Panic Disorder Overview

Reviewed by: HU Medical Review Board | Last reviewed: January 2012 | Last updated: May 2020

Panic disorder is a condition where a person experiences recurring panic attacks. It’s one of the cluster of anxiety disorders that also includes social anxiety and generalized anxiety disorders, obsessive-compulsive disorder (OCD), agoraphobia and post-traumatic stress disorder (PTSD).

What Are Panic Attacks?

Panic attacks are sudden and devastating feelings of terror accompanied by physical symptoms. These may include:

  • Heart palpitations (may be pounding, rapid and/or fluttering)
  • Chest pain
  • Pounding heart
  • Trouble breathing
  • Dizziness or faintness
  • Sudden sweating
  • Weakness
  • Nausea
  • Flushing or chilling
  • Smothering sensations
  • Tingling or numbness in the hands
  • Hyperventilating (rapid shallow or deep breathing that can make you feel even more panicked)

Patients describe a profound sense that doom is imminent during panic attacks.

Another characteristic of true panic attacks is that they most likely have no relationship to anything that’s happening at the moment they begin — that is, they come out of nowhere.

Other Symptoms of Panic Disorder

Right now there are two types: panic disorder with and without agoraphobia. Since this is expected to change by 2013, making agoraphobia a separate diagnosis altogether, let’s just look at the two other symptoms that are required to diagnose panic disorder:

  1. For at least a month after a panic attack, the person is anxious or worried most of the time about having another one and/or serious consequences of experiencing another. For example, the person might have the persistent fear of having a heart attack during the next panic attack.
  2. Because of this anxiety, worry or fear, the patient makes significant andproblematic changes in behavior. For example, the person mentioned in #1 might refuse to drive a car because the fear of a heart attack is so profound.

The symptoms of panic disorder can often be so serious that they are disabling. A person with panic disorder may become unable to live a normal life because of the chronic anxiety about future attacks and their consequences. Here is an example:

Gail has experienced two panic attacks where she was paralyzed with fright and felt as if she was about to faint. She was sweating, dizzy, her hands were icy, and she had trouble breathing. The attacks had come out of the blue — once when she was at the grocery store, the other when she was out for a walk.

Now she is constantly worried that this will happen again, and even though there were no specific triggers in either case, she now refuses to shop for food or engage in any exercise. Her family often has meals made out of whatever’s available unless her husband has the time to go to the grocery store.

Panic Disorder and Migraine

Several studies have shown there is a strong relationship between panic attacks and migraine. Some people develop migraine at the time when the attack is at its worst. It appears that more often a migraine or other severe headache can be a prelude to a panic attack, though more research is needed to establish the temporal relationship between the two.

Some research has found that those who have both migraines and panic attacks may have a more serious course of illness in panic disorder than those without migraines.

Research also suggests that people who have panic disorder and also depression may have more migraines than those with panic disorder alone.

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