Updated date:

What Is Panic Disorder?


Misbah has done her Bachelor's degree in Psychology. She loves to attend seminars based on Psychological issues

The Panic Attack

Psychiatric psychopathology has long distinguished between three basic forms of anxiety. The first is anxiety, called slow-flowing or generalized anxiety. It is chronic and relatively low in intensity. The second is acute anxiety, paroxysmal of short duration, with remarkable intensity of partial mental and physical symptoms. The third, less common type of anxiety, often of considerable intensity, but not such as fear, attacks of violence, and above all, characterized by a relationship with a specific, specific situation — is called a phobia.

The distinctiveness of phobic anxiety was widely recognized. It was considered the leading symptom of phobic neurosis. On the other hand, panic disorder and slow-flowing anxiety, despite a different clinical picture, were considered rather close forms of anxiety and considered the basic symptoms of anxiety neurosis.

In the last forty years, views have grown seriously, questioning this psychopathological closeness between seizure anxiety and generalized anxiety. The literature review shows that this change in the way of thinking has become started, and today it is widely believed that there is a disease separate from other anxiety disorders with the leading symptom in the form of repeated anxiety attacks.

The isolation of the disorder with repeated seizures began with the breakthrough work of Klein and Fink, in 1962. They found different therapeutic efficacy of tricyclic antidepressants in people with generalized and paroxysmal anxiety. It was a kind of revolution: the ideas of Freud were questioned. Who considered psychodynamic concepts enough to explain the differences in different types of anxiety.

This work triggered large studies of patients with panic disorder. According to many authors, they argue for the distinctness of the pathogenetic mechanisms of panic disorder. To be precise, it can be added that other, less-numerous authors are still cautious about such an approach to this day. Ultimately, however, starting in 1980 after extensive consultations, the panic-attack syndrome became a separate diagnostic category in additional American classifications.

A similar decision was made by the authors of the latest international classification: ICD-10. Although, due to the theoretical and descriptive nature of these modern psychiatric classifications, these findings do not mean that panic disorder is a separate disorder.

A panic attack (panic) is a state of very strong anxiety, along with rapidly increasing vegetative symptoms.

Panic Attack and Anxiety Disorder

In addition to the separate anxiety disorder, also known as panic disorder, the concept is still used as a definition of a characteristic symptom not necessarily related to panic disorder. An anxiety attack as a symptom — or, strictly speaking, not a symptom, but a psychopathological syndrome — is then a concept from another level of the diagnostic process. It can also occur in other circumstances following various mental disorders and somatic diseases.

A panic attack is a state of very strong anxiety, along with rapidly increasing vegetative symptoms. Vegetative (somatic) symptoms are so characteristic and usually dominant in the seizure picture, that there are grounds to think of panic as a "somatic" state. For example, panic can be defined as "a state of vegetative agitation with fear and catastrophic thoughts."
Panic builds up quickly within minutes to sometimes extreme sizes, and the entire seizure usually lasts no longer than 30 minutes. The accompanying somatic symptoms vary from patient to patient, but the most common ones are: a feeling of rapid heartbeat, chest pains, shortness of breath or choking, dizziness, sweating, a feeling of unreality of the world, and a change in one's own psyche. As a rule, it goes with experiences that can be considered secondary (to a certain extent, because in these people, they are particularly susceptible to catastrophic thoughts) to the ongoing physical and mental change. The patient has a feeling of a catastrophe, imminent death. He is afraid of losing control over himself, of being mad.

What is Panic Disorder?

An anxiety attack with such a picture is a non-specific and frequent clinical phenomenon; occurs in about 9% of people in the entire population. It can be provoked by psychoactive substances, some drugs (e.g., procaine, penicillin, the so-called Hoigne syndrome), and abuse of caffeine. Such seizures go with heart diseases (especially mitral valve prolapse syndrome!), Hyperthyroidism, and chemoprotective tumor of the adrenal glands, and maybe part of an epileptic seizure.

Panic attacks occur in the alcohol abstinence syndrome, and may also be part of the depression picture. But after excluding these diseases, there is a group of patients for whom the triggering factor cannot be seen. A diagnosis of anxiety disorder with panic attacks (panic disorder) is then made if the attacks occur repeatedly.

To understand the experience of a person with a panic disorder very much one must know that between panic attacks, the person does not feel good. He is anxiously awaiting a recurrence of the seizure, or he or she has other anxiety or somatic complaints of a psychogenic nature. This "fear of fear" is especially typical. It is the combination of unexpected, repeated panic attacks with this "fear of anxiety" that distinguishes this disorder from other anxiety disorders.

Another specific form of anxiety that can add to panic disorder is agoraphobia, i.e., the fear of leaving home, going to the store, being in public places, traveling alone. Especially this type of anxiety, if it is severe, can significantly limit the possibilities of everyday functioning, professional, and social life, etc.

The Causes Of Panic Disorder

As in the case of many psychological ailments, also in panic disorder, the causes are conditioned by many factors and are the result of the interaction of biological, psychological, and social influences. The first ones include hereditary conditions, characteristic elements of the structure, and functioning of specific brain structures, as well as the strength of the reaction of the nervous system to environmental stimuli related to temperament. From a psychosocial perspective, the importance of learning factors is emphasized. Fear may be understood here as a learned reaction arising because of observation (e.g., a parent presenting a similar pattern of behavior, real events involving sudden and threatening ailments in relatives) or by associating anxiety with a specific situation in the mechanism of classical conditioning.

Anxiety can be a side effect of certain medications or substances

Medical Causes Of Anxiety Disorders

For some people, anxiety may be related to an underlying health problem. Sometimes, anxiety symptoms are the first indicators of the disease. If the doctor assumes your anxiety may have a medical cause, they may ask you for some tests to look up the problem.

Following are some medical problems that may be related to anxiety:

  • Heart disease
  • Diabetes
  • Thyroid problems
  • Respiratory disorders such as asthma
  • Drug abuse or withdrawal
  • Withdrawal from alcohol, anti-anxiety medications
  • Chronic pain
  • Irritable bowel syndrome

Risk Factors of Anxiety Disorders

These factors may increase your risk of developing anxiety disorders:

  • Injury. Children who have experienced violence or trauma or have witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in their lives. Adults who experience traumatic events may also develop anxiety disorders.
  • Stress caused by illness. A medical condition or serious illness can create serious concerns about problems such as treatment
  • Increasing your stress. A large event or accumulation of less stressful life situations can cause excessive anxiety — for example, death in the family, stress at work, or constant worries about finances.
  • Personality. People with certain personality types are more prone to anxiety disorders than others.
  • Other mental health disorders. People with other mental disorders, such as depression, often have an anxiety disorder as well.
  • Having relatives with anxiety disorders. Anxiety disorders can run in families.
  • Drugs or alcohol. Using drugs, alcohol, or inappropriate withdrawal from addiction can cause or worsen anxiety.

Signs of a Panic Attack

Prevention of Anxiety Disorders

There is no way to predict with certainty what will cause someone to develop an anxiety disorder, but steps can be taken to reduce the impact of symptoms:

  • Get help early. Anxiety, like many other mental illnesses, can be more difficult to treat if you delay. Contact your doctor and seek psychotherapy.
  • Stay active. Take part in activities that you enjoy and that make you feel good. Enjoy social interaction and caring relationships that can reduce your concerns.
  • Avoid alcohol and drugs. Alcohol and drug use can cause or worsen anxiety. If you are addicted to any of these substances, even quitting smoking can make you anxious.

Cognitive Behavior Therapy is a practical, task-based method of treating panic attacks, and the patient and therapist roles are active.

Treatment of Panic Disorder

We can now treat panic disorder effectively and relatively quickly. Research shows that the best results are achieved by the combined use of pharmacotherapy and cognitive-behavioral psychotherapy, although sometimes it is enough to use one of these methods alone. Because of adequate treatment, most patients experience a clear, sometimes spectacular improvement. The essence of cognitive-behavioral psychotherapy (CBT), in this case, is to help understand the panic mechanism and learn to react appropriately in the situation of experiencing anxiety, which leads to its gradual extinction.

CBT therapy involves the correction of automatic, catastrophic thoughts that worsen anxiety symptoms and anxiety, anticipatory anxiety, and predisposes to avoidance behaviors. Thanks to anxiety-reduction strategies, cognitive changes, and interoceptive contacts, patients are more likely to avoid situations and thus improve their quality of life, overcome agoraphobia, and dependence on relatives, which often seriously impairs daily activities, often reaching the level of disability.

Conclusion - Mental Hygiene

Chronic stress related to habitual behavior and an unfavorable environment is usually the main cause of worse treatment outcomes in patients with agoraphobia within 12 weeks after the end of CBT therapy, as well as in the two-year follow-up evaluation. Then, it is important to identify situations that predispose to greater psychological susceptibility to prevent relapse and chronicity of the disorder.

As a result of adequate treatment, most patients experience a clear, sometimes spectacular improvement. The essence of cognitive-behavioral psychotherapy, in this case, is to help understand the panic mechanism and learn to react appropriately in the situation of experiencing anxiety, which leads to its gradual extinction

What is CBT?

Web References




Bibliographic References

When Panic Attacks: The New, Drug-Free Anxiety Therapy That Can Change Your Life by David D. Burns, MD M.D

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2021 Misbah


Misbah (author) from The Planet Earth on March 15, 2021:

Thank you so much, Lora, for sharing your experience with me

I am glad those symptoms never returned back

A supportive partner and a healthy atmosphere helps a lot

Thanks for being brave enough to share it with us

God Bless you always

Lora Hollings on March 15, 2021:

I enjoyed reading your article on panic disorder, Misbah. I had all the symptoms of this disorder when I first drove a very long distance across 5 states to a new home. I will never forget how my heart started beating very rapidly, I could hear the pounding of blood in my ears, and the palms of my hands were sweating so much as I was gripping the wheel. Of course, it didn’t help that I was on the interstate with so many trucks and I was in a very small car at the time! I had to keep signaling my husband to pull over so that I could take frequent rests at the rest stops in order to continue. We did finally make it and I’ve never had a return of those symptoms. Thank God! You did an excellent job on your article covering the topic very well.

Misbah (author) from The Planet Earth on March 14, 2021:

Thanks a lot, Peggy

I am very happy to know that you liked it

Have a peaceful Sunday

Sending Blessings

Misbah (author) from The Planet Earth on March 14, 2021:

Thanks a lot, Mr. Bill

Your support and kindness means a lot to me

I am glad you liked it

Have a blessed Sunday


Peggy Woods from Houston, Texas on March 14, 2021:

You did a great job explaining panic disorders and the risks associated with them, and the treatments.

Misbah (author) from The Planet Earth on March 14, 2021:

Manatita, Thanks a lot for your kind words

I am glad you liked it

Happy Sunday


Bill Holland from Olympia, WA on March 14, 2021:

Excellent article! Well-written and informative, concise and clear. Well done!

manatita44 from london on March 14, 2021:

A very thorough and well-expressed article. An interesting field for the more scholarly humans to study.

Misbah (author) from The Planet Earth on March 14, 2021:

Thanks a lot Chitra di for appreciating

I am glad you liked it

Peace and Blessings

Happy Sunday

Misbah (author) from The Planet Earth on March 14, 2021:

Thanks Ek,

I am glad you liked it

Peace and Blessings Always

Misbah (author) from The Planet Earth on March 14, 2021:

Rosina, I am glad to know that you found it informative

Thanks for your kind comments

Sending Blessings

Chitrangada Sharan from New Delhi, India on March 14, 2021:

A very well written article about Panic disorder. You have provided great detailed information, and I am sure it will help many.

Thank you for sharing this.

EK Jadoon from Abbottabad Pakistan on March 13, 2021:


Well written article, Misbah. You have illustrated the information in a decent way. Keep up the good work.

Have a peaceful day!

Rosina S Khan on March 13, 2021:

This is a detailed article about panic disorder and the various ways to deal with it, including the drawbacks. It was nice reading it, gathering information about all of it. Thanks for sharing, Misbah.

Misbah (author) from The Planet Earth on March 13, 2021:

Thanks a lot, Pamela

I am glad you liked it

Yes, you are right, Panic disorder is a tough diagnosis


Misbah (author) from The Planet Earth on March 13, 2021:

Thanks a lot Devika for the appreciation


Pamela Oglesby from Sunny Florida on March 13, 2021:

This is a very thorough, well-written article, Misbah. Panic disorder is a tough diagnosis. CBT therapy sounds very good for patients suffering with this much anxiety.

Misbah (author) from The Planet Earth on March 13, 2021:

Thanks a lot, Liz for your appreciation

I am glad you find it useful and informative


Devika Primić from Dubrovnik, Croatia on March 13, 2021:

Hi Misbah Panic Disorder is explained well, a disorder that affects many individuals.

Liz Westwood from UK on March 13, 2021:

This is an interesting, well-structured and useful article. It explains panic disorder well.

Misbah (author) from The Planet Earth on March 13, 2021:

Tamara, You're welcome; I'm so glad you liked it


Tamara Yancosky from Uninhabited Regions on March 13, 2021:

Thank you for sharing. ♥️

Tamara Yancosky from Uninhabited Regions on March 13, 2021:

Yes, acute anxiety can be debilitating.

Related Articles