Panic Disorder

Panic disorder is diagnosed in people who experience spontaneous, seemingly out-of-the-blue panic attacks, and are preoccupied with the fear of a recurring attack. Panic attacks occur unexpectedly, sometimes even during sleep.

A panic attack is defined as the abrupt onset of intense fear that reaches a peak within a few minutes and includes at least four of the following symptoms:

• a feeling of imminent danger or doom
• the need to escape
• heart palpitations
• sweating
• trembling
• shortness of breath or a smothering feeling
• a feeling of choking
• chest pain or discomfort
• Nausea or abdominal discomfort
• dizziness or lightheadedness
• a sense of things being unreal, depersonalization
• a fear of losing control or "going crazy"
• a fear of dying
• tingling sensation
• chills or heat flush

Since many of the symptoms of panic disorder mimic those of illnesses such as heart disease, thyroid problems, and breathing disorders, people with panic disorder often make many visits to emergency rooms or doctors' offices, convinced they have a life-threatening illness. It often takes months or years and a great deal of frustration before receiving the correct diagnosis.

Panic disorder typically develops in early adulthood. It is three times more common in women than in men. Many people don't know that their disorder is real and highly responsive to treatment. Some are afraid or embarrassed to tell anyone, including their doctors and loved ones, about what they experience for fear of being considered a hypochondriac. Instead they suffer in silence, distancing themselves from friends, family, and others who could be helpful or supportive.

The disorder often occurs with other mental and physical disorders, including other anxiety disorders, depression, irritable bowel syndrome, asthma, or substance abuse. This may complicate of getting a correct diagnosis.

Agoraphobia

People with panic disorder who avoid places or situations where they previously had a panic attack have agoraphobia. They typically avoid public places where the need for immediate escape might be difficult, such as shopping malls, public transportation, or large sports arenas. Their world may become smaller and smaller as they remain on guard for the next anticipated panic attack. Some will develop a fixed route or territory from which they cannot deviate. It may become impossible for them to travel beyond what they feel are their safety zones without suffering severe anxiety. About one in three people with panic disorder develops agoraphobia.