Panic disorder is a condition characterized by recurring overwhelming feelings of panic, often for no apparent reason. Although it is natural to experience feelings of anxiety and panic in response to certain situations among people with panic disorder, panic attacks strike on a regular basis without reason or warning.

When a person experiences a panic attack, the feelings of fear and anxiety are disproportionate for the given situation. The affected individual eventually develops a constant fear of having further panic attacks, which can leave them struggling to cope with day-to-day activities such as shopping, driving or in some cases, simply leaving the house. These individuals basically try to avoid any scenario that may leave them feeling helpless should another attack occur. Although an isolated panic attack can be extremely distressing, it is not uncommon and is not the same as panic disorder.

In order to be diagnosed with panic disorder, a person must experience recurrent panic attacks, with at least one of those attacks followed by a month or more of either:

• Persistent fear over the implications of the attack, such as “going crazy”, having a heart attack or fear of a further attack.
• Significant behavioral changes such as avoiding shops, exercise or situations that are unfamiliar.

Panic disorder usually starts to develop during adolescence or early adulthood and is estimated to affect around 6 million adults in the U.S. The condition is twice as common among women as it is among men.

The cause of panic disorder is not fully understood but researchers have found evidence of both a biochemical and genetic basis for the condition. Scientists are studying the parts of brain that play a role in fear and anxiety in the hope of developing better treatments and are also looking at the ways in which environmental factors and stress may play a role. Panic attacks are also often associated with depression, suicidal tendency, phobias and substance abuse.

Symptoms

As well as experiencing sudden feelings of fear and nervousness, people with panic disorder develop physical symptoms such as trembling, sweating, nausea and heart palpitations. During an attack, a sense of impending doom or loss of control may lead the person to genuinely believe they are having a heart attack, losing their mind or are about to die. This overwhelming feeling of terror often triggers hyperventilation which can then cause other physical symptoms by disrupting how oxygen and carbon dioxide are balanced in the bloodstream.

If a person experiences four or more of the following symptoms, they may be having a panic attack:

• Sweating and hot flushes.
• Intense fear or anxiety and a feeling of dread and apprehension.
• Fear of losing control or dying.
• Trembling, shivers and chills.
• Palpitations and irregular heart rhythm.
• Tightness and pain in the chest, shortness of breath or even choking.
• Nausea, dry mouth, abdominal cramps and an urge to urinate or defecate.
• Dizziness and feeling faint or fainting.
• Ringing in the ears.
• Numbness, tingling or pins and needles in the hands and legs.

Although individuals having a panic attack can feel as if they are having a heart attack, the chest pain experienced is different to that which occurs during heart attack. During a panic attack, the chest pain usually occurs in the middle of the chest area, whereas during a heart attack, the pain usually moves towards the left arm.

Experiencing an attack

A panic attack usually peaks after 10 minutes and lasts for around 5 to 20 minutes. Excess anxiety associated with a panic attack may cause two consecutive attacks leading to a longer duration of the overall event. During an attack, the person often feels detached from themselves and their surroundings which can lead to confusion and disorientation. The frequency and severity of panic attacks varies from person to person, with some people experiencing attacks once or twice a month and others more than once a week.