Panic Disorder Is Panic Disorder Caused by a Chemical Imbalance? By Katharina Star, PhD Katharina Star, PhD Facebook LinkedIn Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. Learn about our editorial process Updated on September 17, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print BSIP/UIG/Getty Images You may have heard that mental health conditions are caused by chemical imbalances in the brain, but what exactly does that mean? The term "chemical imbalance" is shorthand for the complex balance of neurotransmitter systems in the brain required for the maintenance of mental health. The following describes the chemical imbalance theory and other potential factors that may influence the development of panic disorder. The “Chemical Imbalance” Theory According to chemical imbalance theories, panic disorder symptoms can be attributed to imbalances in naturally occurring chemical messengers in the brain, known as neurotransmitters. These help communicate information between nerve cells brain throughout the brain. The human brain is thought to have hundreds of these different types of neurotransmitters, and chemical imbalance theories suggest that a person can become more susceptible to developing panic disorder symptoms if one or more of these neurotransmitters do not remain balanced. The neurotransmitters serotonin, dopamine, norepinephrine, and gamma-aminobutyric acid (GABA) are specifically believed to be linked to mood and anxiety disorders. These neurotransmitters are in charge of regulating various bodily and mental functions. First, serotonin is a neurotransmitter that is largely associated with mood, sleep, appetite, and other regulatory functions in the body. Experts have also found that reduced levels of serotonin are connected to depression and anxiety. The neurotransmitter dopamine may also contribute to symptoms. Dopamine influences, among other functions, a person’s energy levels, attention, rewards, and movement. Norepinephrine is also related to anxiety as it released in the fight-or-flight response, or they physiological response to stress. Last, GABA plays a role in balancing excitement or agitation and inducing feelings of calm and relaxation through its inhibitory effect. The Chemistry of Depression Other Theories Other theories about the causes of panic disorder look at the possibility of genetic or environmental influences. Genetic theories are based on the solid evidence of the familial link of panic disorder. Six controlled studies show a 5.7% to 17.3% increased risk of PD when a relative who also suffers from this condition. Other theories look at environmental factors, such as one’s upbringing or current life stressors, as key influencers in the development of panic disorder. For instance, problems in childhood, such as being raised by overprotective and anxious parents, attachment issues, and experiences of abuse or neglect, may impact a person later in life. Experiencing difficult life stressors and transitions, including grief and loss or other major life changes, can also affect a person’s wellbeing and vulnerability to developing a mental health condition. Biological Theories of Panic Disorder A Combination of Influences Currently, most professionals who treat panic disorder rely on a multidimensional theory to understand the causes of panic and anxiety symptoms. This theory is based on the notion that a combination of factors leads to the development of panic disorder, meaning that a chemical imbalance may be partly to blame. Other influences, such as genetics and environmental factors, also likely play a role in a person’s experience with panic disorder. Treatments If you are considering treatment options, your doctor or therapist may follow a treatment approach that addresses multidimensional factors. Early detection and diagnosis will be important in getting you on the right treatment plan for your particular needs. The most common treatment options for panic disorder include medication, psychotherapy, and self-help strategies. Medications, such as antidepressants and benzodiazepines, may be prescribed to bring equilibrium back to your neurotransmitters. Psychotherapy may help with dealing with past hurts, getting through life challenges, and overcoming negative thoughts and behaviors. Self-help techniques can promote relaxation, stress management, and getting through anxiety on a day-by-day basis. Your doctor or therapist will most likely recommend a combination of these treatment options to assist in managing your condition. Although the exact cause of panic disorder is still unknown, treatment is available that can help in managing all of the possible influences causing your panic disorder symptoms. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. 5 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Martin EI, Ressler KJ, Binder E, Nemeroff CB. The neurobiology of anxiety disorders: brain imaging, genetics, and psychoneuroendocrinology. Psychiatr Clin North Am. 2009;32(3):549-75. doi:10.1016/j.psc.2009.05.004 Dayan P, Huys QJ. Serotonin, inhibition, and negative mood. PLoS Comput Biol. 2008;4(2):e4. doi:10.1371/journal.pcbi.0040004 Klein MO, Battagello DS, Cardoso AR, Hauser DN, Bittencourt JC, Correa RG. Dopamine: Functions, Signaling, and Association with Neurological Diseases. Cell Mol Neurobiol. 2019;39(1):31-59. doi:10.1007/s10571-018-0632-3 Na HR, Kang EH, Lee JH, Yu BH. The genetic basis of panic disorder. J Korean Med Sci. 2011;26(6):701-10. doi:10.3346/jkms.2011.26.6.701 Bouton ME, Mineka S, Barlow DH. A modern learning theory perspective on the etiology of panic disorder. Psychol Rev. 2001;108(1):4-32. doi:10.1037/0033-295X.108.1.4 Additional Reading American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: Author. Bourne, E. J. (2011). The Anxiety and Phobia Workbook. 5th ed. Oakland, CA: New Harbinger. By Katharina Star, PhD Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Panic Disorder Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.