Understanding Panic Disorder: When the Body Sounds a False Alarm

Panic is a natural human response — it’s part of the body’s survival system. When we're faced with immediate danger, our bodies activate a fight-or-flight response, flooding us with adrenaline and preparing us to either confront the threat or escape it. But what happens when this alarm system goes off for no clear reason?

That’s where panic disorder comes in.

What Is Panic Disorder?

Panic disorder falls under the category of anxiety disorders, as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

To be diagnosed with panic disorder, a person must meet two main criteria:

• A. They experience recurrent, unexpected panic attacks — sudden episodes of intense fear or discomfort that peak within minutes.

• B. They have persistent worry or concern about having more attacks or experience maladaptive behavior changes as a result. For example, someone might start avoiding places or situations where they've had a panic attack before, fearing it could happen again.

  
  

What Are Panic Attacks?

A panic attack is a sudden surge of overwhelming fear or discomfort, often accompanied by distressing physical and psychological symptoms. These episodes can strike without warning, even during periods of rest or relaxation.

What makes panic attacks especially frightening is that they mimic serious medical emergencies, like heart attacks. In fact, many people experiencing a panic attack for the first time genuinely believe they are dying or losing control of their mind.

Why Does Panic Happen Without Real Danger?

While panic serves a real evolutionary purpose, the issue in panic disorder is that the body misinterprets non-threatening situations as dangerous — essentially a false alarm.

There isn’t a single cause, but a combination of factors may contribute:

• Genetics: Some people may be biologically more prone to anxiety and panic.

• Stress: High stress levels can trigger or worsen panic attacks.

• Sensitivity to bodily sensations: People with panic disorder often have a heightened awareness of internal physical changes, which can spiral into fear.

• Neurochemical imbalances: Dysregulation in brain chemicals like serotonin and norepinephrine may play a role.

• Trauma or major life events: Sometimes panic disorder begins after a period of intense psychological stress.

  
  

Symptoms of a Panic Attack (DSM-5 Criteria)

According to the DSM-5, a panic attack includes at least four of the following 13 symptoms:

1. Palpitations, pounding heart, or accelerated heart rate

2. Sweating

3. Trembling or shaking

4. Sensations of shortness of breath or smothering

5. Feelings of choking

6. Chest pain or discomfort

7. Nausea or abdominal distress

8. Feeling dizzy, unsteady, light-headed, or faint

9. Chills or heat sensations

10. Paresthesias (numbness or tingling sensations)

11. Derealization (feelings of unreality) or depersonalization (being detached from oneself)

12. Fear of losing control or “going crazy”

13. Fear of dying

    
    

No two panic attacks are exactly alike. One person might feel like they can’t breathe, while another might experience intense chest pain or a sensation of detachment from reality. The symptoms are very real, even if there's no external threat.

Living with Panic Disorder

Panic disorder can be incredibly disruptive. Fear of the next attack can lead to avoidance behaviors — skipping social events, not going out alone, avoiding exercise or crowded places — in an attempt to avoid triggering another episode. Over time, this can shrink a person’s world and lead to agoraphobia or other complications.

Getting Help

The good news? Panic disorder is treatable. Common treatment approaches include:

• Cognitive Behavioral Therapy (CBT): Helps reframe thought patterns and reduce fear of panic symptoms.

• Medication: SSRIs, SNRIs, or benzodiazepines may be prescribed in some cases.

• Mindfulness and breathing techniques: These help ground individuals during the early signs of a panic attack.

If you or someone you know is struggling with symptoms of panic disorder, seeking support from a mental health professional can make a significant difference.

Final Thoughts

Panic is part of the human condition — but when the brain’s alarm system misfires too often or too intensely, it can make daily life feel unpredictable and frightening. Understanding what panic disorder is, and recognizing its symptoms, is the first step toward reclaiming a sense of safety and control.

Remember: You're not alone, help is out there.