- A classic panic attack is characterized by rapid onset of a brief period of sympathetic nervous system hyperarousal accompanied by intense fear.
- In panic disorder, multiple panic attacks occur (including at least two without a recognizable trigger). Patients experience at least 1 month of worried anticipation of additional attacks and/or maladaptive (e.g., avoidance) behaviors.
Median age of onset is 24 years. Prevalence significantly decreases after 60 years. Predominant sex: female > male (2:1)
Lifetime prevalence: 4.7%
Etiology and Pathophysiology
Patients resist the initial surge of adrenaline which exacerbates the symptoms—in essence, they get anxious about being anxious.
There is a higher incidence of panic disorder among family members.
- Life stressors of any kind can precipitate attacks, including history of sexual or physical abuse.
- Substance abuse, smoking, bipolar disorder, major depression, obsessive-compulsive disorder (OCD), and simple phobia
Healthy lifestyle, including healthy diet, regular exercise, and stress-reduction techniques (such as mindfulness) are useful.
Commonly Associated Conditions
- Other psychiatric diagnoses: PTSD, social phobia, simple phobia, major depression, bipolar disorder, substance abuse, OCD, separation anxiety disorder
- More common in patients with asthma, migraine headaches, hypertension, mitral valve prolapse, reflux esophagitis, interstitial cystitis, irritable bowel syndrome, fibromyalgia, nicotine dependence
- Panic disorder increases the risk of suicide attempts and ideation.
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