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* 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.

What Is Panic Disorder?
Panic disorder is a serious health problem in this country. At least 1.6% 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.

Is Panic Disorder Serious?
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.

What Is the Treatment for Panic Disorder?
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% 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.

What Happens if Panic Disorder Is not Treated?
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.

What Causes Panic Disorder?
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.