Biology 202
2002 First Paper
On Serendip

Panic Disorder Symptoms and Causes
By: Natasha Gjivoje
Everyone, at one point or another, has felt anxious. It could have been due to stress. It could have been as a result of having to perform in front of an audience. It could have been for fear of not being accepted by the graduate school of your choice. But have you ever had episodes of intense anxiety and fear, unexpectedly and in the absence of any real external threat? If you have, then you were very likely experiencing a "panic attack," the hallmark of panic disorder, which occurs when the brain’s normal mechanism for reacting to a threat become used inappropriately (9). This disorder is associated not only with a number of somatic and cognitive symptoms, but has a large number of possible causes as well. Generally, it is possible to have healthy people experience an isolated panic attack and not actually have the panic disorder. Up to ten percent of people with panic attacks fit in this category (6). In order to be diagnosed with the panic disorder, a person must experience at least two unexpected panic attacks and develop constant concern about having another attack (4). In the United States, about three million people will experience panic disorder at some point in their life(3).

So what are the symptoms of a panic disorder? As mentioned above, a person can have a panic attack and not have a panic disorder, but all panic disorders begin with panic attacks. During the attack, the person might experience just several or more than several of the following symptoms (to be deemed a panic disorder, the person must experience at least four of the following symptoms): racing or rapid heart beat, chest pain, breathing difficulties, choking sensation, nausea and/or vomiting, a feeling of detachment from the body, dizziness, shaking/trembling, excessive perspiration, sleeping difficulties, and among others, a lack of concentration, and a fear of dying/having a heart attack (1). Most panic attacks last for only several seconds, but the symptoms may persist for several hours (2).

A person with a panic disorder, in which the panic attacks recur often, eventually develops a fear of having another attack. This often actually induces a panic attack and the cycle just keeps on going (6). Many times the patient will convince himself/herself so fervently that they are dying that many sufferers often feel the need to go to the emergency room and get tested. Even though this disorder is easily as well as successfully treatable, if it is not diagnosed it can become very debilitating to the individual (9).

But what causes a panic disorder? There is no definitive answer when it comes to this question. It is believed that there are a number of causes for this type of disorder, ranging form causes of genetic nature, to causes tied to the brain and biochemical abnormalities (6). Sometimes panic disorders run in families. It is not unusual for a mother and a daughter to have a panic disorder, just like it has been proved through research that if one of genetically identical twins has the disorder, it is likely that the other will also (9). Thus the conclusion is that in some cases a genetic factor, in combination with the environment, may play a role in the individual’s predisposition to the mental illness.

On the other hand, some individuals are believed to have panic disorder due to biochemical abnormalities in the brain. Research suggests that this type of mental illness many be a result of increased activity in the hippocampus and locus coeruleus, portions of the brain that monitor internal and external stimuli and control the brain’s responses to them (6). There is also indication that the amygdala plays a role in this disorder. The amygdala, along with the hippocampus are major centers of the limbic system—a system that "controls" our emotions (5).
Also, in this type of disorder, many neurotransmitter alterations exist. Those neurotransmitters include serotonin, norepinephrine, gamma-aminobutyric acid, corticotropin-releasing hormone, and cholecystokinin. Since all these neurotransmitters are closely related and work together in the body, it only takes a change in one to cause a change in all of them, resulting in a number of extensive feedback mechanisms (6). For that reason, panic disorders are treated with, for example, Selective Serotonin Reuptake Inhibitors, which work block the reuptake of serotonin in the body so that its presence is increased in the brain. This is very important because serotonin is a neurotransmitter that plays a major role in "quieting" the stress response (7).

But a panic disorder can also be triggered by an "overdose" of a stimulant such as caffeine or cocaine. Caffeine is a stimulant that interferes with a chemical in the brain called "adenosine." This chemical acts as a natural tranquilizer or a sedative in our body, and when it is meddled with, it can not work properly to calm the body down and therefore the individual is more likely to experience a panic attack (8).

In addition to the above causes, medical professionals believe that panic disorders focus on bringing underlying conflicts in an individual to expression—such as anger and unexpressed conflicts in intimate relationships. Also, those who believe in the above notion place emphasis on the importance of a person’s way of thinking, a person’s response to stress, and their overall perception. Individuals with panic disorder often feel that they are unable to control their lives and are unable to attain certain goals and achievements. Statistically speaking, women are twice as likely to develop a panic disorder then are men, probably due to their more "vulnerable" nature and increased likeliness of taking things more seriously and letting events effect them more permanently then men (6).

There are many theories concerning the causes of panic disorder. And they are probably all applicable and necessary for everyone is an individual, and everyone has different predispositions, whether those happen to be genetic, or biochemical, or both. That is why it is much easier to point out a symptom of a panic disorder than it is to point out its cause. Panic disorders are currently widely studied and researched. This type of disorder, although treatable, can be very devastating and debilitating to the person if it goes on untreated—it can cause specific phobias such as fear of driving a car, or fear of leaving the house. It can cause the loss of a job, and it can cause relationship problems (4). Luckily, even with this disorder’s rather undefined nature of causality, there is much treatment available that has helped at least eighty percent of panic disorder sufferers cope with this problem (6).

WWW Sources
1)Anxiety and Panic Hub, resource about anxiety and panic attacks

2)APA Online, Answers to Q’s about panic disorder

3)Panic Disorder, good overview of disorder and its treatments

4)Anxiety Disorders- including Panic Disorder and Phobias, additional info on panic attacks

5)Anxiety Disorders Treatment Target: Amygdala Circuity, explains how amygdala may have a role in anxiety and panic disorder

6)Mental Health: A Report of the Surgeon General, great site for panic disorder info

7)SSRI’s and Panic Disorder, All about Paxil, Prozac, Zoloft, and Luvox

8)Caffeine…Panic Attacks and caffeine don’t mix, effects of caffeine on panic attacks

9)Understanding Panic Disorder, additional info about panic disorder

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