What Is Panic Disorder?


In this hectic and fast-growing world, people are more prone to stress, anxiety, and depression due to several reasons. Anxiety may result in more body vulnerability to panic attacks. Initially thought to aggravate neurochemical disturbance in people with panic disorder (PD), this may elicit panic because they induce feelings that people with high anxiety threshold fear.1

Panic disorder (PD) is a form of anxiety  characterised by recurrent and unexpected panic attacks. People with panic disorder frequently live in dread of the next panic attack, and may avoid certain circumstances or locations due to the possibility of an attack induced by them. This fear can develop into the fear of being in places or circumstances where the exit is difficult or humiliating. The precise origin of panic disorder is unknown, but it is thought to be a combination of genetic, and environmental  variables.

Causes of panic disorder

Those assigned female at birth(AFAB) are more prone to this disorder when compared to those assigned male at birth (AMAB)  as per researchers,  although the disorder is equally harmful to everyone. The causes of this disorder could be worrying/being concerned too much about a situation. 

Risk factors

The risk factors of the disorder could be biological or environmental (see table 1).Table 1: Risk factors of panic disorder

GeneticAs suggested by higher association with: Family history of panic attacks or panic disorderA family pattern usually exists; people with a close biological family member with panic disorder are up to 8 times more likely to develop the condition.PersonalityTemperament 
Anatomical2Damage of different regions of the brain:Prefrontal cortexInsulaThalamusAmygdalaHypothalamusperiaqueductal grey substanceParabrachial nucleus 
Physiological3Regular occurrence of respiratory stimulation. The most common respiratory defect documented in Parkinson's patients with PD is increased CO2 sensitivity ⇒  fundamental abnormalities of the physiological mechanisms controlling breathing in Parkinson's disease.
OthersAge of onset: late adolescence - early adulthood (typically 18 - 35), but may occur at any age.Gender: see above
Despite the strong statistics on underlying genetics, up to 50%  of patients have no close relatives with PD.Major life stresses, e.g., death or serious illness of a loved oneTrauma, e.g., sexual assault, serious accidentMajor life changes, e.g., divorce, a new babyFamily environmentSmokingExcessive caffeine intakeHistory of childhood physical or sexual abuse

Signs and Symptoms

Table 2: Some symptoms representing panic disorder

Cardio-respiratory type symptoms
1. Palpitations
2. Shortness of breath
3. Coughing
4. Chest pain
1. Numbness
2. Fear of dying
Autonomic/mixed somatic symptoms
1. Sweating
2. Trembling
3. Nausea
4. Chills/hot flashes
5. Dizziness
1. Feelings of unreality
2. Fear of going insane 
3. Dread of losing control

Management and treatment

  • Before any treatment, a patient must be diagnosed, and treatment is tailored depending on the  symptoms’ severity and underlying biological or environmental causes/risk factors. . Treatment for panic disorder frequently combines medication with other types of psychological/psychiatric therapies , such as cognitive-behavioural  therapy (CBT), which can assist people  identify and change negative patterns of thinking and behaviour  that contribute to the panic disorder  and can be  effective in PD associated with other morbidities, e.g.,  Parkinson's disease
  • Medications used for treating PD include the following groups that target a possible neurotransmitter defect, and are among the many others available, e.g.
    • Selective serotonin reuptake inhibitors (SSRIs)
    • Serotonin-norepinephrine reuptake inhibitors (SNRIs)
    • Tricyclic antidepressants (TCAs) 
    • Benzodiazepines 
  • The treatment lasts for 6-8 weeks4  
  • It is crucial to remember that each individual will respond differently to treatment, so it may take some trial and error manoeuvring to find the best mix of treatment modalities
  • As a result, it's important  to closely collaborate  with a mental health expert to create a treatment strategy that is suited to your particular requirements


How is PD diagnosed?

Well, there are procedures like: screening, evaluation, and patient education.


Screening is done to check the patient’s medical history, and their high and low sensitive points. Screening tools, like patient health questionnaires , help to diagnose the patient, where several questions are asked, e.g.  did you knowingly or unknowingly hurt yourself or others?


Careful medical examination is done. Thyrotropin levels and electrocardiography are frequently ordered to find underlying medical causes.

Patient education

Reviewing the patient's fears of illness, and expectations for medical testing and therapy is a crucial stage after the clinical diagnosis has been made. More than 80% of patients with panic disorder exhibit  medical symptoms, and the majority of patients  are terrified of experiencing  severe illness-like  heart attacks.5  

Can panic disorder be prevented? 

Yes, panic disorder can be prevented by changing the quality of health and lifestyle. Changing certain aspects of one's lifestyle, such as abstaining from drinking and caffeine, exercising frequently, and getting better sleep can all  help manage panic disorder. Managing sleep habits, thinking positively, and eating healthy  leads to less stress and anxiety.

Who is  at risk of panic disorder? 

People who are already facing severe problems are more prone to PD. Patients already with cardiovascular disease, diabetes, hypertension, and other health problems could lead to PD.

How common is panic disorder?

In America, about 2-4% of the adult population suffer from PD. In the United Kingdom, about 1% of   individuals have PD. In India, 5-7% of people suffer from PD.

When to get medical advice?

You should seek a doctor, when you get negative thoughts about yourself, overthink things, feel anxious about any little situation, or get any of the symptoms like nausea, sweating, or hot flashes.


  • Panic disorder is a form of anxiety conditions that is characterised  by recurrent and unexpected panic attacks
  • If left untreated, it could negatively impact your life and could be fatal
  • According to the researchers, PD is most common in women when compared to men, as women are more emotional
  • PD can be caused by overthinking the situation repeatedly, sensitive people who could not bear difficult situations
  • Sometimes, it could be related to other severe diseases such as Parkinson’s
  • Sweating, trembling, nausea, chills/hot flashes, and dizziness are some of the symptoms of PD. 
  • Screening, evaluation, and history of the patient are to be  performed   to establish a diagnosis before commencing any treatment
  • The treatment includes CBT, medications, in addition to  changing your lifestyle, eating, and sleeping habits
  • One should visit the doctor when needed, take care


  1. McNally RJ. Anxiety sensitivity and panic disorder. Biological psychiatry. 2002;52(10):938-46. Available at: Anxiety sensitivity and panic disorder - Biological Psychiatry (biologicalpsychiatryjournal.com) - Abstract
  2. Meuret AE, White KS, Ritz T, Roth WT, Hofmann SG, Brown TA. Panic attack symptom dimensions and their relationship to illness characteristics in panic disorder. Journal of Psychiatric Research. 2006;40(6):520-7. Available at: Panic attack symptom dimensions and their relationship to illness characteristics in panic disorder - ScienceDirect - Abstract
  3. Sardinha A, Freire RCdR, Zin WA, Nardi AE. Respiratory manifestations of panic disorder: causes, consequences and therapeutic implications. Jornal Brasileiro de Pneumologia. 2009;35:698-708. Available at: SciELO - Brazil - Respiratory manifestations of panic disorder: causes, consequences and therapeutic implications Respiratory manifestations of panic disorder: causes, consequences and therapeutic implications
  4. Perna G, Caldirola D. Management of treatment-resistant panic disorder. Current treatment options in psychiatry. 2017;4:371-86. Available at: Management of Treatment-Resistant Panic Disorder (nih.gov)
  5. Katon WJ. Panic disorder. New England Journal of Medicine. 2006;354(22):2360-7. Available at: Panic Disorder | NEJM
    This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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    Srishti Dixit

    Masters of Science in Biomedical Engineering, University of Strathclyde, Glasgow

    Hi! My name is Srishti Dixit I am currently doing my masters in Biomedical Engineering. I have always been inclined towards research and scientific writing since my bachelors. Sharing knowledge about health and healthy lifestyle and alarming people about it is important. A healthy mindset and body is always a first step to positivity. Reading articles spread awareness and encouragement to follow a healthy lifestyle.

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