Panic Disorder

The cardinal features of panic disorder are short-lived, sudden attacks of terror and fear of losing control. Attacks begin without warning during non-threatening activities. Affected individuals often go to the emergency room or consult a cardiologist because their physical symptoms--severe difficulty in breathing; a pounding, rapid heart rate; and a choking sensation--may appear to be a heart attack. (Patients who suspect that they are having a heart attack should see a doctor immediately.) Panic attacks generally peak within 10 minutes and dissipate within 20 to 30 minutes. They are characterized by some combination of the following symptoms:

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• shortness of breath or hyperventilation
• heart palpitations or a racing pulse
• discomfort in the chest
• dizziness, lightheadedness, or feeling faint
• choking, nausea, or stomach pain
• sweating
• hot or cold flashes
• trembling or shaking
• sense of unreality
• tingling or numbness
• fear of dying or losing one's mind.

Symptoms of depression and anxiety are frequent in persons with panic disorder and in members of their family. Although both panic attacks and symptoms of depression or anxiety may respond to antidepressant medications for some patients, others may require separate medications for the panic disorder and for the depression and anxiety. The prevalence of panic disorder is 1 to 2 percent in both men and women. Attacks commonly begin in the late teens or early 20s and often go undiagnosed and untreated.

The most common complication of panic disorder is agoraphobia--fear of being in public places, especially when alone--which develops as a result of trying to avoid situations that have triggered panic attacks in the past. Left untreated, panic attacks and agoraphobia can markedly restrict an individual's lifestyle. Panic disorder is also associated with an increased frequency of major depression, alcohol and drug dependency, and suicide.