What Is Panic Disorder?

Panic disorder, a type of anxiety disorder, is a mental health difficulty that includes anxiety and panic attacks and causes significant disturbances in the everyday life of people affected by this condition. 

In this article, we will cover questions like: 

• What is panic disorder exactly? 
• What is the difference between panic and anxiety attacks
• What causes panic disorder as such? 
• What are the symptoms by which you can recognise it? 
• How is it treated?

Panic Definition

Panic disorder is a type of anxiety disorder characterised by panic attacks. These attacks are sudden and present as highly intense feelings of fear, uncertainty, loss of control, discomfort and distress that are, ultimately, extremely overwhelming. 

Panic attacks can be divided into unexpected and expected. Unexpected panic attacks happen “out of nowhere,” suddenly and unexpectedly, when there isn’t an immediate danger or obvious external trigger. Expected panic attacks happen when there is an obvious external cue that may provoke a panic attack in a person. For example, people who have some form of phobia may experience a panic attack when faced with the object or situation they fear. Generally speaking, unexpected panic attacks are mostly associated with panic disorder.

Panic attacks include mental, emotional and physical distressing sensations, which make the experience of a panic attack highly unpleasant and disturbing for the person experiencing it. 

The National Institute of Mental Health points out that women are more susceptible to panic attacks compared to men, and around 2.7% of people in the United States are diagnosed with panic disorder [1].

Panic Attack vs Panic Disorder

Panic disorder is a medical diagnosis, whilst a panic attack is a personal experience of the sufferer, and the main symptom of panic disorder. Not all people who have experienced a panic attack will be diagnosed with panic disorder, as panic attacks can happen just once and never again. But people who experience panic attacks more frequently may be diagnosed with panic disorder, as the disorder itself is diagnosed in people who repeatedly experience panic attacks.

As the MSD (Merck Manual of Diagnosis and Therapy) suggests, for a panic disorder to be diagnosed, a person needs to experience panic attacks, as the main symptom, for at least a month [2]. Furthermore, they must also experience either persistent anxiety and worry about another panic attack occurring, or changes in behaviour as a result of the panic attacks (for example, avoiding certain places or situations that may trigger a panic attack). Strong physical reactions often accompany panic attacks, and a person who experiences panic may believe that they are suffering a heart attack. 

If you have never experienced a panic attack, you may ask what a panic attack is like. People who have experienced it describe that it feels like they “are going to die”. Although highly unpleasant, panic attacks are not dangerous to physical health, and aside from the emotional distress, don’t cause lasting physical consequences. It is good to be aware of the potential impact chronic stress can have, though, as repeated panic attacks may cause this (and therefore physical health risks in the long run).

Symptoms Of Panic Disorder

The National Health Service of the UK (NHS) names anxiety and panic attacks as the two main panic disorder symptoms [3]. 

Anxiety is a feeling of fear, unease, distress and general worrying about the future. Panic is the highest form of anxiety, in which the anxious feelings become so overwhelming that they “erupt” as a combination of physical, emotional and mental distress. 

The NHS also lists panic attack symptoms:

• Hyperventilation (fast and shallow breathing).
• A rapid heart rate.
• Trembling all over the body.
• Nausea.
• Vertigo.
• Lightheadedness.
• Sweating or hot flashes.
• Chest pain.
• Sensation of choking.
• Dry mouth or blurry vision.
• Depersonalisation (feeling like you’re not connected to your body).

The emotional symptoms of panic attacks include intense negative feelings of fear and distress, and mentally, people who experience panic attacks may have racing thoughts with negative content.

Panic attacks can last between 5 to 20 minutes. Furthermore, panic attacks can have different frequencies for different people. So, some may have one or two attacks in a month, while others may have them as frequently as a few attacks in a week. 

Anxiety Attacks vs. Panic Attacks

An anxiety attack and a panic attack are similar terms, often used interchangeably. Nevertheless, anxiety attacks are not medically recognised, while panic attacks are recognised as the prerequisite for being diagnosed with panic disorder. 

In essence, many people refer to anxiety attacks when they want to express that they are highly anxious. For example, for people with social anxiety, this may happen before they need to engage in a big social group or when they are about to give a public presentation. 

What Causes Panic Disorder?

There isn’t one particular cause of panic disorder. The Mental Health UK organisation lists a few things that may interact and cause panic disorder [4]. 

They include:

• Genetic makeup.
• Chemical imbalance in hormones or neurotransmitters.
• Personal experiences like trauma, grief, violence or excessive stress.
• Drug and substance misuse, like recreational drugs, alcohol or caffeine.

A study conducted by Stanford University in California, on the other hand, found a few traits and comorbid disorders that may provoke panic attacks, especially in adolescents [5]. In particular, they found that having high negative affectivity (i.e. frequently experiencing negative emotions and having a poor self-concept) and a fearful response to anxiety symptoms (i.e. avoiding anxiety and believing that they can’t cope with it) can contribute to a bigger risk of having a panic attack. Another study found neuroticism and low extraversion is often correlated with panic disorder in adults [7]. This makes sense, as frequent experiences of negative emotions and a low ability to regulate oneself, coupled with a low self-concept and being afraid of not being able to cope with anxiety, increase the likelihood of a person experiencing panic attacks. 

Panic Disorder Treatment

The Nexus Nursing Institute covers some of the essential aspects of panic disorder treatment [6]. First of all, they underline that panic disorder is a mental health disorder that can only be diagnosed by a certified specialist based on the presence of the DSM-5 symptoms for Panic Disorder [8].

They continue by explaining the panic disorder treatment, which most often is a combination of anti-anxiety medications like benzodiazepines, or/and other medications like antidepressants and anticonvulsants and talk therapies, especially Cognitive Behavioural Therapy. 

Furthermore, people with panic disorder can also engage in some “home remedies” to help them lower the possibility of a panic attack and better cope with the distress of this disorder.

They include:

• Managing and reducing stressors.
• Having a healthy lifestyle, sleep schedule and diet.
• Having a support network that can provide understanding and support.
• Practising calming techniques and activities like yoga, meditation or grounding.

What to do if someone is having a panic attack

When someone is having a panic attack, they feel strong psychological, emotional and physical distress with a lot of negative sensations. Often, the experience will pass after a few minutes, and it’s important to know that the person experiencing it can not voluntarily stop it.

Mind name a few things you can do to help someone who has a panic attack [9]: 

• Stay calm.
• Move to a quieter place.
• Reassure them that this will pass.
• Ask them to engage in a simple task like watching you raise your arms over your head.
• Prompt the person to slow their breathing pace and do it together with them.
• Speak to the person with a calm, comforting voice, asking them what they need.

If you want to help someone who is already in treatment for panic disorder, remember to be supportive and patient with them, show calmness when they experience a panic attack and understand their healing pace. 

Final Thoughts On Panic Disorder

Panic disorder is a type of anxiety disorder that is characterised by anxiety and panic attacks. Accompanied by strong physiological, emotional and mental reactions, panic attacks may come unexpectedly and usually last for a few minutes.

Understanding this disorder and the nature of panic attacks can help us better recognise the disorder and seek timely professional help.