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• #1 Panic attacks and panic disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021

  A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you’re losing control, having a heart attack or even dying. […] Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. But if you’ve had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder. […] Although panic attacks themselves aren’t life-threatening, they can be frightening and significantly affect your quality of life. But treatment can be very effective. […] Panic attacks typically begin suddenly, without warning. They can strike at any time when you’re driving a car, at the mall, sound asleep or in the middle of a business meeting. You may have occasional panic attacks, or they may occur frequently.

• #2 Panic Disorder: When Fear Overwhelms – National Institute of Mental Health (NIMH)

  https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms

  Do you sometimes have sudden attacks of anxiety and overwhelming fear that last for several minutes? Maybe your heart pounds, you sweat, and you feel like you cant breathe or think clearly. Do these attacks occur at unpredictable times with no apparent trigger, causing you to worry about the possibility of having another one at any time? […] People with panic disorder have frequent and unexpected panic attacks. These attacks are characterized by a sudden wave of fear or discomfort or a sense of losing control even when there is no clear danger or trigger. […] Panic attacks often include physical symptoms that might feel like a heart attack, such as trembling, tingling, or rapid heart rate. Panic attacks can occur at any time. Many people with panic disorder worry about the possibility of having another attack and may significantly change their life to avoid having another attack. Panic attacks can occur as frequently as several times a day or as rarely as a few times a year.

• #2 Panic attacks and panic disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021

  Panic attacks have many variations, but symptoms usually peak within minutes. You may feel fatigued and worn out after a panic attack subsides. […] Panic attacks typically include some of these signs or symptoms: Sense of impending doom or danger, Fear of loss of control or death, Rapid, pounding heart rate, Sweating, Trembling or shaking, Shortness of breath or tightness in your throat, Chills, Hot flashes, Nausea, Abdominal cramping, Chest pain, Headache, Dizziness, lightheadedness or faintness, Numbness or tingling sensation, Feeling of unreality or detachment. […] One of the worst things about panic attacks is the intense fear that you’ll have another one. You may fear having panic attacks so much that you avoid certain situations where they may occur. […] If you have panic attack symptoms, seek medical help as soon as possible. Panic attacks, while intensely uncomfortable, are not dangerous. But panic attacks are hard to manage on your own, and they may get worse without treatment.

• #3 Panic Attacks & Panic Disorder: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/4451-panic-attack-panic-disorder

  Panic attacks are common. Every year, up to 11% of people in the United States experience a panic attack. […] Approximately 2% to 3% of people in the U.S. have panic disorder. Women are two times more likely to have panic disorder than men. […] Symptoms include difficulty breathing racing heart and trembling feeling intense terror and choking sensation. A panic attack happens suddenly. Symptoms usually peak within 10 minutes after it starts and then disappear soon after. […] A panic attack happens suddenly. Symptoms usually peak within 10 minutes after it starts and then disappear soon after. […] Panic attacks usually last 5 to 20 minutes. But some people have reported attacks lasting up to an hour. […] Experts dont know exactly why some people experience panic attacks or develop panic disorder. Your brain and nervous system play key roles in how you perceive and handle fear and anxiety.

• #3 Panic Attacks & Panic Disorder: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/4451-panic-attack-panic-disorder

  Panic attacks are sudden, intense feelings of fear that cause physical symptoms like a racing heart, fast breathing and sweating. Some people who experience panic attacks develop panic disorder, a type of anxiety disorder. Therapy and medications can treat panic attacks and panic disorder. […] Panic attacks are the main feature of panic disorder. But they can happen alongside other conditions, such as: Anxiety disorders, Mood disorders, Phobias, Psychotic disorders, Substance use disorders, Trauma- and stressor-related disorders, Certain medical conditions. […] While panic attacks by themselves arent dangerous or harmful to your health, frequent attacks can lead to a decrease in your quality of life and other issues. […] Panic disorder is an anxiety disorder that involves multiple unexpected panic attacks. A main feature of panic disorder is that the attacks usually happen without warning and arent due to another mental health or physical condition. Theres often not a specific trigger for them.

• #4 Panic disorder – NHS

  https://www.nhs.uk/mental-health/conditions/panic-disorder/

  Panic disorder is an anxiety disorder where you regularly have sudden attacks of panic or fear. […] But someone with panic disorder has feelings of anxiety, stress and panic regularly and at any time, often for no apparent reason. […] Symptoms include: a racing heartbeat, feeling faint, sweating, nausea, chest pain, shortness of breath, trembling, hot flushes, chills, shaky limbs, a choking sensation, dizziness, numbness or pins and needles, dry mouth, a feeling of dread or a fear of dying, a churning stomach, a tingling in your fingers, feeling like you’re not connected to your body. […] Most panic attacks last between 5 and 20 minutes. Some have been reported to last up to an hour. […] The number of attacks you have will depend on how severe your condition is. Some people have attacks once or twice a month, while others have them several times a week.

• #4 Panic disorder – NHS

  https://www.nhs.uk/mental-health/conditions/panic-disorder/

  Although panic attacks are frightening, they’re not dangerous. An attack will not cause you any physical harm, and it’s unlikely you’ll be admitted to hospital if you have one. […] You may be diagnosed with panic disorder if you have regular and unexpected panic attacks followed by at least a month of continuous worry or concern about having further attacks. […] Treatment aims to reduce the number of panic attacks you have and ease your symptoms. […] If your symptoms do not improve after CBT, medicine and connecting with a support group, your GP may refer you to a mental health specialist such as a psychiatrist or clinical psychologist. […] Panic disorder is treatable so it’s best to get medical help as soon as you can. […] If you do not get medical help, panic disorder can escalate and become very difficult to cope with.

• #5 How Long Do Panic Attacks Last: Duration, Coping, and More

  https://www.healthline.com/health/mental-health/how-long-do-panic-attacks-last

  Panic attacks are abrupt attacks where you feel fear, discomfort, and like you’re losing control even when there’s no danger. These attacks occur out of the blue with no warning and some symptoms can feel like a heart attack. […] Panic attacks are typically short, reaching their peak in less than 10 minutes. An attack usually lasts anywhere from a few minutes up to 30, though repeated attacks can recur for hours. […] Most panic attacks last only a few minutes though they often feel like a lifetime when you’re experiencing one. Symptoms typically peak within 10 minutes and then begin to fade away. […] It’s possible to have a panic attack that’s especially long or short. Some attacks can peak in a few seconds, with the entire attack lasting just minutes, while others may last longer. […] Most research has described single panic attacks lasting up to 30 minutes. Some reports by individuals have described attacks lasting hours or even days.

• #6 Panic disorder & panic attacks – Beyond Blue

  https://www.beyondblue.org.au/mental-health/anxiety/types-of-anxiety/panic-disorder

  Panic disorder is when panic attacks are recurrent and disabling. Having one panic attack doesnt mean you have panic disorder. […] If you have panic disorder you may: have recurring and unexpected panic attacks. […] During a panic attack, you get a sudden sense of overwhelming panic and fear. Panic attacks usually last for up to half an hour, with the worst symptoms in the first 10 minutes. […] If you have panic disorder they can happen as often as several times a day. […] Common signs and symptoms of a panic attack include: a sense of overwhelming panic or fear, the thought that you are dying, choking, losing control or going mad, increased heart rate, difficulty breathing (feeling that there is not enough air), feeling choked, excessive sweating, dizziness, light-headedness or feeling faint.

• #7 Panic Disorder: When Fear Overwhelms – National Institute of Mental Health (NIMH)

  https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms

  Panic disorder often begins in the late teens or early adulthood. Women are more likely than men to develop panic disorder. […] People with panic disorder may have: Sudden and repeated panic attacks of overwhelming anxiety and fear, A feeling of being out of control, or a fear of death or impending doom during a panic attack, An intense worry about when the next panic attack will happen, A fear or avoidance of places where panic attacks have occurred in the past, Physical symptoms during a panic attack, such as: Pounding or racing heart, Sweating, Chills, Trembling, Difficulty breathing, Weakness or dizziness, Tingly or numb hands, Chest pain, Stomach pain or nausea. […] Panic disorder sometimes runs in families, but no one knows for sure why some family members have it while others dont. Researchers have found that several parts of the brain and certain biological processes may play a crucial role in fear and anxiety.

• #8 Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html

  Panic disorder (PD) is defined by the DSM-5 as recurrent panic attacks that include characteristic symptoms and lack an obvious trigger. PD includes at least one month of persistent concern for panic attack recurrence and may include maladaptive behavioral changes. The most common symptom of a panic attack is heart palpitations. Panic attacks that are nocturnal or lack fear require a more extensive workup; however, these features are not uncommon in PD. […] Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur: Palpitations, pounding heart, or accelerated heart rate; Sweating; Trembling or shaking; Sensations of shortness of breath or smothering; Feelings of choking; Chest pain or discomfort; Nausea or abdominal distress; Feeling dizzy, unsteady, light-headed, or faint; Chills or heat sensations; Paresthesias (numbness or tingling sensations); Derealization (feelings of unreality) or depersonalization (being detached from oneself); Fear of losing control or going crazy; Fear of dying.

• #8 Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html

  The two main categories of treatment for GAD and PD are pharmacotherapy and psychotherapy, with cognitive behavior therapy (CBT) being the most effective and well-studied form of psychotherapy for PD. First-line medications are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). […] Antidepressants are effective for treating PD, with an estimated number needed to treat of 10 for remission after two to six months of treatment. SSRIs and SNRIs are preferred over tricyclic antidepressants or monotherapy with benzodiazepines because of a higher risk of adverse effects with tricyclic antidepressants and benzodiazepines, although all have comparable effectiveness.

• #9 Panic Attacks and Panic Disorder – Mental Health Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/mental-health-disorders/anxiety-and-stressor-related-disorders/panic-attacks-and-panic-disorder

  A panic attack involves the sudden appearance of intense fear or discomfort plus at least 4 of the following physical and emotional symptoms: chest pain or discomfort, a sensation of choking, dizziness, unsteadiness, or faintness, fear of dying, fear of going crazy or of losing control, feelings of unreality, strangeness, or detachment from the environment, flushes or chills, nausea, stomachache, or diarrhea, numbness or tingling sensations, palpitations or an accelerated heart rate, shortness of breath or a sense of being smothered, sweating, trembling or shaking. […] Panic disorder is diagnosed when people have repeated unprovoked and unexpected panic attacks plus at least one of the following for at least 1 month: persistent worry that they will have more panic attacks or worry about the consequences of the attack (for example, that they will lose control or go crazy), changes in behavior due to the panic attacks (for example, avoiding situations that may cause an attack).

• #10 Panic disorder – Wikipedia

  https://en.wikipedia.org/wiki/Panic_disorder

  Panic disorder is a mental and behavioral disorder, specifically an anxiety disorder characterized by reoccurring unexpected panic attacks. Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something terrible is going to happen. The maximum degree of symptoms occurs within minutes. There may be ongoing worries about having further attacks and avoidance of places where attacks have occurred in the past. […] Panic disorder is usually treated with counselling and medications. The type of counselling used is typically cognitive behavioral therapy (CBT) which is effective in more than half of people. Medications used include antidepressants, benzodiazepines, and beta blockers. Following stopping treatment up to 30% of people have a recurrence.

• #10 Panic disorder – Wikipedia

  https://en.wikipedia.org/wiki/Panic_disorder

  Panic disorder affects about 2.5% of people at some point in their life. It usually begins during adolescence or early adulthood, but may affect people of any age. It is less common in children and elderly people. Women are more likely than men to develop panic disorder. […] Individuals with panic disorder usually have a series of intense episodes of extreme anxiety during panic attacks. These attacks typically last about ten minutes, and can be as short-lived as 15 minutes, but can last twenty minutes to an hour, and they can occasionally last for even longer or until helpful intervention is made. The intensity and symptoms of panic during panic attacks may vary. […] Common symptoms of panic disorder attack include rapid heartbeat, perspiration, dizziness, dyspnea, trembling, uncontrollable fear such as: the fear of losing control and going crazy, the fear of dying and hyperventilation. Other symptoms are a sensation of choking, paralysis, chest pain, nausea, numbness or tingling, chills or hot flashes, vision problems, faintness, crying and some sense of altered reality. In addition, the person usually has thoughts of impending doom.

• #11 Panic Attacks and Panic Disorder – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/panic-attacks-and-panic-disorder

  Panic disorder is diagnosed after general medical disorders that can mimic anxiety are eliminated, and when symptoms meet diagnostic criteria stipulated in the DSM-5-TR. Patients have recurrent panic attacks in which 1 attack has been followed by one or both of the following for 1 month: persistent worry about having additional panic attacks or worry about their consequences (eg, losing control, going crazy) and maladaptive behavioral response to the panic attacks (eg, avoiding common activities such as exercise or social situations to try to prevent further attacks). […] Some patients recover without treatment, particularly if they continue to be exposed to situations in which attacks have occurred. For others, especially without treatment, panic disorder follows a chronic waxing and waning course. Panic attacks often recur when medications are discontinued. Cognitive-behavioral therapy (CBT) has been shown to be effective for panic disorder. Patients may have their own distinct but dysfunctional cycle of thinking that can induce anxiety and/or panic. CBT involves clarifying these cycles and then teaching patients to recognize and control their distorted thinking and false beliefs.

• #12 DSM-5 Criteria for Diagnosing Panic Disorder

  https://www.verywellmind.com/diagnosing-panic-disorder-2583930

  In addition, at least one panic attack is followed by one month or more of the person fearing that they will have more attacks, causing them to change their behavior, which often includes avoiding situations that might induce an attack. […] It’s important to note that a panic disorder diagnosis must rule out other potential causes for the panic attack (or the event that feels like one): The attacks must not be due to the direct physiological effects of a substance (such as drug use or medication) or a general medical condition. […] According to DSM-5, a panic attack is characterized by four or more of the following symptoms (the presence of fewer than four symptoms may be considered a limited-symptom panic attack): Palpitations, pounding heart, or accelerated heart rate, Sweating, Trembling or shaking, Sensations of shortness of breath or smothering, A feeling of choking, Chest pain or discomfort, Nausea or abdominal distress, Feeling dizzy, unsteady, lightheaded, or faint, Feelings of unreality (derealization) or being detached from oneself (depersonalization), Fear of losing control or going crazy, Fear of dying, Numbness or tingling sensations (paresthesias), Chills or hot flushes. […] To be diagnosed with panic disorder, you much have recurrent, unexpected panic attacks. They must not be the result of a medical condition, other mental health condition, or substance use.

• #13 Panic attacks and panic disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021

  Panic attack symptoms can also resemble symptoms of other serious health problems, such as a heart attack, so it’s important to get evaluated by your primary care provider if you aren’t sure what’s causing your symptoms. […] Panic attacks may come on suddenly and without warning at first, but over time, they’re usually triggered by certain situations. […] Symptoms of panic disorder often start in the late teens or early adulthood and affect more women than men. […] Left untreated, panic attacks and panic disorder can affect almost every area of your life. You may be so afraid of having more panic attacks that you live in a constant state of fear, ruining your quality of life. […] For some people, panic disorder may include agoraphobia avoiding places or situations that cause you anxiety because you fear being unable to escape or get help if you have a panic attack. Or you may become reliant on others to be with you in order to leave your home.

• #14 Panic disorder – Wikipedia

  https://en.wikipedia.org/wiki/Panic_disorder

  Panic disorder typically begins during early adulthood; roughly half of all people who have panic disorder develop the condition between the ages of 17 and 24, especially those subjected to traumatic experiences. However, some studies suggest that the majority of young people affected for the first time are between the ages of 25 and 30. […] Panic disorder can continue for months or years, depending on how and when treatment is sought. If left untreated, it may worsen to the point where one’s life is seriously affected by panic attacks and by attempts to avoid or conceal the condition. In fact, many people have had problems with personal relationships, education and employment while struggling to cope with panic disorder.

• #15 Panic Attack Coping Skills | Panic Disorder Symptoms and Treatment

  https://www.therecoveryvillage.com/mental-health/panic-disorder/

  A mild panic disorder would be a person who only has a few attacks or does not experience high-intensity anticipatory anxiety. Moderate to severe panic disorder are when attacks happen frequently or the anxiety between attacks disrupts the individuals life. […] Following the first attack, anxiety about future attacks may begin to develop. Some individuals may experience panic attacks but not feel anxiety regarding possible future attacks. […] For people with a severe panic disorder, anticipatory anxiety may be so severe that they stop going to locations where they have had a panic attack previously. This anxiety can often result in the development of agoraphobia. […] Years, after experiencing the initial panic attack and experiencing any panic attacks, about half of people with this disorder, will have made significant strides in recovering. However, about one-quarter of people still experience severe anticipatory anxiety even years after their last panic attack.

• #16 Panic Disorder (Symptoms) | Center for the Treatment and Study of Anxiety | Perelman School of Medicine at the University of Pennsylvania

  https://www.med.upenn.edu/ctsa/panic_symptoms.html

  At first, panic attacks usually seem to come out of the blue, but over time a person may come to expect them in certain situations. […] The frequency and severity of panic attacks vary widely between individuals. […] Panic disorder can continue for months or years, depending on how and when treatment is pursued. […] If left untreated, symptoms may become so severe that a person has significant problems with their friends, family, or job. […] Some people may experience several months or years of frequent symptoms, then many symptom-free years. […] In others, symptoms persist at the same level indefinitely. […] There is some evidence that many people, particularly those whose symptoms begin at an early age, may naturally experience a partial or even complete reduction in symptoms after middle age.

• #17 Panic Disorder & Depression – Bridges to Recovery

  https://www.bridgestorecovery.com/panic-disorder/panic-disorder-depression/

  Panic disorder and agoraphobia have a high rate of co-occurrence, and somewhere between 30 and 50 percent of all panic disorder sufferers will be diagnosed with co-occurring agoraphobia. […] Panic disorder and depression must be diagnosed separately, based on the appearance of multiple symptoms over an extended period of time (two weeks for major depression and one month for panic disorder). […] After a dual diagnosis for panic disorder and depression has been made, patients should be referred to integrated treatment programs that will address all the symptoms of both conditions at once.

• #18 Panic Attacks and Panic Disorder | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/panic-attacks-and-panic-disorder-hw53796

  Symptoms of a panic attack may include: A feeling of intense fear, terror, or anxiety. Trouble breathing or very fast breathing. Chest pain or tightness. A heartbeat that races or isn’t regular. […] Symptoms of panic disorder may include: Repeated, unexpected panic attacks. Worry that you’ll have another attack. Because of this fear, you may change your daily activities to avoid situations that may trigger it. […] Panic attacks may continue for years, especially if you also have agoraphobia (avoiding places where you fear another attack will occur). These attacks can be mild to severe. You may have long periods of time without panic attacks. And you may have other periods of time when attacks occur often. […] Panic disorder may last a lifetime. Most people who have panic disorder get better with treatment. But the attacks can come back, especially if treatment is stopped too soon.

• #18 Panic Attacks and Panic Disorder | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/panic-attacks-and-panic-disorder-hw53796

  A panic attack is a sudden, intense fear or anxiety. It may make you short of breath or dizzy or make your heart pound. You may feel out of control. Some people believe that they’re having a heart attack or are about to die. An attack usually lasts from 5 to 20 minutes. But it may last longer, up to a few hours. If these attacks happen often, they are called a panic disorder. […] Panic attacks can be scary and so bad that they get in the way of your daily activities. Treatment can help most people have fewer symptoms or even stop the attacks. […] A panic attack may cause a feeling of intense fear, terror, or anxiety. Other symptoms include trouble breathing, chest pain or tightness, and a fast or irregular heartbeat. […] When you have panic disorder, you have repeated, unexpected panic attacks. And you may worry that you’ll have another attack. Because of this fear, you may change your daily activities to avoid situations that may trigger it.

• #19 Overcoming Panic Disorder

  https://give.brighamandwomens.org/overcoming-panic-disorder/

  Anxiety and panic are interrelated, and both contribute to panic disorder, says Gabe Gruner, LICSW, a psychotherapist at the Psychiatry Outpatient Clinic at Brigham and Womens Hospital. […] The low-level of arousal that comes from anxiety about future panic attacks can trigger an actual panic attack. […] About one third of people with panic disorder will show symptoms of agoraphobia, the fear of public or enclosed places where escape might be difficult. […] The underlying mechanism that drives panic disorder is called anxiety sensitivity, a phenomenon where an individual becomes afraid of their bodily sensations, explains Gruner. […] Most psychologists agree that anxiety sensitivity is not hereditary, but rather learned from personal experiences. […] The process of learning to fear bodily sensations is called interoceptive conditioning.

• #20 Panic Disorder | Fact Sheet – ABCT – Association for Behavioral and Cognitive Therapies

  https://www.abct.org/fact-sheets/panic-disorder/

  The panic attack itself can be viewed as the combination of physical sensations and the frightening thoughts about these sensations: “The chest pain that I am feeling must mean that I am having a heart attack.” […] Because these thoughts are frightening, the nervous system is turned on (as would occur under conditions of real danger). As a result, more physical symptoms are likely to be experienced, which in turn may be thought of as further evidence of danger. […] Persistent overbreathing or hyperventilation (taking in more air than is needed) may contribute to panic attacks. […] When fear of the body sensations is lessened, so is the fear of the return of a panic attack. These new behavioral treatments eliminate panic attacks in most clients. This favorably compares to the use of prescription medications to reduce panic attacks.

• #21 Panic attack | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/panic-attack

  Symptoms of a panic attack include extreme anxiety and physical sensations of fear, such as increased heart rate, shortness of breath, trembling and muscle tension. […] Symptoms of a panic attack can include: heightened vigilance for danger and physical symptoms, anxious and irrational thinking, a strong feeling of dread, danger or foreboding, fear of going mad, losing control, or dying, feeling lightheaded and dizzy, tingling and chills, particularly in the arms and hands, trembling or shaking, sweating, hot flushes, accelerated heart rate, a feeling of constriction in the chest, breathing difficulties, including shortness of breath, nausea or abdominal distress, tense muscles, dry mouth, feelings of unreality and detachment from the environment. […] A person who experiences recurring panic attacks is said to have panic disorder, which is a type of anxiety disorder. They generally have recurring and unexpected panic attacks and persistent fears of repeated attacks. […] Without treatment, frequent and prolonged panic attacks can be severely disabling. The person may choose to avoid a wide range of situations (such as leaving their home or being alone) for fear of experiencing an attack.

• #22 Panic Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430973/

  Panic disorder is fairly common in the general population. Among all anxiety disorders, it has the highest number of medical visits and serves as a very costly mental health condition. Panic disorder is characterized by recurrent, unexpected panic attacks. Panic attacks are defined by the Diagnostic and Statistical Manual of Mental Health Disorders (DSM) as an abrupt surge of intense fear or discomfort reaching a peak within minutes. Four or more of a specific set of physical symptoms accompany a panic attack. Panic attacks occur as often as several times per day or as infrequently as only a few attacks per year. A hallmark feature of panic disorder is that attacks occur without warning. There is often no specific trigger for the panic attack. Patients suffering from these attacks self-perceive a lack of control. Panic attacks, however, are not limited to panic disorder. They can occur alongside other anxiety, mood, psychotic, substance use, and even medical disorders. Panic attacks can be associated with increased symptom severity of various disorders, suicidal ideation and behavior, and diminished treatment response in patients with concomitant anxiety and mental disorders. Making an accurate diagnosis of panic disorder is not possible without a thorough awareness of what constitutes panic attacks. According to DSM 5 (Fifth Edition) criteria, at least one panic attack must be followed by one month or more of persistent concern over having more attacks, worry about the consequences of the attacks or maladaptive behavior such as avoidance of work or school activities. Panic disorder is not a benign disease, it can significantly affect the quality of life and lead to depression and disability. In addition, these patients are also at a higher risk for alcoholism and substance abuse compared to the general population. Panic disorder can be diagnosed if recurrent unexpected panic attacks are happening, followed by one month or more of persistent concern over having more attacks, along with a change in the behavior of the individual to avoid a situation in which they attribute the attack. Panic disorder is associated with a higher risk of suicidal ideation. It is also associated with a decrease in the quality of life as the patient is not able to function normally in his social and family life. The disorder is associated with an increased risk of comorbid medical conditions and smoking. Prognosis can be guarded. The presence of panic disorder without other psychopathology is rare. Most people will have a recurrence of symptoms even after a symptom-free period. Compliance with treatment is a major issue, and thus relapse of symptoms is common. Only about 60% of patients achieve remission within 6 months. Triggers for poor outcomes include a chronic illness, high interpersonal sensitivity, unmarried, low social class, and living alone. Besides premature adverse cardiac events, these patients are also at risk for suicide. Panic disorder has no cure, and its course is unpredictable. The currently available pharmacological therapy and cognitive behavior therapy does work in about 80% of patients, but relapses are common. About 20% of patients continue to have symptoms that lead to poor quality of life. About two-thirds of treated patients have a good prognosis, achieving remissions for about six months at a time. More important, there is a high risk of coronary artery disease in patients with panic disorder, and the risk of sudden death is increased compared to the general population. Finally, the suicide rate is much higher in patients with panic disorder. There is a high association of social, occupational, and physical disability caused by panic disorder.

• #23

  https://step2.medbullets.com/psychiatry/120628/panic-attack–panic-disorder

  A panic disorder is characterized by recurrent panic attacks associated with 1 month of subsequent persistent worry about having another panic attack or behavioral changes related to the attack. […] Symptoms include 4 or more panic attacks in a 4-week period, or 1 panic attack followed by at least 1 month of fear of another panic attack. […] Panic attack symptoms may include intense fear of dying and discomfort, sympathetic overdrive, sweating, palpitations, abdominal distress/nausea, hyperventilation, paresthesias, light-headedness, chest pain, chills, choking, disconnectedness/loss of reality, and shaking. […] Panic attack symptoms have no precipitating stimulus and often peak within 10 minutes and last 20-30 minutes from onset. […] Panic attacks may be triggered by injury, illness, interpersonal conflict or loss, cannabis use, or stimulants (i.e., caffeine or decongestants). […] Long-term prognosis is good with ~65% of patients achieving remission within 6 months.

• #24 Panic Disorder: When Fear Overwhelms – National Institute of Mental Health (NIMH)

  https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms

  Panic disorder is generally treated with psychotherapy (sometimes called talk therapy), medication, or both. […] Cognitive behavioral therapy (CBT), a research-supported type of psychotherapy, is commonly used to treat panic disorder. CBT teaches you different ways of thinking, behaving, and reacting to the feelings that happen during or before a panic attack. […] Health care providers may prescribe medication to treat panic disorder. Different types of medication can be effective, including: Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), Beta-blockers, Anti-anxiety medications, such as benzodiazepines. […] Both psychotherapy and medication can take some time to work. Many people try more than one medication before finding the best one for them.

• #25 Panic attack – Wikipedia

  https://en.wikipedia.org/wiki/Panic_attack

  Panic attacks, while unpleasant, are not life-threatening. However, recurrent panic attacks can negatively affect one’s mental health if people experiencing them do not seek treatment. Sometimes, panic attacks can develop into phobias or panic disorder if untreated. However, when treated, people do very well, with symptoms decreasing or fully disappearing within several weeks to months.

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