What is panic disorder?
Anxiety disorders are defined by the 5th edition of the American Psychological Association (APA)’s Diagnostic and Statistical Manual (DSM-5) as a group of disorders "that share features of excessive fear and anxiety and related emotional disturbances".[1] Panic disorder is an anxiety disorder characterized by recurrent, unexpected panic attacks.[1]
What are the main signs and symptoms of panic disorder?
Per the American Psychological Association (APA), the symptoms of panic disorder are as follows:
- Recurrent, unexpected panic attacks
- Concern or worries about the panic attacks
- Significant, negative changes in behavior related to the panic attacks, such as avoiding situations that might trigger an attack[1]
The main symptom of a panic attack is a sudden attack of fear or intense discomfort. This is accompanied by other symptoms including trembling, sweating, shaking, heart palpitations, a pounding heart, a fast heart rate, a feeling of choking or suffocation, chest pain, nausea, abdominal distress, dizziness, faintness, light-headedness, feeling unsteady, chills, feeling overheated, numbness, tingling, feelings of unreality, depersonalization, fear of losing control, and fear of dying.[1]
How is panic disorder diagnosed?
Panic disorder is diagnosed through a psychological evaluation performed by a clinician after ruling out other potential symptom causes such as medication, drugs, other anxiety disorders, or other medical conditions.[2] The psychological evaluation is typically based on diagnostic criteria set by a publication such as the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) or the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems (ICD).
The diagnostic criteria for panic disorder in the 5th edition of the DSM are as follows: recurrent, unexpected panic attacks, at least one of which must have been followed by a month or more of worries about the panic attack(s) and/or by negative changes in behavior related to the attack. The diagnosis of panic disorder can only be made if the symptoms can't be better explained by the effects of a medication or drug, by another medical condition, or by another mental disorder.[1]
Have any supplements been studied for panic disorder?
Taking inositol regularly may reduce the frequency of panic attacks.[3] In one small randomized controlled trial (RCT) in people with panic disorder, taking 12 grams per day of inositol for a month was more effective at reducing the frequency of panic attacks than a placebo.[4] And in another small RCT, taking 18 grams per day of inositol for a month was as effective as a month of daily fluvoxamine (an antidepressant) at reducing the frequency of panic attacks, although antidepressants like fluvoxamine usually take a minimum of 4 weeks to begin working.[5] Inositol appears to be a promising supplement for panic disorder, although more research is needed.[6]
However, if a panic attack is already in progress, taking a dose of inositol may not have any effect on the panic attack: A 1997 study in seven people with panic disorder found that a single 20-gram dose of inositol had no effect on a chemically-induced panic attack.[7]
Frequently asked questions
Anxiety disorders are defined by the 5th edition of the American Psychological Association (APA)’s Diagnostic and Statistical Manual (DSM-5) as a group of disorders "that share features of excessive fear and anxiety and related emotional disturbances".[1] Panic disorder is an anxiety disorder characterized by recurrent, unexpected panic attacks.[1]
Anxiety, as defined by the APA, combines uneasiness or dread about future events, physical symptoms of tension, and the anticipation of impending danger.[11] In contrast, fear is an emotional and physiological response to an immediate threat.[12] Anxiety and fear are both normal emotions that everyone experiences from time to time. In anxiety disorders, however, anxiety and fear are persistent — present for longer than 6 months — and either are excessive or are present long after they’re developmentally appropriate. Anxiety disorders can often interfere with daily activities, either directly (as with selective mutism, in which people cannot talk in some situations) or because people with anxiety disorders may rearrange their lives to avoid situations that trigger their symptoms (as with agoraphobia, in which certain spaces or situations trigger anxiety).
Per the American Psychological Association (APA), the symptoms of panic disorder are as follows:
- Recurrent, unexpected panic attacks
- Concern or worries about the panic attacks
- Significant, negative changes in behavior related to the panic attacks, such as avoiding situations that might trigger an attack[1]
The main symptom of a panic attack is a sudden attack of fear or intense discomfort. This is accompanied by other symptoms including trembling, sweating, shaking, heart palpitations, a pounding heart, a fast heart rate, a feeling of choking or suffocation, chest pain, nausea, abdominal distress, dizziness, faintness, light-headedness, feeling unsteady, chills, feeling overheated, numbness, tingling, feelings of unreality, depersonalization, fear of losing control, and fear of dying.[1]
An awareness of a rapid heart rate is one of the symptoms of a panic attack, and exercise does temporarily increase heart rate. And it does seem that people with panic disorder may avoid exercise,[8] possibly due to its perceived risks of triggering an attack. However, one small study found that exercise did not induce panic in most of the people with panic disorder in the sample.[9] Moreover, awareness of the physical signs of anxiety may actually decrease after settling into an exercise routine.[10]
Panic disorder is diagnosed through a psychological evaluation performed by a clinician after ruling out other potential symptom causes such as medication, drugs, other anxiety disorders, or other medical conditions.[2] The psychological evaluation is typically based on diagnostic criteria set by a publication such as the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) or the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems (ICD).
The diagnostic criteria for panic disorder in the 5th edition of the DSM are as follows: recurrent, unexpected panic attacks, at least one of which must have been followed by a month or more of worries about the panic attack(s) and/or by negative changes in behavior related to the attack. The diagnosis of panic disorder can only be made if the symptoms can't be better explained by the effects of a medication or drug, by another medical condition, or by another mental disorder.[1]
Taking inositol regularly may reduce the frequency of panic attacks.[3] In one small randomized controlled trial (RCT) in people with panic disorder, taking 12 grams per day of inositol for a month was more effective at reducing the frequency of panic attacks than a placebo.[4] And in another small RCT, taking 18 grams per day of inositol for a month was as effective as a month of daily fluvoxamine (an antidepressant) at reducing the frequency of panic attacks, although antidepressants like fluvoxamine usually take a minimum of 4 weeks to begin working.[5] Inositol appears to be a promising supplement for panic disorder, although more research is needed.[6]
However, if a panic attack is already in progress, taking a dose of inositol may not have any effect on the panic attack: A 1997 study in seven people with panic disorder found that a single 20-gram dose of inositol had no effect on a chemically-induced panic attack.[7]
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References
Examine Database References
- Cortisol - Schruers K, van Diest R, Nicolson N, Griez EL-5-hydroxytryptophan induced increase in salivary cortisol in panic disorder patients and healthy volunteersPsychopharmacology (Berl).(2002 Jun)
- Panic Attacks - Benjamin J, Levine J, Fux M, Aviv A, Levy D, Belmaker RHDouble-blind, placebo-controlled, crossover trial of inositol treatment for panic disorderAm J Psychiatry.(1995 Jul)
- Panic Attacks - Palatnik A, Frolov K, Fux M, Benjamin JDouble-blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorderJ Clin Psychopharmacol.(2001 Jun)