What is Panic Disorder?

Have you ever been in a completely safe, everyday situation, but unexpectedly - and very suddenly - felt an overwhelming sense of fear and danger? If so, you probably had a panic attack, but don’t worry, it’s much more common than you may think. The Canadian Mental Health Association states that nearly one in three adults might experience a panic attack within a year. If panic attacks are something you worry about having on a regular basis, you may struggle with panic disorder, and about 4% of people will experience it in their lifetime (Canadian Mental Health Association, n.d.). If you feel as though you may be experiencing these things, or you are just curious to learn more, we encourage you to stick around for the rest of this post where we talk about symptoms, effects, risk factors, how it impacts the brain and how we can treat it!

 What is Panic Disorder?

According to the DSM-5, panic disorder is when a person has frequent, unexpected panic attacks and is continually worried about having more panic attacks. (2022). A panic attack feels like a sudden very intense fear, or discomfort. The peak of a panic attack can happen within just a few minutes, and they only last about 15 minutes, but it can feel like a lifetime.

Different cultures describe panic symptoms in different ways. In Hispanic cultures, panic attacks might be called ‘ataque de nervios”, which can include screaming, crying, or even lashing out. In Cambodian culture, there’s something called “Khyâl attacks” (wind attacks), where people feel dizzy, short of breath, and have cold hands and feet.

How does panic disorder affect your life?

While panic disorder can begin in childhood, most people start experiencing symptoms in adolescence, or early adulthood. This is especially challenging because panic can affect your ability to focus on school or work, and can lead to dropping out of school, or losing a part-time job. Because the attacks are unexpected, you may avoid certain things or places, especially social settings. This can have impact your ability to make friends, or deal with the responsibilities of life, leaving many people feeling lonely. Panic disorder can also negatively affect your physical health, due to prolonged anxiety and the increased risk for substance abuse. Experiencing constant fear and anxiety can put physical stress on your body which can make you more tired and it can also make it easier to get sick. This stress can stay with the body and have long-term effects. 

Symptoms

According to the American Psychiatric Association (2022), a person must have all 4 of the following symptoms:

1. Frequent, unexpected panic attacks (a sudden feeling of intense fear) that has at least 4 of the following features:

   • Racing heart

   • Sweating

   • Trembling/shaking

   • Shortness of breath

   • Feeling like you are choking

   • Chest pain/discomfort

   • Feeling nauseous, or other stomach pains

   • Feeling dizzy/light-headed

   • Hot/cold flashes

   • Numb or tingling sensations

   • Feeling detached from reality, or yourself

   • Fearing losing control

   • Feeling like you are dying

     
     

2. After at least one attack, you experience at least one of these things for at least a month:

   • Continual worries about having another panic attack.

   • Unhelpful changes in behavior in an attempt to prevent a panic attack (like avoiding going to school, or being around people).

     
     

3. The panic symptoms are not due to a drug, a medication, or a medical condition.

   
   

4. The symptoms are not better explained by another psychological disorder, like PTSD, social anxiety, or OCD.

Risk Factors

Some people are more likely to experience panic disorder than others. Factors like these will increase the likelihood that you’ll experience a panic attack, or the longer lasting panic disorder.

• Bad experiences in childhood: If someone went through really tough stuff, abuse, or a stressful home environment they might be more likely to have panic attacks later in life. For example, a person who grew up in a household where there was a lot of yelling and fighting might become extra sensitive to stress.

  
  

• Smoking or Vaping: Smoking can actually make panic attacks worse. Nicotine affects the brain in ways that can increase anxiety. For example, Someone who smokes to “calm down” might actually be making their body more likely to panic.

  
  

• Big life stress: Most people who have their first panic attack can connect it to something stressful that happened recently. This could be things like: a breakup, a big test or school pressure, a family problem, or losing a loved one.

  
  

• Health Conditions:  Panic disorder happens more often in people with certain health issues, such as thyroid problems (can cause a racing heart and nervousness, which feel like panic symptoms), chronic pain, or migraines (the body is already under stress, making anxiety worse), heart conditions (some heart problems cause palpitations(fast heartbeat), which can trigger panic), irritable bowel syndrome (the gut and brain are connected, so stomach problems can increase)

  
  

What is happening in the brain?

We are starting to learn about how Panic Disorder (PD) affects the brain. Scientists have found that people with PD have more activity happening in an area called the parietal cortex, which is responsible for things like attention to movement, and anticipation. This makes sense since people with PD are constantly on the lookout for danger (Wang et al, 2021). They also found less activity than usual happening in parts of the brain responsible for cognition (a fancy term for logical thought) and short-term memory. This means that during a panic attack, it can be hard to convince your brain, with facts, that everything is actually OK, and also makes it hard to remember how to calm your mind down during the actual attack.

How can it be treated?

This can seem a little overwhelming, but there are ways to treat it. Sure, there are some medication options, but the most effective option is something called Cognitive Behavioural Therapy (CBT). Think of it as tricking your brain into changing the way it thinks about things. It does involve homework from a licensed counselor, but over time, it’ll change how your mind makes associations.

Sometimes CBT can be used with the medications, like Tricyclic antidepressants (TCAs) and serotonin selective reuptake inhibitors (SSRIs). These both help your brain have more of the chemical serotonin, which is responsible for feeling satisfied.

Closing

Overall, panic disorder is difficult to live with because it is hard on your mind and body. The way in which people experience or talk about their experience with panic disorder will differ based on culture, or current stressors, but it is important to remember that your feelings are always valid. There are many options that can be used to treat panic disorder such as medication, talk therapy, or even a combination of both which helps those who struggle with it to live long and fulfilling lives. Research is also still actively being done to look further into panic disorder and its effects on the brain which is hopeful. Most importantly, you are not alone, there are people and resources out there to help; you got this!

Call-to-Action

We would love to hear from you, if you are able leave a comment below! Is this your first time learning about panic disorder? Or maybe you have some information on panic disorder that we haven’t included that you want others to know? Perhaps you have an experience you want to share or some words of wisdom/tips for those who may be struggling with PD at the moment? Having a community as well as giving and receiving support can make such a positive impact on the lives of individuals, and that community and support can start with us right here.

References

Andrews, G., & Royal Australian and New Zealand College of Psychiatrics Clinical Practice Guidelines Team for Panic Disorder and Agoraphobia. (2003). Australian and New Zealand Clinical Practice Guidelines for the Treatment of Panic Disorder and Agoraphobia. Australian and New Zealand Journal of Psychiatry, 37(6), 641–656.

American Psychiatric Association,  issuing body. (2022). Diagnostic and statistical manual of mental disorders : DSM-5-TR (5th edition, text revision.). American Psychiatric Association Publishing.

Canadian Mental Health Association. (n.d.). Panic disorder. https://bc.cmha.ca/documents/panic-disorder-2/#:~:text=While%20up%20to%20a%20third,panic%20disorder%20in%20their%20lifetime.

Villines, Z. (2022). Physical symptoms of anxiety: What to know. Verywell Health. Retrieved March 6, 2025, from https://www.verywellhealth.com/anxiety-symptoms-5086955

Wang, H.-Y., Xu, G.-Q., Ni, M.-F., Zhang, C.-H., Li, X.-L., Chang, Y., Sun, X.-P., & Zhang, B.-W. (2021). Neural basis of implicit cognitive reappraisal in panic disorder: an event-related fMRI study. Journal of Translational Medicine, 19(1), 1–304. https://doi.org/10.1186/s12967-021-02968-2