Symptoms, Impact, and Treatment of Panic Disorder

Fear and anxiety can be normal reactions to specific situations and stressful events. Panic disorder differs from this normal fear and anxiety because it is often extreme, and may seem to strike out of the blue.

What exactly is panic disorder? According to the DSM-5, panic disorder is a type of anxiety disorder that is characterized by extreme and frequent panic attacks. A person with panic disorder may experience symptoms such as severe feelings of terror, rapid breathing, and rapid heart rate. People with panic disorder may experience these attacks unexpectedly and for no apparent reason, but they can also be preceded by some sort of triggering event or situation.

• Feelings of extreme terror that occur suddenly without warning.
• Panic attack symptoms, including a pounding heart, sweating, trembling, numbness in the hands and feet, dizziness, weakness, chest pain and rapid breathing.
• During an attack, many people suffering from panic disorder describe feeling as if they are having a heart attack or on the verge of dying.
• Constant fear that another attack might happen at any time.
• Behavior changes as a result of having panic attacks, such as avoiding certain situations, areas or objects out of fear that they will trigger another attack.

The National Institute of Mental Health (NIMH) reports that approximately 2.7 percent of the adult U.S. population experiences panic disorder each year. Approximately 44.8 percent of these individuals experience cases of panic disorder that are classified as "severe."

According to the Anxiety and Depression Association of American, nearly six million American adults experience the symptoms of panic disorder during any given year. While panic disorder can strike at any point in life, it most often begins during late adolescence or early adulthood and affects twice and many women as it does men.

Panic disorder can lead to serious disruptions in daily functioning and make it difficult to cope with normal, everyday situations that may trigger feelings of intense panic and anxiety. In some cases, people with panic disorder may even begin avoiding certain situations, places, or people in order to minimize the chances of experiencing panic attacks. For example, an individual who has experienced a panic episode in a crowded shopping center may begin avoiding similar situations in order to prevent triggering panic symptoms.

Because panic disorder often leads to individuals avoiding certain situations or objects, it can also lead to phobias. For example, a person suffering from panic disorder might stop leaving home in order to prevent having an attack or losing control in public. In time, this person might develop agoraphobia, a marked fear of being in a variety of situations outside of the home in which escape might be difficult or help might not be available if debilitating symptoms develop.

While previous versions of the DSM categorized panic disorder and occurring with or without agoraphobia, the newest edition of the diagnostic manual lists the two as distinct and separate disorders.

Panic disorder, like other anxiety disorders, is often treated with psychotherapy, medication, or a combination of both. Cognitive-behavioral therapy is one treatment approach that can help people with panic disorder learn new ways of thinking and reacting to anxiety-provoking situations. As part of the CBT process, therapists help clients identify and challenge negative or unhelpful patterns of thinking and replace these thoughts with more realistic and helpful ways of thinking.

Exposure therapy is another approach that is often used in the treatment of anxiety disorders including panic disorder. This technique involves progressive exposure to the objects and situations that trigger a fear response. People experiencing panic disorder symptoms are exposed to fear-triggering situations in conjunction with learning and practicing new relaxation strategies.