Panic Disorder is a condition where a person experiences recurrent unexpected panic attacks. Panic attacks consist of episodes of intense fear or discomfort that peaks within minutes and are associated with bodily changes that occur during a fearful or anxiety provoking situation. These include changes in heart beat (increased rate or intensity), chest pain or discomfort, sweating, trembling, sense of choking, inability to breathe or shortness of breath. There may be feelings of nausea or discomfort in the abdomen. The person may feel giddy, unsteady, light-headed, or faint, and have hot, cold, numbness or tingling sensations over the body. There may also be feelings of things or surroundings being unreal or a sense of being detached from oneself. People also often report a sense of losing control or “going crazy” or dying. Rarely, there may be uncontrollable crying spells.
These attacks are followed by the person becoming worried about the consequences of these attacks or having future attacks. This includes being unduly worried about physical illnesses, or the social consequences of an attack such as embarrassment. Self-medication and use of addictive substances to reduce anxiety is also seen. They tend to make unreasonable changes to their lifestyle and behaviours to avoid having further attacks. Examples include avoiding physical exertion, reorganizing daily life to ensure that help is available in the event of a panic attack, and restricting usual daily activities.
In a panic disorder, the attacks do not occur in response to an expected anxiety provoking situation (e.g., in public speaking, specific phobias, separation from loved ones etc). They are often unexpected and recurrent. The attacks can also occur while the person is relaxed or even partly asleep. The frequency and severity of panic attacks vary widely. They may be as frequent as daily to once in a few months. The frequency may vary within the same person over time.
About 1 to 8 out of every thousand individuals are affected by panic disorder. Women are twice as commonly affected as men. The disorder usually begins in the early twenties and if untreated, usually follows a chronic but waxing and waning course. Individuals with panic disorder often make frequent visits to the doctor and tend to miss work and school resulting in a poor functional state including school dropouts and unemployment. It also leads to additional issues such as depression and suicide.
Clear-cut reasons for the development of panic disorder have not been found. However, those individuals who are temperamentally anxious and prone to negative emotions and those with childhood experiences of physical or sexual abuse may be at a higher risk of developing this disorder. Smoking has also been found to be a risk factor for panic attacks and panic disorder. Most individuals report significant stressors in the months before their first panic attack. There is an increased risk for panic disorder among children of parents with psychiatric disorders.
Before diagnosing panic disorder, your doctor will make sure that the attacks are not related to any medications that you may be on or as a result of the use of addictive substances. Medical causes of the symptoms including heart problems, thyroid disorders, lung diseases etc are also ruled out.
Based on the severity and frequency of the attacks, your doctor may choose to treat you with medications, psychotherapy, or a combination of both. The treatments will help to reduce the frequency and severity of attacks and improve functioning and quality of life. Most patients are able to lead normal or near normal lives if treated.