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Running head: PANIC DISORDER
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Panic Disorder: Etiology, Symptoms, and Treatment
Jaime L. Harrington
Florida Institute of Technology
PANIC DISORDER
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Panic Disorder: Symptoms, Etiology, and Treatment
The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American
Psychiatric Association [APA], 2013) entry for Panic Disorder (PD) highlights that panic attacks
must be recurrent. Additionally, there is a difference between a “panic attack” and panic disorder,
noting an “attack” is not a mental disorder and cannot be coded. Panic disorder; however, is a
specifier in the criteria for the disorder. The diagnostic criterion for PD requires more than
simply the presence of recurrent unexpected attacks. According to the DSM, a person must
experience recurrent panic attacks that are unexpected and are triggered by specific situations.
Further beyond the unexpected attacks there must be a consistent worry or fear about having
another attack resulting in behavior changes for at least one month. This results in the diagnosis,
the importance of the attacks, as well as the individual’s response to them.
The diagnostic criteria for Panic Disorder discussed in the DSM-V include:
“An abrupt surge of intense fear or intense discomfort…reaching peak within minutes… four (or
more) of the following symptoms occur:”
“Note: Abrupt surge can occur from a calm or anxious state.”
“Heart palpitations or pounding heart…sweating…muscle trembling or shaking…shortness of
breath or sensation of being smothered… chest pain or discomfort… abdominal distress or
nausea… light-headed or dizzy… derealization or depersonalization… fear of losing control or
dying… chills or numbness… these symptoms are limited-symptom attacks… not attributable to
substance-related effects (e.g., withdrawal, medication side-effects), other medical conditions
(e.g., hyperthyroidism, menopause), other psychiatric disorders (e.g., specific phobias, obsessive
compulsive disorder… diagnosis of panic disorder is based on experience of recurring;
unexpected panic attacks in a person’s life… one attack is followed by a 1-month period of
PANIC DISORDER
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constant worry about having additional attacks (e.g., having a heart attack), the individual
changed their behavior in a maladaptive way (e.g., avoiding situations that may provoke panic
sensations)… the individual may experience frequencies and intensities of expected and
unexpected panic attacks” [APA], 2013).
Panic attacks can occur within the context with any anxiety disorder, stress disorder,
posttraumatic stress disorder, and substance abuse disorder, as well as medical conditions similar
to cardiac or respiratory conditions. PD has been linked to things like heart attacks and/or a
suppressed immune system, and this may not even address what the individual is physically and
mentally dealing with. There are many different types of treatments for PD; typically, some of
the most effective treatments are a combination of medications and talk therapy. With decades of
compelling empirical data, cognitive behavioral therapy (CBT) seems to be the most widely used
and depending on the length of treatment, patients with PD could see significant improvements
in their symptoms. This paper compares previous research into the etiology, symptoms, and the
treatments of panic disorder, as well as discusses any areas that highlight the need for future
research into the disorder, which may benefit any additional and future diagnosis of PD.
Etiology
Researchers examined the development and presence of anxiety symptoms from childhood to
adolescence (Bosquet & Egeland, 2006). They examined infant functioning, attatchment, and
other childhood functioning in 155 children for 17 years. They report that infant reactivity
predicts anxiety symptoms all the way through childhood and adolescence. Many other factors
contributed, but this was consistently present. These data suggest that anxiety disorders can start
and be detected in infants.
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In a seperate study, researchers compared the hormonal stress response differences upon stress
induction in participants with PD, PTSD, MDD, and healthy patients to serve as a function for
diagnosis (Wichman, Kirschbaum, Bohme, & Petrowski, 2017). A total of 118 female patients
were assessed, 47 being healthy, 30 with PD, 23 PTSD, and 18 MDD. Blood samples were taken
from patients in the second half of their menstrual cycle during the late afternoon hours. Their
research supports other studies of a “stress” hormone hypo-responsiveness (muscle response) in
patients with PD, dissociation between the hormone and ACTH (morning hormone)
concentration, as well as a hypo-responsive pattern in comparison to the healthy participants.
The study suggests that stress responsiveness may be a common transdiagnostic marker of the
disorders, further investigation is needed but this gives more insight into the etiology and
symptoms of PD, and why its lifespan is longer in women.
