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Panic disorder is a type of anxiety disorder in which a person regularly experiences panic attacks – sudden episodes of fear and anxiety that usually last between 10 and 15 minutes, but may have side effects that last for hours, and cause symptoms such as a racing heartbeat, heavy perspiration and shortness of breath. About 6 million Americans aged 18 and older suffer from panic disorder at some point in their lifetime, according to the National Institute of Mental Health (NIMH).

In most cases, people with panic disorder experience attacks that seem to occur randomly and appear to be unrelated to the environmental situation. These are known as unexpected or uncued attacks. However, attacks may also be related to a specific type of situation – for instance, whenever a person crosses a bridge or is in a crowd.

Panic disorder is among the most common anxiety disorders. It is diagnosed when a patient has recurrent panic attacks. In addition, a patient needs to have experienced one of the following criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV after at least one attack during a period of at least one month:

• Ongoing concern that attacks will continue
  
  
• Worry about the potential significance and impact of an attack
  
  
• Change in behavior to avoid future attacks

Recurrent panic attacks are not diagnosed as panic disorder if another medical condition (such as an overactive thyroid gland), or another type of anxiety disorder or other mental disorder is responsible for the attacks. Such disorders may include:

• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Separation anxiety disorder
• Specific phobia
• Social phobia

Panic disorder also is not diagnosed if the use of medications or other substances (such as caffeine or illegal drugs) is responsible for the attacks.

Panic disorder is likely to first appear during the period between late adolescence and a person’s mid-30s. About half of all people who develop panic disorder do so by age 24. In some cases, patient attacks peak in late adolescence, subside for some time and then peak again during a person’s mid-30s. Onset of panic disorder is unusual after age 45. Women are twice as likely as men to be diagnosed with panic disorder.

Deep emotional distress is common in patients diagnosed with panic disorder. Personal relationships, job performance and overall happiness may suffer as patients become demoralized and depressed.

Patients may use alcohol or recreational drugs to attempt to deal with these feelings. Among patients with panic disorder, about 30 percent use alcohol and 17 percent use illegal drugs to combat stresses brought on by panic attacks, according to the National Mental Health Association. Recent research indicates that panic disorder may contribute to the development of an alcohol use disorder and vice versa.

Left untreated, panic disorder can have devastating consequences, with 20 percent of patients attempting suicide.