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Panic Disorder: Causes & Treatment for Panic Attacks

panic disorder, panic attack
Credit: Sarah Jane Taylor | Shutterstock

The hallmark of panic disorder is sudden and repeated bouts of extreme fear that can last for several minutes or even longer. These episodes are referred to as panic attacks. Panic attacks are characterized by heightened feelings of disaster or of losing control even when there is no immediate threat.

The fear can be limited to a specific circumstance, such as getting in an elevator or driving over a bridge, and some attempt to manage their disorder by avoiding certain situations.

Many people associate agoraphobia with panic attacks. While agoraphobia was originally thought to involve a fear of public places and open spaces, experts now believe agoraphobia is a complication or outgrowth of panic attacks. People with panic disorder are fearful of having another attack and often avoid places where previous attacks have occurred. As their attacks become more frequent, their world gets smaller and smaller.

About 6 million adult Americans suffer from varying degrees of panic disorder, with women being twice as likely to suffer from this mental health issue as men. While it can occur at any age, panic disorder commonly begins during late adolescence and early adulthood.

Causes of panic disorder

While researchers have not determined a specific cause of panic disorder in some individuals, many believe it is a combination of environmental and genetic factors.

Family history seems to play a large role in determining who will suffer from a panic disorder. Researchers have identified several parts of the brain that are involved in fear and anxiety.

Some scientists believe that people with panic disorder have an abnormality that causes them to misinterpret benign sensations as threats, causing their fear reaction to go into overdrive. [Related: Women With No Fear Feel Panic in Experiments]

Some researchers think that people with panic disorder misinterpret harmless bodily sensations as threats.

While biology may be a factor, environment can also be influential. If a parent or close adult suffers from panic disorder, a child may begin to think panic is a standard reaction and mimic adult behavior.

Researchers are also looking for ways in which stress and environmental factors may play a role. A major stressful life event, such as an accident or the death of someone close, can trigger a panic attack in someone who previously exhibited no signs of the disorder.

However, it doesn’t have to be a significant event to plant the seed of a panic attack. A fairly routine visitor to the doctor as a child, for example, can spark a life-long fear of all medical professionals.

Symptoms of panic disorder

Many people who suffer from panic disorder use similar phrases when describing an incident — it feels as if you are out of control and having a heart attack.

Other physical signs include profuse sweating, heavy or labored breathing, pounding or racing heart that can cause chest pain, weakness or dizziness, numbness or tingling in the hands or other extremities, a feeling hot or a cold chill, tingly or numb hands and stomach pain.

While some people can identify their triggers for a panic attack, they often come on suddenly. One of the biggest sources of panic is the fear of having another attack.

Connection to addiction

Drugs and alcohol are often used by those with panic disorder as a way to calming themselves or numb their fear of a looming attack. A study published in Behavior Research and Therapy found that 10 percent to 20 percent of individuals with panic disorder struggle with substance abuse and that alcoholism occurs in 10 percent to 40 percent of those who have panic disorder.

However, since alcohol and drug abuse can trigger panic attacks, this attempt at self-medication often exacerbates the problem. The symptoms of panic disorder often precede substance abuse or alcoholism.

Treatment

While some people with very limited triggers can manage to avoid certain situations, those with frequent, full-fledged panic attacks can become very disabled by their condition. [Related: To Stave Off Panic, Don't Take a Deep Breath]

Sufferers can generally receive successful treatment before they start to avoid places or situations where panic attacks have occurred.

Unchecked, panic disorder can be disabling and evolve into agoraphobia — the sufferer prefers to remain housebound or only goes out on a limited basis with a small circle of trusted people.

Early treatment can often prevent panic disorder from developing into agoraphobia, but it can sometimes be a tough condition to diagnose. However, once a diagnosis is in place, it is one of the most treatable of all of the anxiety disorders.

As with most mental health issues, panic disorder is treated by psychotherapy, medication or a combination, depending on the severity and the response of the individual.

Cognitive behavior therapy, a type of psychotherapy that teaches a person different ways of reacting to situations, has been an especially effective treatment for panic disorder.

As for medications, anti-anxiety medications and antidepressants are commonly prescribed to ease panic disorders. Beta-blockers are sometimes used to address the physical symptoms such as a fast heart rate and chest pains that often accompany panic disorder.

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