks adds to their anxiety and fear. 

Understanding potential triggers and addressing underlying anxiety issues are essential steps in managing and mitigating panic attacks effectively.

Symptoms of Panic Disorder

Some common symptoms of a panic attack may include the following.

  • Palpitations

  • Breathlessness

  • Feeling of choking

  • Dizziness

  • Lightheadedness

  • Nausea

  • Chills or sweating

  • Shaking

  • Hot flashes

  • Sense of unreality or dreamlike sensations

  • Chest discomfort

  • A fear of dying

A panic attack might be induced by a specific incident or external stimulation. At times, the symptoms of a panic attack appear for no apparent cause. Due to their unexpected nature, they can have a considerable impact on your daily life. 

Causes of Panic Disorder

The causes of PD are still unclear. However, certain common causes for developing the condition may include the following.

1. Genetics

According to research, PD may have a hereditary component. Researchers have found that there are 40 different genes associated with Panic Disorder, the majority of which are connected to our body's neurotransmitter system (which regulates communications between our nerve cells). 

2. Life events

PD is related to major life transitions and stressful life events, such as fighting with family members. Even when life events are exciting and pleasant, they can introduce new obstacles and anxiety into your everyday life.

Examples of such transformations and occurrences are as follows.

  • Leaving home to attend college

  • Relocating to some other place

  • The loss of a loved one

  • Leaving family members after marriage

  • Having your first kid

  • Beginning a new career

Taking care of your emotional and physical health is essential throughout life transitions. You also have the right to get support while dealing with challenges or trauma.

Try seeking emotional assistance from your loved ones. When you are feeling overwhelmed, set limits and communicate. A mental health professional or a therapist can share your pain by listening, giving information, and assisting you in developing coping strategies.

3. Anxiety

Anxiety typically manifests as worry, nervousness, or feeling overwhelmed. Social anxiety, for example, might develop when you are concerned about performing at social events or at places with a large number of people. You may feel extremely self-conscious and may experience physical symptoms such as sweating or shaking.

It is natural for humans to be worried at times. However, being nervous all of the time is a matter of concern and may indicate a generalised anxiety disorder (GAD).

You don’t have to be constantly worried and stressed. If you often feel anxious, it is essential for you to reach out for help. Anxiety can be managed with therapy, lifestyle changes, or medication.

How is Panic Disorder diagnosed?

There is no particular lab test for Panic Disorder. Since the symptoms are similar to those of a heart attack, your doctor will most likely begin by evaluating you and ruling out other health conditions. 

If no other ailment is driving your symptoms and you've experienced the following, it is considered as PD.

  • Two or more unexpected panic attacks (PA)

  • Living in fear of having another episode

  • Concerned about losing control during a PA

  • Avoiding situations that might trigger a PA by changing your behaviour

If you have such symptoms, you are most likely to have Panic Disorder.

Treatment of Panic Disorder

Treatment can help lower the severity and frequency of your PA and improve your everyday functioning. The primary treatment options include psychotherapy and medications.

1. Psychotherapy

Cognitive behavioural therapy (CBT): It teaches you how to think, behave, and react to the feelings that occur during or before a PA. It helps people learn about the disorder and helps them to know new ways of thinking and reacting to anxiety-provoking situations. Therapists in cognitive behaviour therapy help patients understand and learn the challenges and helpful ways of thinking, then replace their old ways of thinking with more realistic and helpful ones.

Cognitive therapy can be used alone or in combination with antidepressants to treat PD. Cognitive behavioural therapy is a common form of therapy and is helpful for people to alleviate their symptoms.

Exposure therapy: Exposure therapy is a common CBT approach that involves facing Panic Disorder-related anxieties and beliefs to help you participate in previously avoided activities. It may be combined with relaxation techniques.

2. Medication 

Medication may include the following.

  • Antidepressants 

  • Beta-blockers

  • Anti-anxiety drugs, such as benzodiazepines

Some common physical symptoms, such as a high heart rate, sweating, and tremors, can be controlled by beta-blockers.

Anti-anxiety sedative drugs such as benzodiazepines can be especially useful in swiftly alleviating PA symptoms. However, some people may develop a tolerance to these drugs and require higher dosages to get the same benefit.

Panic Attacks Prevention 

Preventing panic attacks involves a combination of identifying triggers, learning coping strategies, and adopting healthy lifestyle habits. Working closely with your healthcare provider is essential in this process, as they can help you identify specific triggers that contribute to your panic attacks and tailor a treatment plan accordingly.

Cognitive-Behavioural Therapy

Psychotherapy, particularly cognitive-behavioural therapy (CBT), is a valuable tool for learning effective strategies that can manage triggering events and prevent panic attacks. Through therapy, individuals can develop skills such as relaxation techniques, cognitive restructuring, and exposure therapy to gradually confront and desensitise themselves to anxiety-provoking situations.

Lifestyle Modifications

In addition to therapy, making certain lifestyle modifications can help lower the risk of experiencing panic attacks. Avoiding substances that can worsen anxiety, such as caffeine, alcohol, and nicotine, is crucial. Regular exercise is another important aspect of panic attack prevention, as it helps manage stress, release tension, and improve mood. 

Maintaining a balanced diet and managing stress through healthy coping mechanisms like mindfulness, deep breathing exercises, or hobbies can also contribute to overall well-being and reduce the likelihood of panic attacks.

Before trying any herbal supplements or over-the-counter medications, it's essential to consult with your healthcare provider, as certain substances may interact with medications or make the anxiety symptoms even worse. By implementing these proactive measures and seeking professional guidance, individuals can take proactive steps towards preventing panic attacks and improving their quality of life.

Frequently asked questions 

Here’s a list of common questions and answers related to Panic Disorder.


Can we live a normal life with Panic Disorder?

Managing anxiety can be challenging, but it's possible to live a normal life with proper treatment and support. To successfully manage your condition, it's important to normalise your anxiety, implement stress-reducing strategies, challenge negative thoughts, and prioritise self-care.

Is Panic Disorder a mental disorder?

Panic disorder is a common health issue in humans. It mainly starts in teens or adulthood, but some cases may also begin in childhood. It affects women twice as much as men. There might be a congenital connection too.

What is the main symptom of Panic Disorder?

Individuals with Panic Disorder feel a sudden surge of fear or discomfort or a feeling of losing control, even in the absence of a recognisable danger or trigger. Some common symptoms of a panic attack may include palpitations, breathlessness, a feeling of choking, dizziness, lightheadedness, nausea, chills or sweating, shaking, a sense of unreality or dreamlike sensations, and chest discomfort.


Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.


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