Over 12 million people in the United States are estimated to suffer from panic disorder, and is twice as common in women as it is in men. Panic disorder is a type of anxiety disorder where the patient will experience recurring panic attacks, and the subsequent anxiety of worrying when the next one will happen to the point that it causes disability in their daily life, such as personal relationships, work, school, or social disturbances.

A panic attack is a disturbing experience for the individual, and they may feel like they are having a nervous breakdown or a heart attack. They often also feel nauseated, faint, and experience hyperventilation, sweating, and numbness and tingling in the limbs. Diagnosis is made after repeated panic attacks, and the patient changing his or her life to avoid them.

The mainstay of treatment is cognitive behavioral therapy, along with anti-anxiety medications (Klonopin, Ativan, Xanax) and anti-depressants (Prozac, Zoloft, Lexapro, Paxil, Celexa).

People with panic disorder have:

  • sudden and repeated attacks of fear
  • a feeling of being out of control during a panic attack
  • a feeling that things are not real
  • an intense worry about when the next attack will happen
  • a fear or avoidance of places where panic attacks have occurred in the past
  • physical symptoms
    • pounding heart
    • sweating
    • weakness, faintness, or dizziness
    • feeling a hot flush or a cold chill
    • tingly or numb hands
    • chest pain
    • feeling nauseous or stomach pain

If you have been suffering panic attacks and are concerned you may have panic disorder, it is appropriate to visit a health care provider. The health care provider will perform a physical exam and ask you a series of questions regarding the panic attacks you have been experiencing. Most likely the health care provider will also perform a physical examination in order to ensure you are not suffering from a medical condition, which may be causing the panic attacks.

Family history can also play a role in panic attacks so the health care provider will want you to provide any family medical history. It is very important to answer all questions honestly. Panic disorder sometimes runs in families, but no one knows for sure why some people have it, while others don't.

If the health care provider has decided that you are not suffering from a medical or physical condition, he or she will attempt to gather information regarding the time and place of your panic attacks. Many panic attacks occur in certain situations, so the health care provider will attempt to isolate the specific characteristics that cause your panic attacks.

Researchers have found that several parts of the brain are involved in fear and anxiety. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments.

In general, anxiety disorders are treated with medication, specific types of psychotherapy, or both. Treatment choices depend on the problem and the person’s preference. Before treatment begins, a doctor must conduct a careful diagnostic evaluation to determine whether a person’s symptoms are caused by an anxiety disorder or a physical problem. If an anxiety disorder is diagnosed, the type of disorder or the combination of disorders that are present must be identified, as well as any coexisting conditions, such as depression or substance abuse. Sometimes alcoholism, depression, or other coexisting conditions have such a strong effect on the individual that treating the anxiety disorder must wait until the coexisting conditions are brought under control.

People with anxiety disorders who have already received treatment should tell their current doctor about that treatment in detail. If they received medication, they should tell their doctor what medication was used, what the dosage was at the beginning of treatment, whether the dosage was increased or decreased while they were under treatment, what side effects occurred, and whether the treatment helped them become less anxious. If they received psychotherapy, they should describe the type of therapy, how often they attended sessions, and whether the therapy was useful.


Medication will not cure panic disorder. However, doctors may prescribe medication to help treat panic disorder. The most commonly prescribed medications for panic disorder are anti-anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. Many types begin working right away, but they generally should not be taken for long periods.

Antidepressants are used to treat depression, but they also are helpful for panic disorder. They may take several weeks to start working. Some of these medications may cause side effects such as headache, nausea, or difficulty sleeping. These side effects are usually not a problem for most people, especially if the dose starts off low and is increased slowly over time. Talk to your doctor about any side effects you may have.

It's important to know that although antidepressants can be safe and effective for many people, they may be risky for some, especially children, teens, and young adults. Anyone taking antidepressants should be monitored closely, especially when they first start treatment with medications.

Another type of medication called beta blockers can help control some of the physical symptoms of panic disorder such as excessive sweating, a pounding heart, or dizziness. Although beta blockers are not commonly prescribed, they may be helpful in certain situations that bring on a panic attack.

Some people do better with cognitive behavior therapy, while others do better with medication. Still others do best with a combination of the two. Talk with your doctor about the best treatment for you. 


The most common therapy for treating panic disorder is psychotherapy.

Psychotherapy involves talking with a trained mental health professional, such as a psychiatrist, psychologist, social worker, or counselor, to discover what caused an anxiety disorder and how to deal with its symptoms.

A type of psychotherapy called cognitive behavior therapy (CBT) is especially useful for treating panic disorder. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious and fearful. The cognitive portion helps people change the thinking patterns that support their fears, and the behavioral portion helps people change the way they react to anxiety-provoking situations.

For example, CBT can help people with panic disorder learn that their panic attacks are not really heart attacks. When people are ready to confront their fears, they are shown how to use exposure techniques to desensitize themselves to situations that trigger their anxieties.

CBT is undertaken when people decide they are ready for it and with their permission and cooperation. To be effective, the therapy must be directed at the person’s specific anxieties and must be tailored to his or her needs. There are no side effects other than the discomfort of temporarily increased anxiety.

Some people do better with cognitive behavior therapy, while others do better with medication. Still others do best with a combination of the two. Talk with your doctor about the best treatment for you. 

There is no sole cause of panic disorder. Panic disorder sometimes runs in families, suggesting that inheritance plays a strong role in determining who will get it. No one knows for sure why some people have it, while others don't. When chemicals in the brain are not at a certain level it can cause a person to have panic disorder. That is why medications often help with symptoms because they help the brain chemicals stay at the correct levels.

Researchers have found that several parts of the brain are involved in fear and anxiety. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.

If you think you have an anxiety disorder, the first person you should see is your family doctor. A physician can determine whether the symptoms that alarm you are due to an anxiety disorder, another medical condition, or both.

If an anxiety disorder is diagnosed, the next step is usually seeing a mental health professional. The practitioners who are most helpful with anxiety disorders are those who have training in cognitive behavioral therapy and/or behavioral therapy, and who are open to using medication if it is needed.

You should feel comfortable talking with the mental health professional you choose. If you do not, you should seek help elsewhere. Once you find a mental health professional with whom you are comfortable, the two of you should work as a team and make a plan to treat your anxiety disorder together.

Remember that once you start on medication, it is important not to stop taking it abruptly. Certain drugs must be tapered off under the supervision of a doctor or bad reactions can occur. Make sure you talk to the doctor who prescribed your medication before you stop taking it. If you are having trouble with side effects, it’s possible that they can be eliminated by adjusting how much medication you take and when you take it.

Most insurance plans, including health maintenance organizations (HMOs), will cover treatment for anxiety disorders. Check with your insurance company and find out. If you don’t have insurance, the Health and Human Services division of your county government may offer mental health care at a public mental health center that charges people according to how much they are able to pay. If you are on public assistance, you may be able to get care through your state Medicaid plan.

Panic disorder is often accompanied by other serious problems, such as depression, drug abuse, or alcoholism. These conditions need to be treated separately. Symptoms of depression include feelings of sadness or hopelessness, changes in appetite or sleep patterns, low energy, and difficulty concentrating.

Most people with depression can be effectively treated with antidepressant medications, certain types of psychotherapy, or a combination of the two.

People who have full-blown, repeated panic attacks can become very disabled by their condition and should seek treatment before they start to avoid places or situations where panic attacks have occurred. For example, if a panic attack happened in an elevator, someone with panic disorder may develop a fear of elevators that could affect the choice of a job or an apartment, and restrict where that person can seek medical attention or enjoy entertainment.

Some people’s lives become so restricted that they avoid normal activities, such as grocery shopping or driving. About one third become housebound or are able to confront a feared situation only when accompanied by a spouse or other trusted person. When the condition progresses this far, it is called agoraphobia, or fear of open spaces.

Review Date: 
March 13, 2012