Symptoms and signs of panic disorder

“I felt like I was going to die — even though I was perfectly healthy from a medical perspective.”

A panic attack often feels like a heart attack or a serious medical emergency. Rapid heartbeat, shortness of breath, chest pain, trembling, numbness — and that hard-to-describe yet paralyzing sensation that “something terrible is happening.” The scariest part is that it all seems to come out of nowhere — and no one else truly understands what’s going on inside you.

Panic disorder is invisible, but incredibly real. In Hungary, thousands live with it daily, often for years without help — feeling ashamed or misdiagnosed. But what exactly is this condition? What happens in the body and mind during an episode? How does it develop — and most importantly, is there a way out?

What is panic disorder?

Panic disorder is characterized by recurring, intense episodes of anxiety that strike without warning, as they’re not tied to any specific situation or context. These panic attacks involve both physical symptoms (like rapid heartbeat, shortness of breath, dizziness) and mental symptoms (like fear of dying, detachment from reality, or feeling as though you're observing yourself from outside). The symptoms usually peak within 10 minutes, then gradually subside — depending on whether the person receives help.

Over time, people may begin to fear the next attack itself — a condition known as anticipatory anxiety. This often leads them to avoid certain places or situations in hopes of preventing another episode.

Prevalence of panic disorder

Panic disorder is influenced by genetic, biological, and psychological factors. Research shows it affects women two to three times more often than men and typically begins between the ages of 20 and 30.

Panic attacks can also appear alongside other conditions, such as anxiety disorders, depression, PTSD, substance use disorders, or even cardiac or respiratory issues.

Key symptoms of panic disorder

The core feature of panic disorder is the recurring panic attack, which strikes suddenly and seemingly without cause.

To be classified as a true panic attack, at least four of the following symptoms must occur at once:

• Rapid heartbeat or palpitations

• Sweating, shaking or trembling

• Shortness of breath or a choking sensation

• Chest pain or tightness

• Nausea or abdominal distress

• Dizziness or lightheadedness

• Chills or hot flashes

• Numbness or tingling sensations

• Feeling disconnected from reality (derealization) or from yourself (depersonalization)

• Fear of losing control or “going crazy”

• Fear of dying

If these panic attacks are accompanied by persistent worry — for example, anxiety about when the next attack might happen — and/or if the person begins avoiding certain situations, it’s considered panic disorder. A common example: someone who has a panic attack on a bus might avoid public transport afterward.

It’s important to note that for a diagnosis, the symptoms must not be caused by substance use (like medications or drugs), a medical condition, or another psychological disorder.

Common causes of panic disorder

Several factors can contribute to the development of panic disorder. From a biological perspective, genetic predisposition plays a key role — the condition often runs in families. Overactivity in certain brain areas, particularly the amygdala (often referred to as the brain’s “alarm system”), can heighten the tendency toward anxiety and increase the likelihood of panic attacks.

Psychological stress is another major trigger. Life events such as divorce, accidents, job loss, or the death of a loved one can overwhelm the system and activate the body’s “emergency response.” Past trauma — including abuse or accidents — can also play a significant role.

Panic disorder often co-occurs with other mental health difficulties, including generalized anxiety, depression, and low self-esteem. Learned behaviors and coping patterns from childhood may also contribute to its onset.

Certain physical health conditions that cause symptoms similar to panic attacks may increase sensitivity to bodily sensations, leading to fear — and eventually triggering full-blown panic. Excessive caffeine, alcohol, or drug use can also provoke or intensify symptoms.

Consequences of untreated panic disorder

If left untreated, panic disorder can significantly impact quality of life. People may begin to avoid places or situations where attacks have occurred, leading to a more restricted daily routine. This avoidance can result in social withdrawal and strained relationships.

Work performance often suffers due to difficulties concentrating and functioning under the constant fear of another episode. Prolonged anxiety, fear, and worry may lead to depression. In some cases, individuals turn to alcohol or medication for relief, increasing the risk of dependency.

It’s important to know that panic disorder is a treatable condition. With timely and appropriate support, the intensity and frequency of attacks can be reduced, and quality of life can greatly improve.

Diagnosing panic disorder

Panic disorder is a type of anxiety disorder. The first step in diagnosis is to rule out any underlying physical conditions that might produce similar symptoms. These can include heart conditions, hormonal imbalances, or respiratory issues. To do this, medical tests such as an ECG, blood pressure monitoring, and lab work are often necessary.

Next, a psychologist or psychiatrist conducts an in-depth conversation with the client to assess the frequency, intensity, and impact of the anxiety episodes. To support the diagnosis, psychological assessments like self-report questionnaires may also be used to help determine the presence and severity of panic disorder.

Managing panic disorder at home

One of the key strategies in managing panic attacks is recognizing what’s happening and reminding yourself that the attack itself isn’t dangerous — and it certainly isn’t life-threatening. The first step is to regulate your breathing: slow, deep breaths can ease physical symptoms and reduce fear.

It’s equally important to focus your attention on the breath during these exercises. This increases body awareness and helps ground you in the present moment. This mindfulness-like state can reduce the power of anxious thoughts and worries that often fuel panic.

For prevention, incorporating anxiety-reducing techniques into daily life is essential. Practices such as mindfulness, meditation, progressive muscle relaxation, or yoga can lower general stress levels and improve emotional balance.

And yes, it may sound cliché — but healthy habits really matter. Regular physical activity, quality sleep, and a balanced diet all support both emotional and mental well-being.

When to seek professional help

Many people experience an intense anxiety episode or panic-like symptoms at some point in life. This doesn’t necessarily mean they have panic disorder. Still, there are signs that suggest it’s time to consider reaching out for professional support.

You should talk to a psychologist or psychiatrist if:

• you experience recurring panic attacks that seem to happen out of the blue,

• the intense physical symptoms (e.g. rapid heartbeat, shortness of breath, dizziness) make you fear a serious medical condition,

• you begin avoiding certain places or situations where you’ve had an attack (e.g. public transport, grocery stores, busy areas),

• you live in constant fear of having another attack, and it’s interfering with your daily life,

• you feel like anxiety is controlling you, limiting your work, social life or free time,

• medical exams haven’t found any physical cause, but the symptoms persist.

Medication for panic disorder

Alongside therapy, medication is often used in treating panic disorder—especially if symptoms are severely impacting your quality of life or if therapy alone isn’t enough.

The goal of medication is to reduce the frequency and intensity of panic attacks, ease ongoing anxiety, and improve overall well-being. It’s important to know, though, that medication doesn’t resolve the underlying causes—therapeutic support is often needed to work through those. The best results typically come from combining medication with psychotherapy, such as cognitive behavioral therapy (CBT).

Therapy for panic disorder

If you’ve experienced a panic attack, it’s best to reach out to a psychologist early on, before the symptoms get worse or develop into panic disorder.

Cognitive behavioral therapy (CBT), a research-backed approach, has proven to be highly effective in treating both panic attacks and panic disorder. Through various cognitive techniques, you’ll learn to interpret your body’s signals more realistically—helping you avoid falling into catastrophic thinking patterns.

Panic disorder isn’t “just in your head” or a sign of weakness. It’s a real, treatable condition—and you don’t have to face it alone. We’re here to help.

The sooner you seek support, the sooner your healing can begin—and the faster you can take back control over your life.

Liked the article? Save it to your bookmarks so you can easily find it later—or share it on your favorite social platform!