What is panic disorder?

If panic attacks happen often, they are called a panic disorder. People with panic disorder may:

• Feel exhausted from lack of sleep.
• Use drugs or alcohol. This may help them numb their fears or give them a false sense of courage to face feared situations.
• Have depression.
• Have extreme fears (phobias).
• Have other anxiety disorders, such as post-traumatic stress disorder.
• Have trouble relating to other people in social settings because of intense feelings of anxiety.

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.

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.

Some people have a fear of being in crowds, standing in line, or going into shopping malls. They are afraid of having another panic attack or of not being able to escape. This problem is called agoraphobia. It can be so bad for some people that they never leave their homes.

People who have panic disorder often have depression at the same time.

Treatment for panic attacks and panic disorder includes counseling, such as cognitive-behavioral therapy (CBT). Medicines, such as antidepressants, may also help. Treatment can help most people control or even stop attacks. But symptoms can come back, especially if you stop treatment too soon.

Your doctor will ask about your health and symptoms and do a physical exam. You may get blood tests to rule out other causes of your symptoms. You may have panic disorder if you have at least two unexpected panic attacks, worry about having another attack, and avoid situations that may trigger it.

Medicines for panic disorder are used to:

• Control the symptoms of panic attacks.
• Reduce how many attacks you have and how bad they are.
• Reduce the anxiety and fear linked with having another attack.

Your symptoms should start to improve within a few weeks after you start to take medicines. If they don't improve within 6 to 8 weeks, you may need a higher dose. Or you may need another medicine.

Medicines used most often to treat panic attacks and panic disorder include:

• Antidepressants (SSRIs). Examples are citalopram, escitalopram, and sertraline.
• Antidepressants with mixed neurotransmitter effects (SSNRIs). An example is venlafaxine.
• Other types of antidepressants and benzodiazepines.

The following health professionals can diagnose panic attacks. They may work together with other health professionals to treat panic attacks and panic disorder:

• Emergency medicine specialist
• Family medicine physician
• General practitioner
• Physician assistant
• Nurse practitioner

Treatment for panic attacks and panic disorder may also be provided by a:

• Psychiatrist.
• Psychologist.
• Licensed mental health counselor.

Many community mental health centers, hospital outpatient clinics, and family service agencies have treatment programs for people with panic disorder.

Be sure to take medicines as prescribed. Go to your counseling sessions. Be kind to your body. Try to be active, eat a healthy diet, and get enough rest. Learn relaxation techniques to ease your anxiety. Avoid alcohol, marijuana, and illegal drugs. Don't isolate yourself. Get involved in social groups, or volunteer to help others.

Support groups are often good places to share information, problem-solving tips, and emotions related to panic disorder. Online discussion forums and websites may also offer information and support. Self-help materials can help you learn to cope with panic disorder or anxiety. These include instructional videos, books, and audio materials.

If panic attacks happen often, they are called a panic disorder. You may have panic disorder if you have at least two unexpected panic attacks, worry about having another attack, and avoid situations that may trigger it. Counseling and medicines can help treat this disorder.

Experts aren't sure what causes panic attacks and panic disorder. Attacks occur when you feel stressed or sense danger even though there is none. They may be more likely if you have a family history of panic disorder. They may be triggered by things such as depression, high stress levels, and heavy alcohol use.