(Source: The National Institute of Mental Health)

"It started 10 years ago, when I had just graduated from college and started a new job. I was sitting in a business seminar in a hotel and this thing came out of the blue. I felt like I was dying.

"For me, a panic attack is almost a violent experience. I feel disconnected from reality. I feel like I'm losing control in a very extreme way. My heart pounds really hard, I feel like I can't get my breath, and there's an overwhelming feeling that things are crashing in on me.

"In between attacks there is this dread and anxiety that it's going to happen again. I'm afraid to go back to places where I've had an attack. Unless I get help, there soon won't be anyplace where I can go and feel safe from panic."

Panic Disorder

People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. They can't predict when an attack will occur, and many develop intense anxiety between episodes, worrying when and where the next one will strike.

If you are having a panic attack, most likely your heart will pound and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have nausea, chest pain or smothering sensations, a sense of unreality, or fear of impending doom or loss of control. You may genuinely believe you're having a heart attack, losing your mind, or on the verge of death.

Panic attacks can occur at any time, even during sleep. An attack generally peaks within 10 minutes, but some symptoms may last much longer.

Panic disorder affects about 2.4 million adult Americans1 and is twice as common in women as in men.2 It most often begins during late adolescence or early adulthood.2Risk of developing panic disorder appears to be inherited.3 Not everyone who experiences panic attacks will develop panic disorder—for example, many people have one attack but never have another. For those who do have panic disorder, though, it's important to seek treatment. Untreated, the disorder can become very disabling.

Many people with panic disorder visit the hospital emergency room repeatedly or see a number of doctors before they obtain a correct diagnosis. Some people with panic disorder may go for years without learning that they have a real, treatable illness.

Panic disorder is often accompanied by other serious conditions such as depression, drug abuse, or alcoholism4,5 and may lead to a pattern of avoidance of places or situations where panic attacks have occurred. For example, if a panic attack strikes while you're riding in an elevator, you may develop a fear of elevators. If you start avoiding them, that could affect your choice of a job or apartment and greatly restrict other parts of your life.

Some people's lives become so restricted that they avoid normal, everyday activities such as grocery shopping or driving. In some cases they become housebound. Or, they may be able to confront a feared situation only if accompanied by a spouse or other trusted person.

Basically, these people avoid any situation in which they would feel helpless if a panic attack were to occur. When people's lives become so restricted, as happens in about one-third of people with panic disorder,2 the condition is called agoraphobia. Early treatment of panic disorder can often prevent agoraphobia.

Panic disorder is one of the most treatable of the anxiety disorders, responding in most cases to medications or carefully targeted psychotherapy.

You may genuinely believe you're having a heart attack, losing your mind, or are on the verge of death. Attacks can occur at any time, even during sleep.

People with panic disorder have sudden and repeated attacks of fear that last for several minutes, but sometimes symptoms may last longer. These are called panic attacks. Panic attacks are characterized by a fear of certain disaster or a fear of losing control. A person may also have a strong physical reaction. It may feel like having a heart attack. Panic attacks can occur at any time, and many people worry about and dread the possibility of having another attack.

A person with panic disorder may become discouraged and feel ashamed because he or she cannot carry out normal routines like going to the grocery store, or driving. Having panic disorder can also interfere with school or work.

Panic attacks are characterized by a fear of certain disaster or a fear of losing control.

Symptoms of Panic Disorder

People with panic disorder have:

• Sudden and repeated attacks of fear.
• A feeling of being out of control during a panic attack.
• A feeling that things are not real.
• An intense worry about when the next attack will happen.
• A fear or avoidance of places where panic attacks have occurred in the past.
• Physical symptoms including:
  • Pounding heart
  • Sweating
  • Weakness, faintness, or dizziness
  • Feeling a hot flush or a cold chill
  • Tingly or numb hands
  • Chest pain
  • Feeling nauseous or stomach pain

If you or someone you know develops these symptoms, talk to a doctor or health care provider. There is help available.

When Does Panic Disorder Start?

Panic disorder often begins in the late teens or early adulthood. More women than men have panic disorder. But not everyone who experiences panic attacks will develop panic disorder.

Is There Help?

There is help for people with panic disorder. In fact, it is one of the most treatable anxiety disorders. First, a person should visit a doctor or health care provider to discuss the symptoms or feelings he or she is having. The list of symptoms in this brochure can be a useful guide when talking with the doctor. The doctor will do an examination to make sure that another physical problem is not causing the symptoms. The doctor may make a referral to a specialist such as a psychiatrist, psychologist or licensed social worker.

Medications can help reduce the severity and frequency of panic attacks, but they may take several weeks to start working. A doctor can prescribe medications. Different types of medications are used to treat panic disorder. They are antidepressants, anti-anxiety drugs, and beta blockers. These same medications are used to treat other types of disorders as well.

Psychotherapy, or "talk therapy" with a specialist can help people learn to control the symptoms of a panic attack. Therapy can be with a licensed social worker, counselor, psychologist or psychiatrist. There is no cure for panic disorder, but most people can live a normal life when they receive treatment with medicine and/or therapy.

If you know someone with symptoms of panic disorder, talk to him or her about seeing a doctor. Offer to go with your friend to the doctor's appointment for support. To find out more about panic disorder, call 1-866-615-NIMH (1-866-615-6464).

Panic disorder is one of the most treatable anxiety disorders.

Why Do People Get Panic Disorder?

Panic disorder sometimes runs in families, but no one knows for sure why some people have it, while others don't. When chemicals in the brain are not at a certain level it can cause a person to have panic disorder. That is why medications often help with symptoms because they help the brain chemicals stay at the correct levels.

To improve treatment, scientists are studying how well different medicines and therapies work. In one kind of research, people with panic disorder choose to take part in a clinical trial to help doctors find out what treatments work best for most people, or what works best for different symptoms. Usually, the treatment is free. Scientists are learning more about how the brain works so that they can discover new treatments.

Citations

1Narrow WE, Rae DS, Regier DA. NIMH epidemiology note: prevalence of anxiety disorders. One-year prevalence best estimates calculated from ECA and NCS data. Population estimates based on U.S. Census estimated residential population age 18 to 54 on July 1, 1998. Unpublished.

2Robins LN, Regier DA, eds. Psychiatric disorders in America: the Epidemiologic Catchment Area Study. New York: The Free Press, 1991.

3The NIMH Genetics Workgroup. Genetics and mental disorders. NIH Publication No. 98-4268. Rockville, MD: National Institute of Mental Health, 1998.

4Regier DA, Rae DS, Narrow WE, et al. Prevalence of anxiety disorders and their comorbidity with mood and addictive disorders. British Journal of Psychiatry Supplement, 1998; (34): 24-8.

5Kushner MG, Sher KJ, Beitman BD. The relation between alcohol problems and the anxiety disorders. American Journal of Psychiatry, 1990; 147(6): 685-95.