PanicPanic disorder is, naturally, the affliction of people who suffer panic attacks.

What is a panic attack?

It is a discrete period of intense and extreme fear and/or discomfort, which include a minimum of 4 out of 13 typical symptoms. These symptoms will develop suddenly, and reach a climax within approximately 10 minutes.

Though this peak will occur within 10 minutes, this does not mean that it will take 10 minutes in order to peak. The attack can peak as quickly as a few seconds from the start, and subside gradually over anywhere from a few minutes, to a half hour.

Moreover, the typical symptoms can cause other symptoms, such as blurred vision, throughout the panic attack.

The 13 typical symptoms of a panic attack are:

racing or pounding heart
Sweating
trembling or shaking
shortness of breath
feeling of choking
chest pain or discomfort
nausea or abdominal distress
feeling dizzy, unsteady, or faint
feeling unreal or detached
paresthesias (i.e., numbness or tingling sensations)
chills or hot flushes
fear of dying
fear of going crazy or losing control

Panic attacks can occur throughout any of the anxiety disorders, and are usually triggered by specific feared circumstances or occurrences, or by certain anxious thoughts. Truth be told, even people who do not suffer from anxiety disorders can experience a panic attack every now and then.

However, unlike the panic attacks that occur in people with or without other anxiety disorders, sufferers of panic disorder have panic attacks that occur suddenly, with no warning, trigger, or obvious cause. These sufferers experience recurrent, unexpected panic attacks - lasting at least a month - and are frequently plagued with the following discomforts:

Concern, worry, or fear of having more panic attacks
Worried that panic attacks will have negative consequences, for example heart attack, vomiting, fainting, embarrassment, etc
Changes in behavior due entirely to the panic attacks, for example, avoidance of situations in which panic attacks will be even more embarrassing or dangerous, carrying objects that inspire comfort, etc.

The symptoms of panic disorder are not caused by medical conditions or drug side effects or interactions. They are also not a result of some other psychological problem. Those panic attacks are something else altogether. Panic disorder brings about panic attacks all on its own, for no apparent reason.

All to frequently, this will lead a sufferer to develop agoraphobia. While many people think that agoraphobia is a fear of open spaces, this is not at all true. In fact, it is actually a fear of enclosed spaces (such as shopping malls, elevators, etc) in which there are crowds of people, and where "escape" is not easily accessible.

Most people who have panic disorder also have some degree of agoraphobia, to the level that some cannot even leave their own homes. Among the situations avoided by sufferers of agoraphobia are:

Being more than a short distance from home
Leaving home alone
Shopping in a crowded supermarket
Walking through a crowded shopping mall, away from the exits
Riding a bus, train, or subway
Flying on an airplane
Sitting in a theater, away from the exit, or in the middle of a row
Going to a concert
Attending a sports event
Walking alone in the neighborhood
Standing in a long bank line
Going to a party
Sitting in a meeting
Enclosed places (e.g., riding elevators, being in tunnels, small rooms)
Visiting a museum
Walking on a crowded street
Driving on highways, city streets, or other roads
Exercising
Sexual activity

Causes of panic disorder and agoraphobia include both biological and psychological factors.

Biological factors include:

Brain activity
Neurotransmitter interruptions or over-activity
Genetics and heredity

Psychological factors include:

Misinterpretations of panic symptoms
Attention and memory issues
Life experiences

Treatment of panic disorder and agoraphobia depend on the cause. For biologically caused disorders, medications have been extremely useful. For psychologically caused disorders can be treated through either cognitive therapy, "exposure" to situations therapy, "exposure" to sensations therapy, retention of breath therapy. A combination of both medication and cognitive therapies can be very successful.

SUGGESTED READINGS
Craske, M.G., & Barlow, D.H. (2000). Mastery of your anxiety and panic , third edition (MAP 3) (client workbook and client workbook for agoraphobia). San Antonio TX: The PsychologicalCorporation.

Rachman, S., & de Silva, P. (1996). Panic disorder: The facts . New York, NY: Oxford University Press.Wilson, R.R. (1996). Don't panic: Taking control of anxiety attacks (revised edition). New York: Harper Perennial.

Zuercher-White, E. (1999). Overcoming panic disorder and agoraphobia (client manual). Oakland, CA: New Harbinger Publications.