Panic disorder, sometimes called panic attack disorder, is characterized by acute attacks of intense fear and anxiety. Individuals may describe these attacks as feeling like a heart attack.

Panic disorder is a type of anxiety disorder in which sudden feelings of terror arise seemingly out-of-the-blue. These panic attacks can happen anytime, anywhere and without warning. While panic disorder can be frightening, treatment can help reduce intense symptoms.

What is Panic Disorder?

Panic disorder, sometimes called panic attack disorder, is characterized by acute attacks of intense fear and anxiety. Individuals may describe these attacks as feeling like a heart attack. It is important to be clear that a single panic attack does not constitute a panic disorder. To meet the panic disorder definition, an individual must also experience ongoing concern or worry about future panic attacks.

Symptoms of Panic Disorder

Panic disorder symptoms include the presence of unexpected recurring panic attacks and ongoing worry or behavior change because of the panic attacks. While there are other reasons a person may experience a panic attack, one of the key signs of panic disorder is this anticipatory anxiety.

Additional symptoms of a panic attack include:

  • Rapid heartbeat
  • Tightness in the chest and throat
  • Shortness of breath
  • Trembling or shaking
  • Feelings of looming disaster
  • Feelings of detachment and lack of control
  • Numb or tingling sensations
  • Abdominal cramping and vomiting
  • Headache
  • Dizziness 
  • Hot flashes
  • Chills
  • Sweating

No panic disorder severity scale easily measures the impact of the disorder on a person’s life. However, panic disorder is usually mild, moderate or severe. 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 individual’s life.

Causes of Panic Disorder

Panic disorder causes are largely unknown. The first panic attack usually does not follow a specific trigger but instead happens during a particularly stressful period. 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. The difference between the people who have panic disorder and the people who do not is often assumed to be due to individual personality and baseline anxiety levels.

How Is Panic Disorder Diagnosed?

No panic disorder test can be administered to develop a diagnosis. Instead, a clinician must determine the presence of recurrent unexpected panic attacks. Once a clinician determines that a person has experienced panic attacks rather than some other medical event, the clinician can assess the level of distress caused after the attack. 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.

Who Is at Risk for Panic Disorder?

Panic disorder is overwhelmingly more common in women than men. Panic disorder usually develops between the teenage years and mid-life. It is rare for panic disorder to develop in young children or older adults. Panic disorder often runs in families. People with a close relative who has panic disorder may be predisposed to develop it themselves. Childhood separation anxiety may also cause a person to develop panic disorder later in life.

Panic Disorder Statistics

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. As many as half of the people with panic disorder may develop a co-occurring depressive disorder.

If you or a loved one live with a substance use disorder and panic disorder, consider seeking treatment. The Recovery Village provides patients with panic disorder treatment options designed to address substance abuse disorders while also treating the disorders that can develop alongside them. Call and begin the treatment process today.

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Editor – Thomas Christiansen
With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more
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Medically Reviewed By – Denise-Marie Griswold, LCAS
Denise-Marie Griswold is a Licensed Clinical Addictions Specialist. She earned her Master's Degree in Substance Abuse and Clinical Counseling from East Carolina University in 2014. Read more

BBC News. “Diabulimia: ‘I’ve Got My Life and I’ve Got My Feet’.” January 2, 2019. Accessed January 29, 2019.

Blanchard, Justine Lorelle. “Diabetes and Eating Disorders Come Together as Diabulimia.” Diabetes Health, May 30, 2008. Accessed January 29, 2019.

Culbert, Kristen M., Racine, Sarah E., and Klump, Kelly L. “Research Review; What We Have Learned About the Causes of Eating Disorders — A Synthesis of Sociocultural, Psychological, and Biological Research.” The Journal of Child Psychology and Psychiatry, June 19, 2015. Accessed January 29, 2019.

Hilbert, Anja, et al. “Risk Factors Across the Eating Disorders.” Psychiatry Research, 220(1-2): 500-506, June 6, 2014. Accessed January 29, 2019.

Shaw, Albert, and Favazza, Armando. “Deliberate Insulin Underdosing and Omission Should Be Included in DSM-V Criteria for Bulimia Nervosa.” The Journal of Neuropsychiatry and Clinical Neurosciences, 22(3): 352, July 1, 2010. Accessed January 29, 2019.

National Eating Disorders Association. “Diabulimia.” (n.d.) Accessed January 29, 2019.

Wisse, Brent. “Diabetic Ketoacidosis.” MedlinePlus, January 16, 2018. Accessed January 29, 2019.

Trace, Sara E. Baker, Jessica H. Peñas-Lledó, Eva, and Bulik, Cynthia M. “The Genetics of Eating Disorders.” Annual Review of Clinical Psychology, 9: 589-620, March 2013. Accessed January 29, 2019.

National Task Force on the Prevention and Treatment of Obesity. “Dieting and the Development of Eating Di[…]ght and Obese Adults.” Archives of Internal Medicine, 160(17): 2581-2589, September 25, 2000. Accessed January 29, 2019.

Kinik, Mehmet Fatih, et al. “Diabulimia, a Type I Diabetes Mellitus-S[…]ific Eating Disorder.” Turkish Archives of Pediatrics, 52(1): 46-49, March 1, 2017. Accessed January 29, 2019.

Rabin, Roni Caryn. “An Eating Disorder in People with Diabetes.” The New York Times, February 1, 2016. Accessed January 29, 2019.

Bauer, Ann. “The Diet That’s Too Good to Be True.” Salon, November 8, 2007. Accessed January 29, 2019.

National Eating Disorders Association. “Eating Disorders and Co-Occurring Conditions.” (n.d.) Accessed January 29, 2019.

National Eating Disorders Association. “Eating Disorders and Substance Abuse.” (n.d.) Accessed January 29, 2019.

Murphy, Rebecca, Straebler, Suzanne, Cooper, Zafra, and Fairburn, Christopher G. “Cognitive Behavioral Therapy for Eating Disorders.” Psychiatric Clinics of North America, 33(3): 611-627, September 2010. Accessed January 29, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.