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Panic Disorder: Causes, Symptoms, Treatment and Prevention

Panic disorder refers to a situation when an individual has no less than two panic attacks (one feels overwhelmed and terrified even when one is not in any danger) and continually worries and alters his or her routine to save them from having an extra one. Panic disorder is classified as an anxiety disorder (Richmond, 2021). One out of ten American adults have a panic attack every year, and this starts between fifteen and twenty-five years. Around a third of the individuals in the U.S have one panic attack in their life though most of them don’t have the disorder. Only around 3% of the grown-ups have the disorder and are mostly common among ladies compared to male counterparts (Richmond, 2021). Individuals with the disorder typically have abrupt and recurring attacks of fear which last for a couple of minutes longer than that.

According to Bhatt (2021), panic disorder is typically characterized by the anxiety of losing control even in the absence of real danger. An individual might also have a very robust physical reaction during an attack, and this might feel as developing a heart attack (Richmond, 2021). The Panic attacks can take place anyhow, and most of those who have panic disorder typically fear experiencing another attack. An individual with panic disorder might feel discouraged and ashamed because they can not carry out their regular routines such as driving, going to school or work, or going to the grocery. Panic disorder typically begins in early adulthood or late teens. Minus treatment, recurrent as well as prolonged attacks can be brutally disabling (Richmond, 2021). Affected individuals might avoid many situations like being alone or leaving their houses for fear of suffering an attack.

Causes of panic disorder

In most cases, panic attacks come “from the blue.” One might start while one is sleeping. Embracing alcohol or drugs to handle panic disorder can worsen the symptoms. Attacks might come after an individual uses mild-altering drugs. Some medications, such as antidepressants, can cause panic attacks. However, doctors do not know the exact cause of panic disorder, although there is a possibility that the brains of individuals who have the disorder might be specifically sensitive in reacting to fear (Richmond, 2021). There is a connection between phobias such as claustrophobia, school phobia, and panic attacks. On the other hand, there is a theory that this disorder might come from oversensitivity to carbon dioxide that makes one’s brain think he or she is suffocating.

National Institute of Mental Health (2021), the disorder runs in relatives, although nobody knows why some members have it whereas others do not. Scholars have realized that numerous brain parts and biological processes play a fundamental role in anxiety and fear. Some scholars believe that individuals with panic disorder misunderstand harmless bodily feelings as threats. By learning much about the body and brain functions of individuals with panic disorder, scientists can develop better treatments. Doctors do not know the exact cause of the panic disorder. However, there is also a possibility that the nervous system and the brain play a major role in the manner individuals handle and perceive anxiety and fear (Richmond, 2021). A person’s risk of having panic attacks keeps increasing if the individual has:

Mental health conditions: Individuals that have depression, anxiety disorders as well as other mental conditions are susceptible to panic attacks

Family history: Anxiety disorders such as panic disorders are normally run in families.

Substance abuse complications: Drug and alcohol addiction raises an individual’s risk of a panic attack. Some symptoms common to panic attacks can also occur in conditions that are physical. In this case, some drugs and medications such as alcohol and tranquilizers, and caffeine can induce panic-like signs.

Based on this, it is apparent that some research has expressed that panic disorder can be linked genetically. In contrast, other studies have not found a connection between an individual’s genetics and panic disorder. On the other hand, panic disorder is linked with substantial life changes. For instance, getting married, having a firstborn, or leaving for college are among the substantial life transitions which might create stress and result in the advancement of panic disorder. It is prudent to mention that recalling or fearing a panic attack might lead to another attack.

Symptoms of a panic attack

Panic attacks commonly occur abruptly and minus a warning. There is no simple way of stopping a panic attack the moment it begins. Panic attack symptoms typically peak within ten minutes after they commence and disappear soon afterward (Bhatt, 2021). However, some symptoms persist for more than an hour. Panic attacks can be mistaken to be heart attacks. Individuals with the disorder usually live in the distress of getting another attack and might be fearful of being away from medical aid or alone.

According to the National Institute of Mental Health (2021), Individuals with panic disorder have at least four of these symptoms.

  • Feeling of unreality
  • Shaking or trembling
  • Fear of dying
  • Pounding heart, palpitations, or first heart rates
  • Upset stomach or nausea
  • Discomfort or chest pain
  • Feeling of chocking
  • Sweating, hot flashes, or chills
  • Tingling in the feet, face, or hands or numbness
  • Feeling faint or dizziness
  • Smothering or feelings of shortness of breath
  • Impending doom or fear of losing control
  • Feelings of detachment

Panic attacks can change function and behavior at school, work, or home. Individuals with panic disorder usually worry about the consequences of their attacks (Bhatt, 2021). Based on this, individuals with the disorder might abuse alcohol as well as other drugs. They can feel depressed or sad. Panic attacks are not predictable, and in the initial stages of this disorder, no defined trigger begins the attack. However, remembering a previous attack can activate panic attacks.

Flight or fight reaction

Whenever the body gets faced with an abrupt threat, the brain instructs the autonomic nervous system to trigger the flight or fight reaction. The body is then flooded with many chemicals, such as adrenaline which prompt physiological changes (Bhatt, 2021). For instance, breathing and heart rate are enhanced, and blood gets shifted to muscles in preparation for running away or combat. The disorder is believed to befall when the flight or fight reaction is activated, but there is no imminent danger yet to ensue. An individual might witness signs of a panic attack in stress-free and harmless situations such as while asleep or even watching television. Factors which might make the body inaptly trigger the flight or fight reaction comprise of:

  • Chronic stress because it causes the human body to exceedingly higher quantities of stress chemicals like adrenaline.
  • Acute stress suddenly floods the body with higher amounts of stress chemicals.
  • Usual hyperventilation which affects the balance of blood gases since there is no sufficient carbon dioxide circulating in the blood.
  • Illness might result in physical changes.
  • Heavy physical exercise as it can cause life-threatening for some people.
  • Extreme caffeine intake- the caffeine in tea, coffee, and other beverages is a stimulant and a strong one.
  • Abrupt change of the environment is like walking into a stuffy, hot, or crowded environment.

Tests, exams, and diagnosis

Bhatt (2021) states that many individuals who suffer from the disorder typically seek treatment from the emergency room since the panic attack is ordinarily similar to a heart attack. Here the health care professional performs a mental health exam and a physical exam. The care provider also carries out blood tests. All other medical orders ought to be ruled out before diagnosing panic disorder. All disorders which are related to substance use must be considered since symptoms can resemble the ones of panic attacks.


According to Mount Sinai (2021), serious health complications like thyroid disease, respiratory and heart disease cause symptoms that are the same as those of panic attacks. Therefore, the healthcare provider needs to run tests to rule out all physical complications. In case there is no physical cause, the healthcare provider can make a diagnosis concerning your risk factors and symptoms.

Mental or medical health providers can quickly diagnose panic disorder. They can diagnose panic disorder in case there have been recurrent panic attacks and the individual:

Continuously worried about getting more panic attacks or threats.

Obsesses on losing control during the occurrence of a panic attack.

Changes behaviors to evade circumstances which might cause a panic attack.

Treatment and Management

According to National Institute of Mental Health (2021), medications, psychotherapy or a combination of the two are efficient in ending panic attacks. How long one will need the treatment relies on the cruelty of the complication and how well he or she responds to the treatment. The options comprise of:


According to Richmond (2021), cognitive behavioral therapy is a form of talk therapy or psychotherapy. Here person with panic attacks shares emotions or thoughts with a mental health professional like a licensed psychologist or counselor. The professional plays a role in identifying triggers of a panic attack so one can change his or her behaviors, reactions and thinking. (Skritskaya, 2021). As the individual starts to react in a different way to the causes, the attacks will lessen and eventually stop.


Some antidepressant medicines can help in reducing the frequency or severity of panic attacks. Professional care providers can recommend serotonin selective reuptake inhibitors, tricyclic antidepressants, or serotonin-norepinephrine inhibitors (Richmond, 2021). Serotonin selective reuptake inhibitors comprise paroxetine and fluoxetine while serotonin-norepinephrine inhibitors comprise venlafaxine and duloxetine. On the other hand, tricyclic antidepressants comprise of doxepin and amitriptyline.

Anti-anxiety medications

According to Richmond (2021), benzodiazepines are the commonly recommended anti-anxiety drugs to prevent and treat panic attacks. Although they have risks of dependence or addiction, they have they help with anxiety. They include lorazepam and alprazolam.

Complications of panic attacks

Panic attacks are curable, but people stop to look for help since they get embarrassed. Panic disorder or untreated attacks might affect a person’s capability to enjoy life. If untreated, the disorder might have substantial effects on the life of the victim’s daily life. One can then develop complications such as:

Anticipatory anxiety

The likelihood of having a panic disorder might trigger dangerous anxiety.


Phobias are thrilling and unreasonable fear of specific things. For instance, the fear of heights is known as acrophobia whereas the fear of enclosed places is known as claustrophobia.


Around two thirds of individuals who suffer from panic disorder also develop agoraphobia. Agoraphobia makes a person afraid of being in situations or places where panic attacks can occur. The fear might be so thrilling that one becomes afraid of leaving his or her house. Panic disorder also causes delayed development teen and kids since the fear of getting a panic attack make it hard to maintain relationships or attend school.


Skritskaya (2021) argues that the health care provider can help an individual with panic disorder identify the triggers that lead to panic attacks. Individuals who suffer from the disorder learn strategies of managing the triggering events during psychotherapy to avoid attacks. Alternatively, one can take the following actions to lower chances of having an attack:

  • Manage stress
  • Embrace regular exercises
  • Cut on caffeine intake and above all
  • Maintain a healthy diet

People suffering from panic disorder should talk to their doctor before taking any over-the-counter drugs or herbal supplements since some substances might increase anxiety. Panic disorder is usually a long-term problem which can be hard to treat. Some people who suffer from this condition don’t respond well to their treatment while others might have times when their symptoms are intense and when the symptoms are entirely not present (Skritskaya, 2021). However, individuals with panic disorder witness some symptom relief due to treatment. Additionally, it is likely to prevent the disorder though one can work to reduce symptoms through the use of substances as prescribed by a professional care provider and avoid stimulants and alcohol. It is also prudent to notice whether the one signs anxiety due to an upsetting live event. In case one is bothered by a thing he or she was exposed to or experienced, the situation needs to be shared with the mental health professional or care provider.

In a nutshell, Panic disorder is a situation when an individual has no less than two panic attacks (one feels overwhelmed and terrified even when one is not in any danger) and continually worries and alters his or her routine to save them from having an extra one. Doctors do not know the exact cause of panic disorder. However, there is a possibility that the brains of individuals who have the disorder might be specifically sensitive in reacting to fear. There is a connection between phobias such as claustrophobia, school phobia, and panic attacks. The symptoms of panic disorder include feelings of unreality, shaking or trembling, fear of dying, a pounding heart, palpitations, or first heart rates. Triggers for the disorder comprise extended stress, abrupt changes in the environment, and severe physical reactions. Medications, psychotherapy, or a combination of the two efficiently end panic attacks. Prevention can be achieved if the health care provider identifies the triggers which lead to panic attacks. Individuals who suffer from the disorder need to learn strategies for managing the triggering events during psychotherapy in order to avoid an attack.


Richmond, C. (2021). Panic Disorder and Panic Attacks. WebMD. Retrieved 4 December 2021, from

Bhatt, N. (2021). What are the DSM-5 criteria for diagnosis of panic disorder?. Retrieved 4 December 2021, from

National Institute of Mental Health (2021). Panic Disorder: When Fear Overwhelms. National Institute of Mental Health (NIMH). (2021). Retrieved 4 December 2021, from

Mount Sinai (2021). Panic disorder Information | Mount Sinai – New York. Mount Sinai Health System. (2021). Retrieved 4 December 2021, from

Skritskaya, N. (2021). Treatment of Panic Disorder: Long Term Strategies – Full Text View – Retrieved 4 December 2021, from


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