What is Panic Disorder?

When a person has feelings of terror that strike suddenly and repeatedly with no warning (a panic attack) she or he may develop panic disorder. Panic disorder is different from a one-time or isolated attack because it’s characterized by panic attacks that are repeated and unexpected. The panic attacks occur when the person is not in any real threat or danger.

People who suffer from repeated panic attacks soon learn that they can't predict the next attack and they start to worry about when and where the next one will happen. Because of this constant worrying, they often start to avoid situations where they think they might have a panic attack or where they think help might not be available if they need it.

Avoiding situations like this is unhealthy since it can develop into what are called specific panic-induced phobias (like a fear of driving) or agoraphobia (which is when a person is unable to go beyond known and safe surroundings because of extreme fear and anxiety). Avoiding places because of agoraphobia can lead to serious disability and a serious case of panic disorder.

People who develop panic-induced phobias begin to avoid situations that they fear will trigger an attack, and their lives may become more and more limited because of this. Their work may suffer because they can't travel or get to work on time and relationships may become rocky since panic attacks, or even the fear of them, take over the lives of the affected person and those closest to them.

Panic disorder may progress to a more advanced stage where the person becomes afraid of being in any place or situation where they think they might not be able to escape, or won’t be able to get help if they have an attack. This condition is called agoraphobia. It affects about a third of all people with panic disorder. Sometimes people with agoraphobia can become "housebound" because of their anxiety. Some people with agoraphobia do not have panic attacks and cannot remember a time when they had panic attacks.

Typically people with agoraphobia fear being in crowds, standing in line, entering shopping malls, riding in cars or using public transportation. Often these people restrict themselves to a "zone of safety" that may be only their home or the immediate neighborhood around their home. If they try to move past the edges of this zone they become very anxious. Sometimes a person with agoraphobia is unable to leave home alone, but can leave the house if they are accompanied by a particular family member or friend (a “safe person”). Even when they restrict themselves to "safe" situations, most people with agoraphobia continue to have panic attacks at least a few times a month.

People with agoraphobia can be seriously disabled by their condition. Some are unable to work and they may need to rely on other family members to do the shopping and run household errands. After time, the person with agoraphobia typically leads a life of almost total dependency and great discomfort.

Sleep may be disturbed because of panic attacks that occur at night. This may make the person wake up in the middle of the night in a state of terror. The experience is so frightening that some people who have nocturnal (night-time) panic attacks become afraid of sleeping. This only makes the condition worse because they continually suffer from exhaustion.

The sensations experienced during a panic attack are often mistaken for the symptoms of a heart attack or other life-threatening medical condition. As a result, doctors often aren’t able to diagnose panic disorder until extensive and costly medical procedures fail to provide a correct diagnosis or relief.

But what causes panic disorder? The next section can help explain the causes.