22nd February 2024

Background

Panic disorder has a lifetime prevalence of 1-5%. Patients with this disorder experience recurrent and persistent panic attacks over one month. Panic disorders are characterised by continuous worry or anxiety about having further panic attacks or fear of developing health problems due to recurring panic attacks (such as heart attacks). Whilst all patients with a panic disorder experience panic attacks, not everyone who experiences a panic attack has a panic disorder. Appropriate management of a panic attack in the first instance can prevent the development of a panic disorder.

Panic attacks can be related to a particular situation or can occur randomly without any cause. Factors which cause a panic attack are referred to as situational triggers; these can be external or internal. External triggers can be environmental, situational, or related to a phobia. Internal triggers include stress, lack of sleep or caffeinated drinks. Panic attacks that occur without a trigger are referred to as being spontaneous. The frequency and severity of these attacks can be highly variable.

Individuals experiencing panic attacks may avoid situations they believe trigger their panic episodes; this type of behaviour change is a key feature of panic disorder. As a result, patients struggle with everyday functioning and experience a poor quality of life. Historically, agoraphobia has been associated with panic disorder, but in the more recent DSM-5, they are referred to separately. Panic disorders can be present with or without agoraphobia, however, those with debilitating panic disorder often have comorbid agoraphobia.