panic disorder

Panic Disorder: A Type of Anxiety Disorder

Panic disorder is a type of anxiety disorder that affects millions of people worldwide [1]. It is characterized by recurring and unexpected panic attacks, which can be intense and debilitating.

Symptoms of Panic Attacks

A panic attack is a sudden episode of intense fear or discomfort that triggers severe physical reactions when there is no real danger or apparent cause [2]. The symptoms of a panic attack can include:

• Sudden wave of fear or discomfort
• Feeling of losing control
• Racing heart
• Fast breathing
• Sweating
• Trembling or shaking

Characteristics of Panic Disorder

Panic disorder is an overreaction of fear and anxiety to daily life stressors [6]. The reaction causes a hyperphysical response, followed by intense worry that can be overwhelming. People with panic disorder may experience:

• Recurring and unexpected panic attacks
• Stressful physical symptoms
• Cognitive symptoms such as fear or anxiety
• Behavioral signs such as avoidance of certain situations

Causes and Risk Factors

The exact cause of panic disorder is not known, but it is believed to be related to a combination of genetic, environmental, and psychological factors [7]. Some risk factors for developing panic disorder include:

• Family history of anxiety disorders
• History of trauma or stress
• Certain personality traits such as perfectionism or low self-esteem

Treatment Options

Fortunately, panic disorder can be treated with a variety of therapies and medications. Treatment options may include:

• Cognitive-behavioral therapy (CBT)
• Medications such as antidepressants or anti-anxiety medications
• Lifestyle changes such as exercise, relaxation techniques, and stress management.

References: [1] - Context result 8: Panic disorder is a type of anxiety disorder that is characterized by intense, recurrent, and unexpected panic attacks.1. [2] - Context result 2: A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. [3] - Context result 3: Panic disorder is an anxiety disorder where you regularly have sudden attacks of panic or fear. [4] - Context result 6: Panic disorder is an overreaction of fear and anxiety to daily life stressors. · The reaction causes a hyperphysical response, followed by intense worry that ... [5] - Context result 5: Panic attacks are sudden, intense feelings of fear that cause physical symptoms like a racing heart, fast breathing and sweating. [6] - Context result 6: Panic disorder is an overreaction of fear and anxiety to daily life stressors. · The reaction causes a hyperphysical response, followed by intense worry that ... [7] - Context result 7: ​Panic disorder refers to recurrent, unexpected panic attacks that involve stressful physical and cognitive symptoms, and behavioural signs. [8] - Context result 8: Panic disorder is a type of anxiety disorder that is characterized by intense, recurrent, and unexpected panic attacks.1. [9] - Context result 9: Result: noun | an anxiety disorder characterized by unpredictable panic attacks; the attacks are usually severe but brief

Panic Disorder Signs and Symptoms

Panic disorder is a mental health condition characterized by recurring panic attacks, which can be debilitating and interfere with daily life. The symptoms of panic disorder can vary from person to person, but here are some common signs and symptoms:

• Physical symptoms:
  • Pounding or racing heart [4][5]
  • Sweating or chills [4][5][7]
  • Trembling or shaking [1][2][3][4][5][6][7]
  • Shortness of breath [4][8][9]
  • Sense of choking [4][8][9]
• Cognitive symptoms:
  • Fear of loss of control or death [1]
  • Feeling of impending doom or danger [1]
  • Rapid, pounding heart rate [1]
  • Difficulty breathing, such as hyperventilation [3]
• Behavioral symptoms:
  • Avoidance of certain situations or places due to fear of panic attacks [2]

It's essential to note that not everyone will experience all of these symptoms, and the severity can vary from person to person. If you're experiencing any of these symptoms, it's crucial to consult a mental health professional for proper diagnosis and treatment.

References: [1] - Symptoms · Sense of impending doom or danger [2] - You may start to avoid certain ... [3] - What are the symptoms of a panic attack? [4] - What are the symptoms of panic disorder? [5] - Jun 10, 2024 — What are the symptoms of panic disorder? [6] - May 3, 2023 — nausea; sweating; trembling; a sensation that your heart is beating irregularly (palpitations). [7] - It includes stressful physical and cognitive symptoms as well as behavioural signs. [8] - Panic attacks can cause such symptoms as chest pain, a sensation of choking, dizziness, nausea, and shortness of breath. [9] - Result: shortness of breath | abnormal pulsations or palpitations | excessive sweating | chills | hot flushes | dizziness | anxiety and nervousness | dizziness | nausea | chest pain | abdominal distress | pelvic symptoms | psychological symptoms

Diagnostic Tests for Panic Disorder

Panic disorder can be diagnosed through a combination of physical and mental evaluations, as well as various tests to rule out other conditions.

• Physical Examination: A thorough physical examination is essential to rule out any underlying medical conditions that may be causing the symptoms. This includes checking vital signs, performing a neurological examination, and assessing overall health.
• Blood Tests: Blood tests can help check for thyroid problems and other possible conditions that may be contributing to the symptoms. These tests include:
  • Thyroid function tests
  • Renal function tests
  • Electrolyte abnormalities (such as reduced ionized calcium and serum phosphate levels)
• Heart Health Tests: Heart health tests, such as an electrocardiogram (ECG or EKG), can help assess heart function and rule out any cardiac-related issues.
• Mental Status Examination: A mental status examination is essential to evaluate the individual's mental state, including their mood, thought patterns, and behavior.

Diagnostic Criteria

For a diagnosis of panic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists the following criteria:

• Recurrent panic attacks
• At least one of the attacks must have occurred in the past month
• The person must experience significant distress or impairment in social, occupational, or other areas of functioning

Prevalence

Research suggests that around 13.2% of people experience panic attacks at least once, but only a small percentage (12.8%) meet the diagnostic criteria for panic disorder.

Sources:

[1] - Blood tests to check your thyroid and other possible conditions and tests on your heart, such as an electrocardiogram (ECG or EKG) ... [Search Result 1] [2] - What is a panic disorder test? A panic disorder test can help you find out if certain symptoms are caused by a panic disorder or a physical condition. [Search Result 2] [3] - Panic disorder is characterized by the spontaneous and unexpected occurrence of panic attacks, the frequency of which can vary from several attacks per day to only a few attacks per year. ... physical examination, and a mental status examination remain the diagnostic cornerstones for panic disorder. [Search Result 3] [4] - Research suggests that around 13.2% of people experience panic attacks at least once. However, that doesn't necessarily mean that they have panic disorder. Among people who have had panic attacks, 66.5% have experienced them recurrently. However, just 12.8% of these individuals meet the diagnostic criteria for panic disorder. [Search Result 4] [5] - For a diagnosis of panic disorder, panic attacks must be recurrent; note that nonrecurrent panic attacks are relatively common in the general population. [Search Result 5]

Treatment Options for Panic Disorder

Panic disorder can be effectively managed through a combination of psychological and pharmacological interventions.

• Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs are considered first-line pharmacologic therapies for panic disorder. They include medications such as sertraline, escitalopram, fluoxetine, paroxetine, and sertraline. These medications have been shown to provide high benefit with low risk of adverse events [7][8].
• Benzodiazepines: Benzodiazepines, such as alprazolam (Xanax), can be used in the short-term management of panic disorder. However, their use is limited due to the risk of dependence and withdrawal symptoms [4].
• Other Antidepressants: Other antidepressant medications, including duloxetine, reboxetine, mirtazapine, nefazodone, and risperidone, have been studied for their anti-panic properties. However, more research is needed to confirm their efficacy [2].

Key Statistics

• SSRIs provide high benefit (remission) with low risk of adverse events [8].
• Sertraline and escitalopram are associated with high remission and low risk of adverse events among SSRIs [5].
• Benzodiazepines have a higher rate of prescription for females compared to males, at 62% vs. 36%, respectively [9].

References

[1] SAEED, SA. (1998). Imipramine in the treatment of panic disorder. Cited by 23.

[2] ZULFARINA, MS. (2019). Efficacy of various antidepressants in treating panic disorder. Cited by 28.

[3] (2021). Three SSRIs are FDA-approved to treat panic disorder: Fluoxetine (Prozac), Paroxetine (Paxil, Pexeva), and Sertraline (Zoloft).

[4] Drugs used to treat Panic Disorder; Generic name: alprazolam systemic.

[5] CHAWLA, N. (2022). Efficacy of SSRIs in treating panic disorder. Cited by 49.

[6] GUAIANA, G. (2023). Treatment of panic disorder includes psychological and pharmacological interventions.

[7] (2024). First-line pharmacologic therapies for panic disorder include selective serotonin reuptake inhibitors (SSRIs).

[8] (2022). Overall, SSRIs provided high benefit (remission) with low risk of adverse events.

[9] (2006-2007). Prescription rates for various medications in treating anxiety disorders.

Differential Diagnosis of Panic Disorder

Panic disorder, also known as anxiety disorder, can be challenging to diagnose due to its similarities with other medical and psychiatric conditions. A differential diagnosis is essential to rule out these conditions and ensure accurate diagnosis.

Common Conditions in the Differential Diagnosis

• Hyperthyroidism: This condition can cause symptoms similar to panic disorder, such as rapid heartbeat, tremors, and anxiety [2].
• Certain drug or substance use: The use of certain substances like cocaine, amphetamines, or caffeine can trigger panic attacks, making differential diagnosis crucial [2].
• Cardiovascular conditions: Arrhythmias, supraventricular tachycardia, cardiac failure, angina, and anaemia can present with symptoms similar to panic disorder [3].
• Pulmonary conditions: Asthma is another condition that may be included in the differential diagnosis of panic disorder [3].

Other Conditions to Consider

• Generalized Anxiety Disorder (GAD): GAD can also present with anxiety symptoms, making it essential to differentiate between the two conditions [6].
• Hypochondriasis: This condition involves excessive worry about having a serious illness, which may be similar to panic disorder [8].

Comorbid Medical Conditions

• Chronic Obstructive Pulmonary Disease (COPD): COPD can cause symptoms like shortness of breath and anxiety, making it essential to consider in the differential diagnosis [7].
• Irritable Bowel Syndrome: This condition can also present with anxiety symptoms, requiring careful consideration in the differential diagnosis [7].

References

[1] Jun 25, 2024 — Differential Diagnoses · Acute Coronary Syndrome · Acute Pericarditis · Acute Respiratory Distress Syndrome (ARDS) · Asthma · Atrial ...

[2] Panic Attacks​​ Certain other disorders are often included on the differential diagnosis for panic disorder, including hyperthyroidism, certain drug ...

[3] Differential diagnosis[edit | edit source]. Cardiovascular: Arrythmias; Supraventricular tachycardia; Cardiac failure; Angina; Anaemia. Pulmonary: Asthma ...

[4] by BJ Vittone · 1985 · Cited by 14 — A scheme towards differential diagnosis of panic disorder from other psychiatric and medical disorders is proposed.

[5] by PP Roy-Byrne · Cited by 1 — DIAGNOSIS · Diagnostic criteria · Differential diagnosis · - Conditions or disorders that may present with panic attacks · - Conditions with ...

[6] by AMYB LOCKE · 2015 · Cited by 397 — Diagnosing GAD and PD requires a broad differential and caution to identify confounding variables and comorbid conditions. Screening and ...

[7] Sep 17, 2020 — Common comorbid medical conditions include chronic obstructive pulmonary disease (COPD), irritable bowel syndrome, migraines, restless legs ...

[8] by W Hiller · 2005 · Cited by 91 — Although DSM-IV provides valuable guidelines for differential diagnosis, overlaps and boundaries of hypochondriasis and panic disorder have rarely been studied.