Research suggests that panic disorder has both biological and psychological components, which interact. Family and twin studies indicate that panic disorder involves some genetic vulnerability

Recent studies suggest that people with panic disorder have a low tolerance for the body's normal physiological and psychological response to stress; their body's alarm response goes off with little or no provocation.

The hypothesis that panic disorder patients may have learned to perceive essentially normal physiological events as being dangerous may help in understanding the lowered stress response threshold, giving rise to a "false alarm." Some researchers theorize that the disturbance in coping mechanisms is a product of repeated life stresses in predisposed individuals, leading eventually to panic disorder. Research also suggests that people with panic disorder may not be able to utilize the body's own naturally produced anxiety-reducing substances. It may be that the neuronal receptors that bind with these substances are abnormal in people with panic disorder.

Panic Disorder Can Seriously Harm Your Patients
Even though panic attacks do not represent an immediate danger to the life of the patient, panic disorder can have far more harmful consequences than many other serious medical conditions. Consider the following:

• Many people with panic disorder develop fear about situations they associate with panic attacks and begin to avoid them. Their lives become an ordeal of chronic fear, and they may become greatly restricted in their ability to carry out normal activities like grocery shopping, traveling, and even leaving home, a condition known as agoraphobia.
• Panic disorder can radically impair family, work, and social relationships. Patients may lose their jobs and independence.
• People with panic disorder may also suffer from clinical depression, substance abuse, obsessive-compulsive disorder, or irritable bowel syndrome. According to one study, 20 percent of people with panic disorder attempt suicide.
• Apart from the suffering experienced by the patient, untreated panic disorder is costly to both the patient and the medical system as a whole--because of repeated visits to doctors and emergency departments and unnecessary medical tests.