Panic Disorder: Key Q&A

Is a panic attack the same as a panic disorder?

Panic attacks are sudden episodes of fear and anxiety due to an overwhelming stress response that is greater than a situation would typically warrant. Most people will experience at least one panic attack during their lifetime. However, this does not mean they have a panic disorder.

Panic disorder is a type of anxiety disorder that involves repeated panic attacks in a short time period (e.g., four or more panic attacks in a month). Diagnosis of panic disorder also involves ruling out other conditions that may cause panic attacks or similar symptoms.

How common are panic attacks and panic disorder?

Most people will experience at least one panic attack in their lifetime.

Panic disorder is among the most common type of anxiety disorder. Each year, about 2.4 million Americans experience panic disorder, according to the National Mental Health Association. Women are twice as likely as men to be diagnosed with panic disorder.

How can I tell if I am having a panic attack?

People who have panic attacks often feel as though they are having a heart attack or are losing control of their thoughts. Common symptoms include:

Rapid or pounding heartbeat
Heavy perspiration
Shortness of breath or feeling of suffocation
Chest pain
Dizziness or lightheadedness
Nausea or abdominal cramping
Chills or hot flushes
Tingling and numbness in the hands
Trembling
Sensation of choking
Feelings of unreality or being detached from yourself
Fear of losing control
Fear of dying

If you experience four or more of these symptoms, you could be having a panic attack. As these symptoms multiply, you may feel an impending sense of doom or a loss of mental control. Gradually, these feelings and symptoms will subside. Once the attack has passed, a feeling of fatigue may set in.

How long do panic attacks typically last?

Panic attacks often begin suddenly and without warning. Once they start, they tend to peak within 10 minutes and last for a total of about 30 minutes. However, no two panic attacks are exactly alike, and some patients have reported panic attacks that last for several hours or even an entire day. Panic attacks can strike at any time during waking or sleeping hours, and a high percentage of those affected report that these attacks awaken them in the middle of the night.

What causes a panic attack?

Although the exact cause of panic attacks is not yet understood, stress and various biochemical factors are believed to contribute to the attacks.

Some experts have speculated that panic attacks may be related to the body's "fight or flight" response. This response occurs in the sympathetic nervous system when the body faces danger. Adrenaline, also known as epinephrine, is a chemical secreted by the body in response to stress. When the body faces danger, adrenaline and other hormones are released, allowing the body to either fight or flee from the danger. Researchers believe that during panic attacks, an unknown trigger may activate this response despite the fact that no danger is actually present. Other researchers have cited a similar "suffocation alarm" in the body that falsely indicates that death is imminent, triggering an attack.

Because panic attacks are more likely in people with a family history of such attacks, heredity is also believed to play a role. A first-degree family history of panic disorder increases your risk of experiencing a panic attack by up to eight times. The risk increases to 20 times in situations where panic attacks first appear before age 20.

People who have previously experienced attacks may produce an exaggerated response to normal bodily reactions, which can trigger panic attacks.

How dangerous are panic attacks and panic disorder?

Although panic attacks are frightening for many people, they are often medically harmless. However, if you've experienced repeated panic attacks or long-lasting attacks, you should seek medical care. Conditions such as impending heart attack or overactive thyroid gland can cause symptoms similar to those of a panic attack, as can other lung, intestinal or nervous system disorders.

If you have had repeated panic attacks, you may also be diagnosed with panic disorder. Panic disorder can leave you feeling isolated and adversely affect your quality of life. It can lead to an increased risk of depression, substance abuse and even suicide. According to the National Mental Health Association, about 30 percent of people with panic disorder use alcohol and 17 percent use illicit drugs to combat stresses brought on by panic attacks. Furthermore, about 20 percent of these patients attempt suicide.

If you regularly suffer from panic attacks, you're also at increased risk of developing agoraphobia. Agoraphobia is an inability to venture beyond comfortable surroundings, such as your home, due to intense anxiety. There are two types of panic disorder: panic disorder with agoraphobia and panic disorder without agoraphobia. According to the National Institute of Mental Health, around one-third of all people diagnosed with panic disorder also suffer from agoraphobia.

When is panic disorder most likely to begin?

Panic disorder is likely to first appear during the period between mid-adolescence and your mid-30s. About half of all people who develop panic disorder do so before age 24. In some cases, panic attacks peak in late adolescence, subside for some time and then peak again during the mid-30s. Onset of panic disorder is unusual after age 45.

How effective is treatment for panic disorder?

Very effective. The right treatment regimen can help reduce or prevent panic attacks in 70 to 90 percent of patients, according to the National Mental Health Association. People who experience panic attacks have several treatment options. In most cases, effective treatment consists of a combination of therapy and medications. Most patients require only short-term therapy and concurrent use of medication to control panic attacks.