Causes and Risk Factors

The exact cause of panic disorder is unknown, but a combination of factors is believed to play a role: 

  • Genetics: Panic disorder often runs in families.

  • Brain biology and chemistry: Imbalances in certain neurotransmitters and an overreaction of the body's natural "fight-or-flight" response may be involved.

  • Major stress or traumatic life events: Events like a loss, divorce, or a serious accident can trigger the onset of the disorder.

  • Substance use: Use of caffeine, nicotine, alcohol, and recreational drugs can trigger or worsen panic attacks.

If you or a loved one is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988 or chat at 988lifeline.org. In a life-threatening situation, call 911

Panic disorder

Panic disorder is a type of anxiety disorder characterized by repeated, unexpected panic attacks and persistent worry about having more attacks. Unlike an occasional panic attack that most people experience in response to stress, these episodes often occur without a clear trigger and can significantly interfere with daily life.

Symptoms

Panic attacks are sudden surges of intense fear or discomfort that peak within minutes. Symptoms are both physical and psychological and can be very frightening, often mimicking a heart attack.

Physical Symptoms:

  • Rapid or pounding heartbeat (palpitations)

  • Sweating, trembling, or shaking

  • Shortness of breath or a sensation of smothering/choking

  • Chest pain or discomfort

  • Dizziness, lightheadedness, or feeling faint

  • Nausea or abdominal distress

  • Numbness or tingling sensations (paresthesia)

  • Chills or hot flashes

  • Psychological Symptoms:

  • Intense fear of dying

  • Fear of losing control or "going crazy"

  • Feelings of unreality (derealization) or being detached from oneself (depersonalization)

Diagnosis and Treatment

If you experience symptoms, it is important to see a healthcare professional to rule out other potential medical conditions, such as heart or thyroid problems, which can cause similar symptoms. Diagnosis is made based on recurrent, unexpected panic attacks followed by at least a month of persistent worry about future attacks or significant behavioral changes to avoid them.

Panic disorder is highly treatable, and most people get better with proper care. Treatment options typically include one or both of the following:

Psychotherapy: Cognitive-behavioral therapy (CBT) is considered a highly effective first-line treatment. It helps you understand your feelings and learn coping skills, such as breathing exercises and mindfulness, to manage symptoms and change distorted thoughts.

Medications: Antidepressants (SSRIs and SNRIs) and anti-anxiety medications (benzodiazepines) may be prescribed by a healthcare provider.

You can also make lifestyle adjustments to help manage symptoms, such as exercising regularly, getting enough sleep, and avoiding stimulants like alcohol and caffeine. Support groups, such as those offered by the Anxiety and Depression Association of America (ADAA), can also be beneficial.