What is panic disorder? Causes, symptoms, diagnosis, treatment, complications, and prevention

Panic disorder is a kind of anxiety disorder where the sufferer has sudden attacks of extreme anxiety, worry, and fear when there is no real danger or apparent cause. The attacks also trigger physical reactions.

We refer to these attacks as panic attacks. A panic attack can make you feel as if you are losing control, having a heart attack, or even dying.

According to the UK’s National Health Service (NHS):

“Everyone experiences feelings of anxiety and panic at certain times. It’s a natural response to stressful or dangerous situations. But someone with panic disorder has feelings of anxiety, stress, and panic regularly and at any time, often for no apparent reason.”

Causes of panic disorder

Experts say that we do not yet know what the exact causes of anxiety disorder are. It is probably related to a combination of genetics, brain chemicals, major life stress, or a traumatic event. In some cases, people develop the disorder without any clear reason.

If you are very sensitive to stressful triggers or prone to negative emotions, you are more likely to experience panic disorder and panic attacks than the rest of the population.

Some studies suggest that our body’s natural fight-or-flight response to danger is involved. For example, if a roaring lion suddenly came into the room, your breathing would speed up, the hair on the back of your neck would stand on end, and your breathing would speed up, as your body prepared to either fight or run for your life. Similar reactions occur during a panic attack. The main difference is that during a panic attack, there is no roaring lion or any other sign of danger.

Signs and symptoms

Why is a headache a symptom while a skin rash is a sign? Only the patient is aware of a symptom. If you have a headache and tell nobody about it, they won’t know. A sign, on the other hand, is detectable by not only the patient but by other people too.

The signs and symptoms of panic disorder include:

  • A sense of impending doom.
  • A strong urge to escape.
  • Accelerated heart rate (fast pulse).
  • Butterflies in your tummy.
  • Chills.
  • Chest pain.
  • Fear of losing control.
  • Feeling faint.
  • A choking sensation.
  • Hot flashes.
  • Nausea.
  • Pins and needles or numbness.
  • Shortness of breath.
  • Sweating.
  • Trembling.
  • Strong urge to go to the bathroom.
  • Tinnitus (ringing in your ears).
  • An out-of-body sensation (you feel as if you are not connected to your body). A feeling of detachment or unreality.

These signs and symptoms occur unexpectedly. Many sufferers worry constantly about their next attack.

According to The Mayo Clinic:

“One of the worst things about panic attacks is the intense fear that you’ll have another one. You may fear having panic attacks so much that you avoid certain situations where they may occur.”


The healthcare professional will talk to you about your signs and symptoms, the frequency of your panic attacks, their duration, and your fears and concerns. They will also check your medical history.

Johns Hopkins Medicine says the following about diagnosis:

“Your healthcare provider or a mental health professional may diagnose you with panic disorder based on your symptoms. Generally, if you have 4 or more panic attacks and if you are in constant fear of having another, you have panic disorder.”

Panic Disorder - an image depicting the disorder plus a written definition

Created by MedicalVocab.com using Wikimedia Commons images.

Treatment for panic disorder

Treatment typically comprises a combination of psychotherapy and medication.

  • Cognitive-behavioral therapy (CBT)

CBT is very effective. It helps you understand what brings on the attacks, i.e., identify the triggers, and how to respond. You will also acquire coping skills and learn relaxation techniques, which can reduce the intensity and duration of your panic attacks.

  • Medication

Antidepressants and anti-anxiety drugs may help.

Your treatment should be effective if you have a specialized healthcare professional.

According to the UK’s National Institute for Health and Care Excellence (NICE), which is part of the Department of Health and Social Care in England:

“Psychological treatment, medication and self-help have all been shown to be effective in treating panic disorder. Studies of different treatments found that the benefits of psychological treatment lasted the longest.”

“Different treatments will suit different people, so your healthcare professional should discuss the options with you. Whatever you decide, the chosen treatment should be available promptly.”


If you do not get treatment for your panic disorder, you could eventually develop specific phobias, such as fear of leaving home, crossing the road, or driving.

Problems at work or school may emerge or get worse. There is also a risk of depression, suicidal thoughts, and substance abuse.

Preventing panic disorder

Sometimes it is not possible to prevent the disorder. However, if you get treatment at the first sign of problems, you are much more likely to prevent the disorder from getting worse.

Getting plenty of quality sleep, following a healthy diet, and regular exercise can help reduce anxiety (relax you) and improve your mood.

If you, your child, or a member of your household/family has the signs and symptoms of panic disorder, seek help from a healthcare professional.