Panic Disorder Health Article

Definition

Panic disorder is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that can include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress. These sensations often mimic symptoms of a heart attack or other life-threatening medical conditions.

Many persons with PD develop intense anxiety between episodes. It is not unusual for a person with PD to develop phobias about places or situations in which panic attacks have occurred. As the frequency of panic attacks increase, a person often begins to avoid situations in which they fear another attack may occur or where help would not be immediately available. This avoidance can eventually develop into agoraphobia, which is an inability to go beyond known and safe surroundings because of intense fear and anxiety.

Panic attacks can occur at any time, even during sleep. PD is often accompanied by other serious conditions, such as depression, drug abuse, or alcoholism. The diagnosis of PD is frequently not made until extensive and costly medical procedures fail to provide a correct diagnosis or relief.

Scope

Approximately 2.4 million (1.7%) of the adult US population between the ages of 18 and 54 years old have PD in a given year. Women are twice as likely as men to develop PD. PD typically strikes during young adulthood. Roughly one half of all persons who have PD develop the condition before the age of 24 years.

About 30% of persons with PD abuse alcohol, and 17% abuse drugs such as cocaine and marijuana; these abuses are unsuccessful attempts to alleviate the anguish and distress caused by the patients' condition.

Etiology

Heredity, other biologic factors, stressful life events, and thinking in a way that exaggerates relatively normal bodily reactions are all believed to play a role in the onset of PD. The exact cause or causes of PD are unknown and are the subject of intense scientific investigation.

Studies in animals and humans have focused on pinpointing the specific brain areas and circuits involved in anxiety and fear, which underlie anxiety disorders such as PD. Fear, which is an emotion that evolved to deal with danger, causes an automatic, rapid, protective response that occurs without the need for conscious thought. It has been found that the body's fear response is coordinated by the amygdala, a small structure deep inside the brain.

The amygdala, although relatively small, is a very complicated structure, and recent research suggests that anxiety disorders may be associated with abnormal activation in the amygdala.