Panic disorder – panic attacks, causes, symptoms, diagnosis, treatment & pathology


I’m sure you’ve heard someone say or joke
about “having a panic attack,” but panic attacks are very real situations where someone
has a sudden period of intense fear or discomfort that something bad’s going to happen, and
that there’s some imminent threat or danger. These feelings are often so intense that they’re
accompanied by physiological symptoms like heart palpitations, dizziness, or shortness
of breath. These symptoms peak within the first 10-20 minutes, but some might last hours.
Sometimes patients having a panic attack might feel as though they’re having a heart attack
or some other life-threatening illness. Panic attacks can happen even in familiar places
where there are no real threats, and therefore they’re unpredictable, which can further
increase anxiety about when the next panic attack is going to happen. In order to be characterized as a panic attack,
the Diagnostic and statistical manual for mental disorders, the fifth edition, or DSM-V,
says patients need to have an abrupt onset of four of the following thirteen symptoms:
pounding heart or fast heart rate, chest pain or discomfort, , sweating, trembling, shortness
of breath, nausea, dizziness, chills, numbness, feelings of choking, feelings of being detached
from oneself, fear of losing control, and fears of dying. Admittedly, some of these symptoms might naturally
happen together, and so they can be very hard to tease apart. For example, it would be unusual
for a person that is sweating, feeling dizzy, and feeling chills, to also not be trembling.
It’s also important to note that some of these are physical symptoms whereas others
are specific thoughts/ideas. Panic attacks can happen in the context of several mental
disorders including depressive disorders, posttraumatic stress disorder, and substance
abuse disorders. It can also, however, happen in the context of a panic disorder, which
is basically defined by the panic attacks being recurrent, meaning 2 or more, and unexpected.
In addition, the DSM-V says that for somebody to be diagnosed with a panic disorder, they
also need to have persistent worry or change in behavior because of their panic attacks.
Also, the panic attacks can’t be due to the effects of some substance, like an illicit
drug or medication. Finally, the panic attacks aren’t better explained by some other anxiety
disorder, like agoraphobia or social anxiety disorder. Patients with a panic disorder can’t predict
where the panic attack will happen next, so it’s important to get treated before patients
develop something called avoidance, which is when they actively avoid the places where
one previously happened. They might stop doing activities that they think might trigger the
attacks, like going to the park, riding in elevators, or driving. Avoiding these situations
might temporarily reduce symptoms of anxiety about having a panic attack, but it makes
daily life really tough, right? And ultimately doesn’t stop the attacks from happening. Sometimes patients get anxiety just thinking
about the possibility of having a panic attack, and this is called anticipatory anxiety. Anticipatory
can be particularly debilitating because it might cause the patient to be reclusive and
choose to endure the attacks alone instead of risking an attack in public—this situation
can actually lead to the development of agoraphobia, a fear of going into crowded spaces. Panic disorder is twice as common among women
as men, and it appears to have a genetic component and run in families, although we don’t know
exactly what causes it. Treating someone with panic disorder usually involves psychotherapy,
medication, or both. Cognitive behavior therapy has been an effective type of psychotherapy
for patients with panic disorder, and this relies on five fundamental steps. First, they
just learn about panic disorder, and how to identify certain symptoms. Second, they monitor
their panic attacks using a diary. Third, they work on breathing and relaxation techniques.
Fourth, they start rethinking and changing their beliefs about the severity of a panic
attack from totally catastrophic to a realistic level. Fifth, they allow themselves to be
exposed to situations that provoke fear and anxiety. Now if medications are used, antidepressants
like SSRIs are the most commonly prescribed, which have sedative and relaxing effects.
Anti-anxiety medications might also be prescribed, like benzodiazepines, which also have a relaxing
effect, although the use of anti-anxiety medications can sometimes lead to unwanted side effects
like tolerance, dependence, and withdrawal. If very severe, anti-seizure medications may
sometimes be prescribed. Overall though, between cognitive behavior
therapy and medication, many patients can be effectively treated for panic disorder.

100 comments

  1. I was diagnosed with panic disorder last year. This year I turned 13 and whilst bowing out my candles I thought the house was going to burn down. I ran outside and nobody could stop me. This disorder is honestly ruining my life

  2. Help! I’m having these seizure-like attacks that when I wake up I have no idea it happened but my sister or mom are freaked out because they say that it seems like I’m having a seizure. I’ve been to the hospital because of it and I’ve visited a neurologist and it’s not a seizure. I had an MRI done and an EEG done but nothing life threatening shows up. I’m super confused and just want to know what’s happening to me. Someone please help me or conversaré with me if you are experiencing something similar!

  3. 1. I'm pretty sure I have panic disorder or some other anxiety disorder. Just trying to do as much research as possible and hopefully some day get a diagnosis from a professional.

    2. I had serval panic attacks while vacuuming and avoiding doing so for like a year. That is sad.

  4. I had a panic attack at the doctor and he shouted at me which caused me to feel even more threatened I couldn’t handle it so I ended up curled up in a ball, crying and panting because I couldn’t breathe.
    I should go see a psychiatrist.

  5. I think of heart attack everyday my chest pain heart pain I feel nervous I worry in small things dizziness also I think that I am going to die 😭😖

  6. Paxil/Aropax 20ml works… 😊 I suffered five years with severe panic disorder… had up to 6 panic attacks per day and non stop acute anxiety in between… It was shocking!!!… Now I am perfect for 3 years on Aropax!!! 😊😃😀

  7. How do you get treatment before developing avoidance I had my first panic attack 8 year's ago and avoided the next day. Panic disorder leads to agoraphobia really fast in most people. I still have panic disorder with agrophobia, generalized anxiety and depression.

  8. Panic attacks! That's the one I'm looking for. Not anxiety or nervous breakdown. This is giving me ideas

  9. Hi
    My doctor(neuro surgeon) explaimed to me why I got panic atack. He said that i starts by exessive breathing(always), that cause the CO2 levels in the blood to fall. This causes the blood to be less asidic(highten the PH), the brain starts to get problems when this happens and the result is the storm of thoughts and worry, racing heart, feeling you are going to die, etc. The brain needs the PH-level to be at an certain level, if this changes the brain will start to try to correct it. First the brain try to slow down the breathing to highten the CO2 levels, this feels like you are not able to breath properly, not so strange when the brain is counteracting your breathing. If this is not enough, the last resort may be to faint. This wil stop the exessive breathing and the panic attack.
    You may not notice the exessive(fast) breathing, but it does happens. The doctor said that if you can control the breathing it is impossible to get a panic attack, because the panick attack is caused by decreased CO2 levels in the blood.
    You may not be able to stop the anxiety by doing this, but you can hinder it to become a full blown panick attack.

  10. Always feel my head hurt, my chest is aching and I’m suddenly crying when it comes to certain situations I’m not looking forward too or an unexpected event, sometimes i even wake up crying as-well while my head hurts and my heart is slightly racing…I’m not really sure if this a panic disorder but i am going to my school psychologist to see if it is a serious issue.

  11. I have anxiety, depression, eating disorder, that causes panic attack. I have to deal with it for the entire of my life. When I thought I got better or all these things went away, they are always come back. It is really hard to overcome. And I am suffering it whenever I have to speak in front of many people like presentation.

  12. I had a panic attack just last night. I thought I was having a heart attack. Like I was just walking and then all of a suddenly I started getting worried and then I had pain in my arms and it went to my chest and I felt like my heart was being squeezed and literally thought I was going to die . I felt my chest was gonna burst 😭 and I couldn’t breath and so many things started running through my mind and my friend didn’t know what to do.

  13. With someone diagnosed , i hate when people say “omg I had a huuuge panic attack” and I nod because it hits home .

  14. Just remember that you are not alone and that you are stronger than panic/anxiety attacks. Sometimes its all in our head. We like to overthink. We are gonna be okay.

  15. I still remember the first time I actually had a panic attack, and it was really unpredictable. I was in a seminar or something in a field trip and we were talking about solar panels. Suddenly, I felt like I wanted to break out of my body. I couldn't breathe and it actually felt like hell. It lasted for until the seminar was halfway done and I never forgot it to this day.

  16. I had this in class and told one of my friends that have depression "I don't know what I'm feeling….. " and I started cutting myself silently to calm myself…..

  17. Does anyone else feel really weird and floppy after a panic attack, my friends say I act high during the immediate aftermath and I come up with really weird ideas. I have never been high so idk.

  18. I’m a college athlete with anxiety ocd and panic disorder. I also have Jesus Christ. He helps me remember that this discomfort is temporary. I feel like I’m suffocating sometimes and scared to go to meets or class. But we all need to push through. We got this!

  19. Have mine in college, in almost every class lately. I feel like im going to throw up and have a hard time swallowing. It comes and goes in waves. I am on anti depressants and was wondering if anyone has tried Valium for panic disorder. Thanks

  20. MY FAMILY HAS NO IDEA I HAVE THIS PA problem one time I had a panic attack in front of my family they thought I was just crying lmao thank god this is my biggest secret they don't know this. thank god or they will thing im mentally disturb <3

  21. Ive been suffering from panic attacks since a few years ago, but they died down for a couple of years but now they have come back unfortunately. The worst part is that I have basically every single one of those symptoms and IT SUCKS

  22. What do we do guys, sometiles i wish someone would hit me on my head so that i pass out during a panic atack because the idead runing through my head are the worst part

  23. I was blowing bubbles and not paying attention and then the heart beat sound started and I jumped like 2 feet and screamed.

  24. I always have panic attacks in familiar places and mostly nothing happened
    Once i had a panic attack while i was in bed at night.

  25. My heart pounds and I get dizzy,sweaty and it gets hard to breath I feel like I'm going to throw up with makes me feel even worse I hate it when I get them.. Especially when I'm at home

  26. I had my worst panic attack while I was working out… now I can't even go to the gym anymore, my heart pounds just thinking about it 🙁

  27. my panic attacks are usually short but come back after a minute or two and they are really bad even though they are short

  28. does anyone ever feel like their eyes gets blury and your hearing is weird, like your own voice gets loud and the other gets low?

  29. If anyone needs my help and qant to talk to me Briefly wants to tell me his/her problems feel free to contact me at my whatsapp+923402876480

  30. To anyone struggling with this terrible affliction: IT WILL GET BETTER! I had terrible panic attacks, almost daily, I couldn't function, get out of the house, it took my life away from me. It lasted for two terrible years. Finally I visited a doctor, got my benzos and anti depressants, and took them for almost a year.I've been off of my meds for almost two years now and not a single panic attack. I feel normal again. Have faith people, I know how terrible it can get but it will stop!

  31. My panic disorder kind of accelerated, it started with vomiting, then went to fainting, and then finally panic attacks

  32. This is exactly why I limit my caffeine intake and stop myself from researching what malady I might have, because it accelerates my proclivity towards suffering a panic attack in the near future. It happened two days ago, and I do not want to experience that again, thank you very much.

  33. This really helped me learning.. Subscribed so that I can learn more and help people around me. <3 Stay Strong everyone with this illness <3 I hope you guys recover from this and get the happiest life ever <3

  34. i went through this twice in the past year … i felt like i was fainting and have heart palpitations (also can not breathe unless i take deep breathssss) it feels so awful
    i just feel scared of being around crowds and in pressure situations

  35. something weird happened to me it was before 11 months i was in my school and i was nervous for some reason but then after some seconds my heart start beating so fast with heat in my body then my hands start shaking and i was very nervouse i was really scared i tried to stop it,so is this a panic attack because it is happened for one time i do not know i ask myself is she will come again?!.
    (Sorry my English isn't good🌚💔)

  36. When I have an attack and I cant speak. It's like I freeze up. People will be asking me questions, and I'm just standing there, frozen. It's usually when I'm in an arguement and I want to get away from the arguement, and I tell the Person I need a minute to collect myself, and they wont let me. AMD my heart will be pounding, I get dizzy and super shaky. And the person starts to yell at me and asks me WHY I'm not answering them? Its not fare. And I cant help it.

  37. What about having a panic attack only when I smoke weed ? (and that is coming from a long-term smoker who never had any issues with the substance)

  38. I have been failing my exams because I can't study. I live alone and I get panic attacks then I can't do anything and just watch youtube all day

  39. My first attack: 1) My pulse was around 100-120bpm because I counted it. 2) I’m feeling light headed and I feel like I’m going to faint 3) I was researching heart attack first aid and facts 4) I took Aspirin 5) I rushed myself to the ER 6) Physiological symptoms can really make you panic more, raising my BP to 160 at some point. 7) I felt numbness on the neck, arms and back like how a heart attack would 8) I am not very religious but trust me I was being very sorry for my sins, thought that my time was up 9) 160 blood pressure happened some other time 10) I really hate the chest tightness/discomfort, if you are experiencing it, how can you really be so sure it’s not it? Are heart attacks painful? 11) Shortness of breath was also a thing of my past, it’s just chest tightness now though, I was literally gasping for air like I’m having asthma or something.

    TIPS:
    1) as far as breathing is concerned, the more you gasp for air, the more that you’ll be needing air, so as much as you’d like to take every air into you, stop and slow your breathing to normal even if you feel you are out of breath. Also, don’t yawn very often because it’s not an escape, it’ll make things worse.

    2) loosen your garment, and learn to stomach-out when you inhale. Just make your stomach bigger as you breathe air in.

    3) Now, for the chest tightness, that one I’m still trying to cope with.

  40. I haven't had a panic attack since I was a kid at school and recently, I got a really bad one out of nowhere. I felt like I was going to choke on my tongue, my heart was racing, my hands and feet went cold… Now I'm on edge that I'm going to get another one. I haven't felt right for a week ;-;

  41. Well my therapist believes I could have a panic disorder even though my panic attacks aren’t from an unknown source, I know why I have them (it’s always social events or the mandatory dance class I have to take for my course) it’s basically just because I avoid situations that I know will cause a panic attack leading to me having no social life and causing problems with my university course

  42. Pounding heart/fast heart rate
    Cheat discomfort
    Sweating
    Trembling
    Shortness of breath
    Nausea
    Dizziness
    Chills
    Feelings of being detached from one self
    Fear of losing control
    Fear of dying

    Yep. That’s me:)

  43. I had 2 but I did not breakdown. Another 2 times I broke down but I had few to none symptoms of a panic disorder. Whattt???

  44. Anxiety is gut problem cause by stones in the liver bile duct….you can fix that with andreas Moritz liver flush

  45. Im feeling this when i'm thinking a negative thoughts,thinking i might fail,or having a new friends maybe they dont like me…i dont really trust peopleeee. When they have FAKEU PERSONALITIES/ATTITUDES

  46. I thought I was having a stroke. My face went numb, lost speech, pounding heart, dizziness, shaking , feeling of impending doom – awful

  47. Just wasted my time ……. leant nothing new …… they have to hurry up and develop safe drugs for this disgusting and debilitating disorder …

  48. I had my first panic attack when I was at school. It Wasa loud noise/voice which caused this and i remember, that I covered my ears the whole time, it felt like everything turned around in my head, I couldn‘t breath and talk. I was sweating and trembling and crying during class and I couldn‘t walk, so I had to stay inside..

  49. the moment i get in a vehicle and drive more than a mile from my house the panic starts. i have to take Klonopin an hour and ahalf before i go anywhere. it sucks. I've had anxiety since i was 17 but the panic disorder only started within the last 3 years. I'm now 35. but i manage.

  50. I had an operation like 6 months ago but before that I had been in so much pain that I Don't want to remember it…I had never been afraid of pain before that I could bear all the pain but after that I really can't bear amy pain.. After I found out that there is a chance that that pain cam come back I can't breathe I can't sleep(because I had that pain while I was sleeping).. What can i Do to avoid a this panic..I can't breath I can't eat I can't sleep.. It really freaks me out

  51. i’ve had these but the attacks eventually goes away when i cry so hard, do others experience the same thing?

  52. I get dizzy can’t breathe ya know the normal stuff but I get these waves of an out of body feeling like in my legs. like they feel weightless and whole body feels like someone hit a refresh button on my whole body. It doesn’t make any sense

  53. Is it normal to cry non stop during a panic attack? I feel like I had a panic attack but I’m not sure, I was trembling, feeling dizzy, heart pounding and I was really scared, but none of the symptoms I’ve read mention crying. I spent one hour crying and I wouldn’t respond to anyone. Is that a panic disorder or not ? I’ve experienced it twice.

  54. I have epilepsy and take lamictal that is a mood stabilizer and used to treat bipolar disorder as well as epilepsy, but even that isn't helping with my anxiety which is strange.

  55. For me, since I was a toddler, I get very dizzy. It feels like I'm spinning in all directions at once. Head over heals and around and around. When it begins it feels like it comes into my body from behind my neck. It oozes in and takes over.

  56. This problem started for me about 2 years ago. I was just walking to school to practice for a performance i had to do with my class and out of nowhere i started to feel super dizzy and i started panicking because i didn't know what was happening to me. Ever since that day my life has been a living hell! I can't live normally anymore. I'm anxious 24/7. I feel dizzy amd anxious every single day. It's been so hard and what sucks the most is that i have no one but myself to help me. My mom and brother always call me crazy and tell me to chill out but they just don't understand how hard it is for me.

  57. I got diagnosed with this it’s ruining my life! I constantly am out of breathe, nauseous, dizzy, my heart races, I cry uncontrollably and I can’t breathe

  58. I had a panic and anxiety disorder plus depression for many years. I thank God that He delivered me from these illnesses. I study the Bible. Through God’s Word we can learn more about life and come to know the One who has created us — Jesus Christ! I have come to learn to trust and meditate God’s Word and focus on Jesus. The key is: develop a relationship to our Creator. Study the Bible and pray everyday to Him. It’s about where our focus is. To God be all the glory! ❤️🙏🏽😀

  59. I am confused because some times I feel dizzy my eyes hurt my hearing is muffled I have short temper I get hot and I am very shake a lot and I feel like I am going to pass out but never do and never lose color and feel very tired

  60. Fear of death, fear of losing control, detachment, choking, chest pain, heart palpitations, numbness and shortness of breath. I just had one that lasted more than an hour.

  61. As for me, I think I have social anxiety mixed with panic disorder? Like I'm really anxious about being judged or meeting new people and I'm really introverted and I can't even raise my hand in class (and if the teacher calls me anyway, I'm always starting to panic and my mind goes blank even though I know the answer). Whenever I actually need to hold a presentation in front of my class, I feel like I could break down and just start crying in every single moment. I'm also scared of being in a crowded place sometimes. But the thing is, there are times when I'm in a crowded place or when I'm sitting next to a stranger and have a panic attack but there are also times when I don't. Honestly, I'm so confused by that because idek what mental disorder this is? I'm pretty sure it's at least social anxiety but I don't know if it's also panic disorder because my panic attacks don't happen like three times a week or something. Could you please tell me your opinion and say, what you think my problem is? I really don't know at all.

  62. I don't believe I have PD but I have had multiple panic attacks.
    I remember in 5 or 6 grade, I went to a symphony, and after words, I had a panic attack.

  63. Right now I do not know if this is the right term but I believe I have Mild P.D. because most of my panic attacks only happen in a certain situation but sometimes like 1 or 2 times i had it out of the blue. It happens mostly when I am having an exam or Math competition where i just start having a panic attack when I do not know the answers or just feel like I am going to fail my test or my school for getting a bad score. It also happens when I can not keep up with all the advanced classes I have (Especially math) which are like for the grade 2 years above me. My parents also have pretty high expectations so I get pretty pressured. I also fear death a lot. I think about the future every single day andhave a persistent worry on what might happen later on. I also expierence a change of behavior quite often. It this classified was Panic Disorder? Correct me if I'm wrong.

  64. I had panic attacks for years. It has been a few months without it. I believe I found a cure for it. I started to study several romance languages. I read and write a lot. I love to read the Bible every day. I believe in healing through prayer as well. "Nothing is impossible with God." I drink a lot of water. I don't use make-up or perfume. I eat less meat, no fast food, well balanced meals. I do drink iced tea. I do not take any medicine at all. If I have headache, I place a wet cloth on my forehead. Hope you get better as well.

Leave a Reply

Your email address will not be published. Required fields are marked *