Panic Disorder: Causes, Symptoms, & Treatment

Renaissance Recovery logo

By: Renaissance Recovery

Medically Reviewed by: Diana Vo, LMFT

Last Updated: 7/1/2021

An image of someone with Panic disorder

Authored By: Joe Gilmore

Table of Contents

Panic disorder is a mental health condition characterized by panic attacks that can significantly impact your quality of life.

If untreated, panic disorder often leads to difficulties at work or school.

Fortunately, with the right combination of treatments, you can live without panic attacks causing problems in all areas of your life.

Ask yourself the following questions:

  • Do you ever experience abrupt attacks of anxiety and overwhelming fear that last for a few minutes?
  • If you experience these panic attacks, do they occur without warning and without apparent triggers?
  • Are you worried about having another panic attack at any given time?

If you respond positively to these questions, you may have a panic disorder.

What is Panic Disorder?

Those with panic disorders suffer from regular and unexpected panic attacks. The panic attacks involve the sudden onset of a wave of fear or discomfort. Panic attacks can also induce a sense of losing control even when there is no apparent trigger or danger.

While panic attacks are central to this disorder, not everyone who experiences panic attacks will develop this disorder.

The panic attacks often involve physical symptoms, such as:

  • Rapid heart rate
  • Tingling sensation
  • Trembling

Attacks can occur at any time. Some people experience several panic attacks in one day, while others may only encounter panic attacks a few times each year.

Panic disorder typically presents in the late teens and early adulthood. According to the Psychiatric Times, women are substantially more likely to develop panic disorder than men.

 

Panic Disorder Definition

You should first consult your primary care provider if you experience panic attacks. They can determine whether you have panic disorder, panic attacks, or another underlying condition with symptoms resembling panic attacks – thyroid or heart problems, for instance.

You may need to undergo any or all of the following for diagnostic purposes:

  • Comprehensive physical exam.
  • Blood tests and tests on the heart (EKG or ECG).
  • Psychological evaluation to discuss your symptoms, concerns, fears, stressors, relationship problems, situations you tend to avoid, and family history.

Additionally, you may need to fill out a psychological questionnaire. You are also likely to be asked about your use of alcohol, prescription medications, and illicit drugs.

Not everyone who experiences panic attacks has this specific mental health condition. For a diagnosis per DSM-5 (the latest edition of the APA’s diagnostic tool), you must meet the following criteria:

  • You have unexpected panic attacks that occur frequently.
  • Following at least one of those panic attacks, you continually worry about the consequences of another panic attack. Alternatively, experiencing a panic attack may trigger behavioral changes – avoiding situations you feel might trigger a panic attack, for example.
  • Your panic attacks are not better explained by substance use, a medical condition, or another mental health condition like OCD (obsessive-compulsive disorder) or social anxiety disorder.

If a mental health professional determines that you have panic attacks but not a diagnosed panic disorder, you may still find treatment beneficial. Untreated, panic attacks often get worse, and they could also develop into phobias or panic disorders over time.

An image of a woman with Panic disorder

What are the Four Different Types of Panic Disorder?

Research shows there are four types of panic disorder.

  • Type I panic disorder: The only symptom is a single panic attack.
  • Type II panic disorder: Panic attacks occur frequently but without any attendant depressive or neurotic symptoms.
  • Type III panic disorder: Panic attacks recur. Gradually, neurotic symptoms develop – generalized anxiety, anticipatory anxiety, hypochondriasis, and agoraphobia, for example.
  • Type IV panic disorder: As panic attacks recur, so depressive symptoms develop.

Type IV panic disorder is divided into three further subtypes as follows:

  • Type IV-1 panic disorder: Depressive symptoms develop, but as secondary to panic attacks . Subsequently, major depression coexists with panic disorder.
  • Type IV-2 panic disorder: Panic disorder changes into major depressive disorder.
  • Type IV-3 panic disorder: Independent occurrence of depressive symptoms and panic attacks.

The most common types of this condition are type III disorder and type IV-1 disorder.

Panic Disorder Symptoms

A panic attack unfolds without warning. You might be in a meeting at work, walking along the street, driving your car, or even sound asleep when a panic attack strikes.

These attacks might occur frequently, or this may occur much more infrequently.

While there is substantial variation among panic attacks, most symptoms peak within a few minutes. Once the symptoms subside, you may feel physically drained.

The most common symptoms of panic attacks are as follows:

  • Sense of impending danger or doom
  • Hot flashes
  • Chills
  • Abdominal cramping
  • Nausea
  • Shortness of breath
  • Tightness in your throat
  • Fear of loss of control or death
  • Trembling
  • Shaking
  • Rapid heart rate
  • Chest pain
  • Sweating
  • Dizziness
  • Faintness
  • Lightheadedness
  • Headache
  • Numbness
  • Tingling sensation
  • Feeling of detachment or unreality

One of the most distressing elements of experiencing panic attacks is the acute fear that you will experience another attack. This can prompt people suffering from panic attacks to avoid certain situations.

Luckily, if you take affirmative action, you can fight back against the fear and worry triggered by panic attacks.

Panic Disorder Treatment

If you are experiencing any symptoms of panic disorder, talk to your health care provider.

Further to an assessment, you may be referred to a mental health professional like a psychologist, psychiatrist, or clinical social worker. Effective treatment of panic disorder hinges on an accurate diagnosis.

A core component of this disorder treatment is psychotherapy, informally labeled talk therapy. This is delivered either in isolation or in combination with medication – more on that below.

CBT (cognitive behavioral therapy), is a research-based form of psychotherapy commonly used for the treatment of panic disorder.

Through CBT sessions, you will explore the closely interlinked nature of your thoughts, feelings, reactions, and behaviors, both during and immediately before a panic attack. As you learn how to react differently to the physical symptoms of fear and anxiety, you may find the frequency of panic attacks drops.

Your therapist may also use exposure therapy, a psychological intervention that helps you to re-engage in activities or situations you have been avoiding. This form of therapy is often used in tandem with relaxation exercises. 

Medications

Various medications can prove effective for the treatment of panic disorder. These include:

  • Antidepressants: SNRIs (serotonin-norepinephrine re-uptake inhibitors) and SSRIs (selective serotonin reuptake inhibitors) are most commonly used to treat major depressive disorder, but they can also alleviate the symptoms of anxiety. Antidepressants take several weeks to kick in, and may induce mild adverse side effects.
  • Beta-blockers: Rarely, beta blockers are prescribed to help manage some physical symptoms of this disorder.
  • Benzodiazepines: Benzos are highly effective for treating the symptoms of anxiety short-term. Tolerance to benzodiazepines rapidly builds, though, and addiction can follow.
An image of people on a beach | Panic disorder

Mental Health Treatment at Renaissance Recovery

Here at Renaissance, we can help you move beyond panic attacks with our evidence-based outpatient treatment programs.

If you require more intensive mental health treatment, we offer IOPs (intensive outpatient programs) and PHPs (partial hospitalization programs). We can also deliver remote therapy via our virtual IOP for mental health.

We provide the following research-based therapies to help you beat the symptoms of panic disorder:

  • Psychotherapy like CBT
  • MAT (medication-assisted treatment
  • Group counseling
  • Individual counseling

For anyone with a co-occurring alcohol use disorder or substance use disorder, we can provide simultaneous treatment for both conditions with our dual diagnosis treatment program.

Take advantage of all these resources and more by reaching out to Renaissance Recovery Center today at 866.330.9449.

An image of people in Ocean Therapy
Addiction and Recovery

Ocean Therapy

Holistic interventions like ocean therapy can effectively supplement evidence-based treatments to promote recovery from addiction. By engaging with ocean therapy, you could strengthen your stress

Read More »
An image of a woman on a beach going through the Opioid Withdrawal Timeline
Addiction and Recovery

Opioid Withdrawal Timeline

The opioid withdrawal timeline is similar regardless of the type of opioids involved, typically lasting for between four and ten days. Opioid withdrawal can be

Read More »
An image of a person going through Codeine Withdrawal
Addiction and Recovery

Codeine Withdrawal

Codeine is a medication prescribed for pain relief, sleeplessness, and coughing. Although the short-term use of codeine under medical supervision is typically safe and effective,

Read More »
an image of a client

Pat C

“I owe my life and my happiness to these people. October 8th, 2019 marked two years of sobriety for me, and prior to finding Renaissance I hadn’t had 24 hours sober in nearly 20 years.”

an image of a client

Paige R

“They truly cared for me and the other people that I served with! From this group, I have made 8 new brothers and friends for life! We have continued on, after the program, to take care of each other”

an image of a client

Courtney S

“Great staff who took the time to get to know me. They have a lot of experience in this field and have first hand experience with what I was going through. IOP is outstanding and really built up a ton of great relationships and found this program to be a ‘breath of fresh air’.”

Diana Vo, LMFT

Diana is an addiction expert and licensed marriage and family therapist who has been in the field of mental health for over 10 years.

Joseph Gilmore

Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country