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Panic Disorder

Panic disorder causes sudden, repeated attacks of intense fear with a racing heart, shortness of breath, and dizziness. It is common, highly treatable, and often mistaken for a heart problem.

Psychiatric
Panic disorder is an anxiety condition marked by repeated, unexpected panic attacks — sudden surges of intense fear that peak within minutes and often strike without warning. Roughly two to three percent of U.S. adults experience it in a given year, and it affects women about twice as often as men. It is one of the most treatable anxiety conditions, yet many people make several emergency room visits for a suspected heart attack before the diagnosis becomes clear. Symptoms: A panic attack usually peaks within about ten minutes and can include:
  • Racing or pounding heart: Palpitations are often the most frightening symptom.
  • Shortness of breath: A smothering or choking sensation, sometimes with chest pain or tightness.
  • Sweating, trembling, or chills: The body's alarm system fires at full strength.
  • Dizziness, nausea, or tingling: Lightheadedness and numbness in the hands or face are common.
  • A sense of unreality or dread: Many people fear they are dying or losing control.
Panic disorder is diagnosed when attacks recur and are followed by at least a month of persistent worry about future attacks, or by avoiding places and situations for fear of triggering one. When that avoidance grows to include crowds, open spaces, driving, or leaving home altogether, the pattern is called agoraphobia, which often develops alongside panic disorder and responds to the same treatments. Causes and Risk Factors: There is no single cause, but several factors raise risk:
  • Family history: Panic and other anxiety disorders tend to run in families.
  • Major stress: Attacks often begin during or after periods of significant life stress or loss.
  • Other mental health conditions: Generalized anxiety disorder and depression frequently occur alongside panic disorder.
  • Stimulants: Caffeine, nicotine, and some medications can provoke or worsen attacks.
Diagnosis: Because panic symptoms mimic medical problems, your physician will first make sure nothing else explains them. Evaluation may include a physical exam, an electrocardiogram, and blood tests — an overactive thyroid (hyperthyroidism) and rhythm disturbances such as supraventricular tachycardia can feel remarkably like panic. Once medical causes are excluded, the diagnosis is made from your history alone; no scan is required. Keeping a brief diary of attacks — when they happen, what you felt, and what was going on around you — often speeds the diagnosis and reveals triggers. Treatment: Most people improve substantially with treatment, and combining psychotherapy with medication often works better than either approach alone:
  • Cognitive behavioral therapy (CBT): The best-studied therapy for panic disorder, it teaches you to reinterpret the physical sensations of an attack and gradually retrains the brain's alarm response.
  • Antidepressant medications: SSRIs such as sertraline and escitalopram are first-line drugs; they take several weeks to reach full effect and are used daily, not as needed.
  • Benzodiazepines: Alprazolam and clonazepam relieve symptoms quickly but can cause dependence, so they are generally reserved for short-term or occasional use.
  • Lifestyle measures: Cutting back caffeine, exercising regularly, keeping a steady sleep schedule, and practicing slow breathing all reduce attack frequency.
When to Seek Immediate Care: Never assume new chest pain is panic. If chest pain occurs with exertion, lasts more than a few minutes, spreads to the arm or jaw, or comes with sweating and breathlessness, call 911 — heart problems must be ruled out first. Panic disorder responds very well to care, and no one should have to organize life around fear of the next attack. The primary care team at Zimmer Medical Group can evaluate your symptoms and build a treatment plan — schedule an appointment today.

Related Medications

Commonly prescribed medications for this condition

SertralineEscitalopramAlprazolamClonazepam

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