When Fear Holds Sway
Panic disorder is an anxiety disorder
characterized by unexpected and
repeated episodes of intense fear
accompanied by physical symptoms
that may include chest pain, heart
palpitations, shortness of breath,
dizziness, or abdominal distress.
These sensations often mimic symp-
toms of a heart attack or other life-
threatening medical conditions. As a
result, the diagnosis of panic disorder
is frequently not made until extensive
and costly medical procedures fail to
provide a correct diagnosis or relief.
Many people with panic disorder
develop intense anxiety between
episodes. It is not unusual for a per-
son with panic disorder to develop
phobias about places or situations
where panic attacks have occurred,
such as in supermarkets or other
everyday situations. As the frequency
of panic attacks increases, the person
often begins to avoid situations where
Facts About Panic Disorder
and substance abuse.3 Appropriate
they fear another attack may occur or
diagnosis and treatment of other disor-
Approximately 2.4 million
where help would not be immediately
American adults ages 18 to 54, or
ders are important to successfully
available. This avoidance may eventu-
about 1.7 percent of people in this age
treating panic disorder.
ally develop into agoraphobia,
group in a given year, have panic dis-
inability to go beyond known and
Fortunately, research—including stud-
safe surroundings because of intense
Panic disorder typically develops in
ies supported by NIMH—has led to the
fear and anxiety.
late adolescence or early adulthood
development of treatments to help peo-
and is twice as common in women as
ple with panic disorder.
Panic disorder may coexist with
other disorders, most often depression
Treatments for Panic Disorder
The amygdala, although relatively
small, is a very complicated structure,
Treatments for panic disorder include
Narrow WE, Rae DS, Regier DA. NIMH
and recent research suggests that
medications, commonly the selective
epidemiology note: prevalence of anxi-
anxiety disorders may be associated
ety disorders. One-year prevalence best
serotonin reuptake inhibitors, and a
with abnormal activation in the
estimates calculated from ECA and
type of psychotherapy known as cogni-
amygdala. One aim of research is to
NCS data. Population estimates based
tive-behavioral therapy, which teaches
use such basic scientific knowledge to
on U.S. Census estimated residential
people how to view panic attacks dif-
develop new therapies.
population age 18 to 54 on July 1,
ferently and demonstrates ways to
reduce anxiety.4 NIMH is conducting a
For More Information
large-scale study to evaluate the effec-
2Robins LN, Regier DA, eds. Psychiatric
tiveness of combining these treat-
National Institute of Mental Health disorders in America: the Epidemiologic
ments. Appropriate treatment by an
(NIMH)Catchment Area Study.
New York: The
Free Press, 1991.
experienced professional can reduce or
Office of Communications and Public
prevent panic attacks in 70 to 90 per-
cent of people with panic disorder.
Public Inquiries: (301) 443-4513
Regier DA, Rae DS, Narrow WE, et al.
Media Inquiries: (301) 443-4536
Prevalence of anxiety disorders and
Most patients show significant
their comorbidity with mood and
progress after a few weeks of therapy.
Web site: http://www.nimh.nih.gov
addictive disorders. British Journal of
Relapses may occur, but they can oftenPsychiatry Supplement,
be effectively treated just like the ini-
tial episode.All material in this fact sheet is in the
4Hyman SE, Rudorfer MV. Anxiety dis-
Research Findingspublic ddomain aand mmay bbe ccopied oor
orders. In: Dale DC, Federman DD, eds.reproduced wwithout ppermission ffromScientific American® Medicine. Volume
Heredity, other biological factors,the IInstitute. CCitation oof tthe ssource iis3.
New York: Healtheon/WebMD Corp.,
stressful life events, and thinking in aappreciated.
2000, Sect. 13, Subsect. VIII, p. 1.
way that exaggerates relatively normal
bodily reactions are all believed to play
5LeDoux J. Fear and the brain: where
a role in the onset of panic disorder.4
have we been, and where are we
The exact cause or causes of panic dis-
going? Biological Psychiatry,
order 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 anxi-
ety disorders, such as panic disorder.5
Fear, 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
a small structure deep inside the brain,
called the amygdala.
NIH Publication No. 01-4596 January 2001
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