Panic disorder is an anxiety disorder that causes repeated, unexpected attacks of intense fear. These attacks may last from minutes to hours.

See also: Generalized anxiety disorder

The exact cause of a panic disorder is unknown. Genetics may play a role in this disorder. Studies suggest that if one identical twin has panic disorder, 40% of the time, the other twin will also develop the condition. However, panic disorder also often occurs in family members who are not blood relatives.

Panic disorder occurs twice as often in women as in men. A person with panic disorder often lives in fear of another attack and may be afraid to be alone or to be far from medical help.

Symptoms usually begin before the age 25. Although panic disorder may occur in children, it is often not diagnosed until you are older. Persons with this condition often have medical tests and exams for symptoms related to heart attack or other conditions before a diagnosis of panic disorder is made.

With panic disorder, at least 4 of the following symptoms suddenly occur within 10 minutes. Attacks may be followed by at least 1 month of persistent fear of having another attack.

• Sensation of shortness of breath
• Dizziness or faintness
• Palpitations or pounding heart
• Trembling or shaking
• Sweating, chills, or hot flashes
• Feeling of choking
• Nausea or upset stomach
• Numbness or tingling
• Chest pain or discomfort
• Fear of dying
• Fear of losing control
• Feelings of unreality
• Feelings of detachment

There are often extreme changes in behavior at home, school, work, or with family. People with the disorder often worry about the significance of their panic attacks. They may think they are "going crazy" or having a heart attack.

A health care provider will perform a physical examination, including blood tests and a psychiatric evaluation. Underlying medical disorders must be ruled out before the diagnosis of panic disorder can be made.

Disorders related to substance abuse should also be considered, because some can mimic panic attacks. Substance abuse may result when individuals with panic attacks try to cope with fear by using alcohol or illegal drugs.

Cardiovascular, endocrine, respiratory, and neurologic disorders may be suspected, and can be present at the same time as panic disorders. Specific diagnostic tests will vary between individuals and will be based on the symptoms.

Many people with panic disorder first seek treatment in the emergency room, because the panic attack feels like a heart attack.