Panic Disorder vs. Situationally Bound Anxiety

Our brains elicit a fight or flight response when faced with anxiety-provoking events. This evolutionary biological development is designed to protect our well-being by alerting us and helping us respond to, threatening external stimuli.  Whilst the somatic symptoms of panic are considered part of the broad continuum of human reactions, panic disorder is not. 

Panic disorder may be differentiated from normal fear reactions as it does not only involve situation-specific responses. Individuals with the condition experience the recurrent occurrence of panic attacks, persistent worry surrounding the probability or inevitability of future panic attacks, changes in behavior (for instance, avoidance), and misappraisal of somatic symptoms. Collectively, the symptoms of panic disorder lead to significant deficits in day-to-day functioning. Furthermore, panic attacks may be differentiated from situationally-bound anxiety due to the attacks’ rapid peak, unexpected onset, and intense severity.

What is Panic Disorder?

Panic disorder is a debilitating mental health condition characterized by repeated, unexpected, discrete fear, anxiety and apprehension. Panic disorder can be differentiated from other anxiety disorders as its symptoms are primarily somatic/physiological. These occurrences are dubbed “panic attacks”. Hallmarks of panic attacks include heart palpitations or increased heart rate, sweating, trembling, chest pain, lightheadedness, dizziness, hot flushes, derealization and depersonalization, and fear of dying. 

Individuals who misconstrue these somatic anxiety symptoms often arrive at emergency care centres to undergo unnecessary assessments. For example, individuals experiencing shortness of breath may perceive they are suffocating; individuals who experience a racing heart may fear an impending heart attack. Oftentimes, panic attacks surface spontaneously and rapidly, giving almost no warning. A hallmark of a panic disorder is an immense fear of the recurrence of another impending panic attack. 

Further, individuals may take drastic steps to avoid their recurrence. For instance, individuals who believe that a racing heart is indicative of a heart attack, or being out of breath is indicative of suffocation, may avoid exercise. 

Collectively, the symptoms of panic disorder are detrimental to one’s day-to-day life and may lead to considerable distress and impairment across important life domains, interfering with functioning (social, occupational or otherwise). Normal functioning is typically only maintained through conscious exertion and additional effort. 

Importantly, the symptoms of panic disorder are not better explained by another mental health condition, or medical disorder, and are not better attributed to the effects of a substance or medication on one’s central nervous system. Further, these symptoms are not attributable to withdrawal.