What is Panic Disorder?

People with panic disorder experience frequent, unprovoked panic attacks that involve some or all of these symptoms:

• Racing heartbeat
• Chest pains
• Terror
• Fear of dying
• Dizziness or lightheadedness
• Nausea Flushes or chills
• Difficulty breathing
• Tingling or numbness
• Feelings of unreality
• Fear of losing control or doing something embarrassing

Panic disorder strikes between 3 and 6 million Americans, and is twice as common in women as in men. It can appear at any age—in children or in the elderly—but most often it begins in young adults. 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. Panic disorder is often accompanied by other conditions such as depression or alcoholism, and may spawn phobias, which can develop in places or situations where panic attacks have occurred.

For example, if a panic attack strikes while you're riding an elevator, you may develop a fear of elevators and perhaps start avoiding them. Some people's lives become greatly restricted—they avoid normal, everyday activities such as grocery shopping, driving, or in some cases even leaving the house. Or, they may be able to confront a feared situation only if accompanied by a spouse or other trusted person. Basically, they avoid any situation they fear would make them feel helpless if a panic attack occurs. When people's lives become so restricted by the disorder, as happens in about one-third of all people with panic disorder, the condition is called agoraphobia. A tendency toward panic disorder and agoraphobia runs in families.

Nevertheless, early treatment of panic disorder can often stop the progression to agoraphobia. Studies have shown that proper treatment—a type of psychotherapy called cognitive-behavioral therapy, medications, or possibly a combination of the two—helps 70 to 90 percent of people with panic disorder. Significant improvement is usually seen within 6 to 8 weeks. Cognitive-behavioral approaches teach patients how to view the panic situations differently and demonstrate ways to reduce anxiety, using breathing exercises or techniques to refocus attention, for example. Another technique used in cognitive- behavioral therapy, called exposure therapy, can often help alleviate the phobias that may result from panic disorder.

In exposure therapy, people are very slowly exposed to the fearful situation until they become desensitized to it. Some people find the greatest relief from panic disorder symptoms when they take certain prescription medications. Such medications, like cognitive-behavioral therapy, can help to prevent panic attacks or reduce their frequency and severity. Two types of medications that have been shown to be safe and effective in the treatment of panic disorder are antidepressants and benzodiazepines.

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