PANIC DISORDER

Panic disorder is the most common of the anxiety disorders, occurring in up to 3% of the adult population. Typically arising when the patient is still young, panic disorder is especially common among women. Panic disorder is present when the patient experiences more than one panic attack; because they can be excruciating experiences, patients worry about having another.

Panic Attack
An estimated 30% of all adults have experienced at least one panic attack. Panic attacks usually begin around the age of 20. Untreated, they can be severely debilitating, although they are often easily treated either with reassurance or by breathing into a paper bag (to rebreathe expired CO2). Situationally predisposed attacks are those in which the patient usually becomes panic-stricken when confronted by the stimulus. Other attacks arise spontaneously, as in panic disorder, and they are referred to as unexpected or uncued.

Criteria for Panic Attack
The patient suddenly develops a severe fear or discomfort that peaks within 10 minutes. During this discrete episode, four or more of the following symptoms occur:

It is estimated that as many as 50% of patients with panic disorder also have symptoms of agoraphobia. When agoraphobia occurs in patients who have panic attacks, it usually develops within the first year. Depression is also frequently found in patients with recurrent panic attacks and the association should not be overlooked.

Panic Disorder with Agoraphobia
On a background of unexpected panic attacks, the patient has had one or more of the following concerns for a month or more after at least one of these attacks:

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