Panic Disorder

[ Cover of publication ] [ blank box ] What are the symptoms of a panic attack?
What is panic disorder?
Is panic disorder serious?
What is the treatment for panic disorder?
What happens if panic disorder is not treated?
What causes panic disorder?
Where do I write for more information?

"All of a sudden, I felt a tremendous wave of fear
for no reason at all. My heart was pounding,
my chest hurt, and it was getting harder to breathe.
I thought I was going to die."

"I'm so afraid. Every time I start to go out,
I get that awful feeling in the pit of my stomach
and I'm terrified that another panic attack is coming."


As described above, the symptoms of a panic attack appear suddenly, without any apparent cause. They may include

Racing or pounding heartbeat
Chest pains
Dizziness, lightheadedness, nausea
Difficulty breathing
Tingling or numbness in the hands
Flushes or chills
Dreamlike sensations or perceptual distortions
Terror--a sense that something unimaginably horrible is about to occur and one is powerless to prevent it
Fear of losing control and doing something embarrassing
Fear of dying

A panic attack typically lasts for several minutes and is one of the most distressing conditions that a person can experience. Most who have one attack will have others. When someone has repeated attacks, or feels severe anxiety about having another attack, he or she is said to have panic disorder.


Panic disorder is a serious health problem in this country. At least 1.6 percent of adult Americans, or 3 million people, will have panic disorder at some time in their lives. The disorder is strikingly different from other types of anxiety in that panic attacks are so sudden, appear to be unprovoked, and are often disabling.

Once someone has had a panic attack--for example while driving, shopping in a crowded store, or riding in an elevator--he or she may develop irrational fears, called phobias, about these situations and begin to avoid them. Eventually, the pattern of avoidance and level of anxiety about another attack may reach the point where the individual with panic disorder may be unable to drive or even step out of the house. At this stage, the person is said to have panic disorder with agoraphobia. Thus panic disorder can have as serious an impact on a person's daily life as other major illnesses--unless the individual receives effective treatment.


Yes, panic disorder is real and potentially disabling, but it can be controlled with specific treatments. Because of the disturbing symptoms that accompany panic disorder, it may be mistaken for heart disease or some other life-threatening medical illness. People frequently go to hospital emergency rooms when they are having a panic attack, and extensive medical tests may be performed to rule out these other conditions.

Others often try to reassure the person who is having a panic attack that he or she is not in great danger. Expressions such as "nothing serious," "all in your head," or "nothing to worry about" may give the incorrect impression that there is no real problem and that treatment is not possible or necessary.


Thanks to research, there are a variety of treatments available, including several effective medications, and also specific forms of psychotherapy. Often, a combination of psychotherapy and medications produces good results. Some improvement may be noticed in a fairly short period of time--about 6 to 8 weeks. Thus appropriate treatment of panic disorder can prevent panic attacks or at least substantially reduce their severity and frequency--bringing significant relief to 70 to 90 percent of people with panic disorder.

In addition, people with panic disorder may need treatment for other emotional problems. Depression has often been associated with panic disorder, as have alcohol and drug abuse. Recent research also suggests that suicide attempts are more frequent in people with panic disorder. Fortunately, these problems associated with panic disorder can be overcome effectively, just like panic disorder itself.

Tragically, many people with panic disorder do not seek or receive treatment. To encourage recognition and treatment of panic disorder, the National Institute of Mental Health (NIMH) is sponsoring a major information campaign to acquaint the public and health care professionals with this disorder. NIMH is the agency of the U.S. government responsible for improving the mental health of the American people by supporting research on the brain and mental disorders and by increasing public understanding of these conditions and their treatment.


Panic disorder tends to continue for months or years. It typically begins in young adulthood, but the symptoms may arise earlier or later in life. If left untreated, it may worsen to the point where the person's life is seriously affected by panic attacks and by attempts to avoid or conceal them. In fact, many people have had problems with friends and family or lost jobs while struggling to cope with panic disorder. It does not usually go away unless the person receives treatments designed specifically to help people with panic disorder.

So, if you or someone you know has symptoms like those described in this brochure, it is important to see a health care professional for a correct diagnosis and proper treatment.


According to one theory of panic disorder, the body's normal "alarm system" tends to be triggered unnecessarily. Scientists don't know exactly why this happens. Panic disorder has been found to run in families, and this may mean that inheritance (genes) plays a strong role in determining who will get it. However, many people who have no family history of the disorder develop it. Often the first attacks are triggered by physical illnesses, a major life stress, or certain medications.

NIMH supports research with animals and humans to learn more about the causes of panic disorder and to find better ways of controlling it.


Anxiety Disorders Association of America
6000 Executive Boulevard, Suite 513
Rockville, MD 20852
American Psychiatric Association
1400 K Street, N.W.
Washington, D.C. 20005
American Psychological Association
750 First Street, N.E.
Washington, D.C. 20002-4242
National Institute of Mental Health
Panic Campaign
5600 Fishers Lane, Room 7C-02
Rockville, MD 20857


Research conducted and supported by the National Institute of Mental Health brings hope to millions of people who suffer from mental illness and to their families and friends. During the past 10 years, researchers have advanced our understanding of the brain and vastly expanded the capability of mental health professionals to diagnose, treat, and prevent mental and brain disorders.

Now, in the 1990s, which the President and Congress have declared "The Decade of the Brain," we stand at the threshold of a new era in brain and behavioral sciences. Through research, we will learn even more about mental disorders such as depression, bipolar disorder, schizophrenia, panic disorder, and obsessive-compulsive disorder. And we will be able to use this knowledge to develop new therapies that can help more people overcome mental illness.

The National Institute of Mental Health is part of the National Institutes of Health (NIH), the Federal Government's primary agency for biomedical and behavioral research. NIH is a component of the U.S. Department of Health and Human Services.

All material in this pamphlet is free of copyright restrictions and may be copied, reproduced, or duplicated without permission from the Institute; citation of the source is appreciated.


This pamphlet was written by Mary Lynn Hendrix, science writer in the Office of Scientific Information, NIMH. Expert assistance was provided by the Scientific Advisory Committee on Panic Disorder: Lewis L. Judd, M.D., chairman; Kenneth Altshuler, M.D.; James Ballenger, M.D.; David Barlow, Ph.D.; Bernard Beitman, M.D.; Dennis Charney, M.D.; Jack Gorman, M.D.; Robert Hirschfeld, M.D.; Matig Mavissakalian, M.D.; Larry Michelson, Ph.D.; Jerilyn Ross, M.A., L.I.C.S.W.; Gary Tucker, M.D.; Michael Telch, Ph.D.; Thomas Uhde, M.D.; Myrna Weissman, Ph.D.; and the following NIMH staff: Alan I. Leshner, Ph.D.; Hagop Akiskal, M.D.; Jack Maser, Ph.D.; Barry Wolfe, Ph.D.; Susan Blumenthal, M.D.; Marsha Corbett; Joan Abell; Lynn Cave.

This pamphlet is provided by the NIMH Panic Disorder Education Program. For more information, call 1-800-64-PANIC.

U.S. Department of Health and Human Services
Public Health Service
National Institutes of Health
National Institute of Mental Health
NIH Publication No. 93-3508
Printed 1991; Reprinted as (ADM)92-1869) 1992
Printed 1993

Bulk sales (Stock No. 017-024-01465-6) by the U.S. Government Printing Office, Superintendent of Documents, Mail Stop: SSOP, Washington, DC 20402-9328.