Panic Disorder
Characterized by recurrent unexpected panic attacks and persistent concern about having additional attacks or their consequences.
Prevalence: 2-3% of adults annually; lifetime prevalence 4.7% (NIMH). 2x more common in women.
Common Symptoms
- Sudden episodes of intense fear
- Palpitations or accelerated heart rate
- Sweating profusely
- Trembling or shaking
- Shortness of breath or smothering sensation
- Feeling of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, lightheaded, or faint
- Chills or heat sensations
- Numbness or tingling sensations
- Derealization (feelings of unreality)
- Depersonalization (feeling detached from oneself)
- Fear of losing control or "going crazy"
- Fear of dying
- Avoiding places where attacks have occurred
- Constant worry about next attack
Risk Factors
- Family history of panic disorder
- Major life stress
- History of childhood abuse
- Smoking
- Caffeine sensitivity
- Female gender
- Temperamental anxiety
- Other anxiety disorders
Treatment Approaches
- Cognitive Behavioral Therapy (CBT) - Most effective
- Panic-focused CBT
- Interoceptive exposure
- Breathing retraining
- Cognitive restructuring
- SSRIs (first-line medication)
- SNRIs
- Benzodiazepines (short-term only)
- Combination of therapy and medication often best
- Virtual reality exposure therapy
- Mindfulness-based therapies
Self-Help & Natural Approaches
- Interoceptive exposure exercises
- Diaphragmatic breathing
- Grounding techniques during attacks
- Regular aerobic exercise
- Reduce caffeine intake
- Quit smoking
- Progressive muscle relaxation
- Mindfulness meditation
- Accept rather than fight panic sensations
- Cognitive restructuring of catastrophic thoughts
- Gradual exposure to feared situations
- Yoga
- Adequate sleep
- Limit alcohol
- Support groups
- Temperature change (cold water on face)
- Physical exercise during panic
- Panic diary to identify triggers
- Self-compassion practice
- Relaxation breathing apps
When to Seek Professional Help
- Frequent panic attacks (more than one per week)
- Persistent worry about panic attacks
- Avoiding important activities
- Developing agoraphobia
- Impact on work or relationships
- Co-occurring depression
- Substance use to cope
- Suicidal thoughts
- Quality of life significantly reduced
Crisis Resources
- 988 Suicide & Crisis Lifeline
- Crisis Text Line: Text HELLO to 741741
- SAMHSA National Helpline: 1-800-662-4357
- Anxiety and Depression Association: adaa.org
- NAMI HelpLine: 1-800-950-6264
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.