**1. Introduction**

A panic attack is an intensive fear characterized by unexpectedness and immobilizing intensity. Often strikes without any warning, very often with no clear trigger, and also may occur when the person is relaxed or even when is asleep. Panic attacks are common. A panic attack can be a one-time occurrence, but usually many people experience repeat episodes, in a longer lifetime period. Among persons that ever had a PA, the majority had recurrent PAs (66.5, s.e. 0.5%). Most people recover without treatment, only a few of them from panic attacks develop panic disorder. Lifetime prevalence of PAs is 13.2% (s.e. 0.1%) [18].

Sometimes recurrent panic attacks are often triggered by a specific situation, in which the person felt endangered before. A panic attack may also occur as part of another disorder, such as panic disorder, social phobia, or depression.

Depending on the relationship between the occurrence of the attack and absence or presence of situational triggers, panic attacks can be divided into the following:


are more likely to occur during the ride, but sometimes individuals they can drive and have no panic attacks, or they happen half an hour after the ride).


The onset of unexpected panic attacks is necessary for the diagnosis of panic disorder with or without agoraphobia.

The frequency and severity of panic attacks vary widely. For example, some individuals have intermediate frequency attacks (e.g., once a week), which occur constantly for months. Others report frequent attacks in a short period (day, week) that are separated for a long period (weeks or months) without seizures or with rare attacks (two per month) over a long period of time. Attacks with limited symptoms (e.g., identical to full panic attacks, but with fewer associated symptoms) are very common in panic disorder.

## **2. Manifestation and diagnosis of panic disorder**

#### **2.1 The signs and symptoms of a panic attack**

The signs and symptoms of a panic attack may include hyperventilation, heart racing, chest pain, and trembling, sweating, and dizziness, with a fear of losing control, going crazy, or dying.

#### **2.2 The signs and symptoms of panic disorder**

Among persons that ever had a PA only 12.8% fulfilled DSM-5 criteria for PD. In comparison with panic attacks, panic disorder is characterized by repeated panic attacks. Panic disorder (PD) is a chronic mental disorder with essential features such as recurrent panic attacks, persisting concern about the attacks, and a change in behavior as a result of the attacks [17].

The lifetime prevalence of PD is two times more likely to occur in women than in men [32]. Age of onset for PD is a wide range between 25 and 53 years regardless of gender. Alongside the variation in age, the most probable period is the late adolescence and the middle of the 1930s. A certain number of PD cases begin in childhood or after 45 years of age [33]. Panic disorder usually begins in late adolescence or early adulthood and affects women about two times more often than men. The median age of onset is 32. Cross-national lifetime prevalence estimates is 1.7% for PD [18].

Individuals with PD show distinctive concern about the consequences of panic attacks. Some fear that attacks indicate the presence of an undetected life-threatening disease (e.g., heart disease), and others fear that panic attacks indicate that they are causing, losing control, or being emotionally weak. However, patients with PD do not necessarily show deterioration in the quality of their lives by becoming prisoners of panic attacks [17]. Some individuals with PD significantly change their behavior (e.g., they leave work). Concerns about the next attack or its consequences are often associated with avoiding behavior. Hence, PD is defined as an experience of having panic attacks and as emotional and behavioral consequences from it.

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theories.

*Panic Attacks and Panic Disorder*

**2.3 Diagnosis of panic disorder**

• Complete physical exam.

common)

thoughts;

agoraphobia.

nied travel by another person;

• Avoiding the phobic situation

*DOI: http://dx.doi.org/10.5772/intechopen.86898*

To help pinpoint a diagnosis it is necessary to do:

such as an electrocardiogram (ECG or EKG).

• Check alcohol or other substance use.

stances where there is no objective danger;

out a psychological self-assessment or questionnaire.

Criteria for diagnosis of panic disorder according to ICD-10 are:

• Blood tests to check the thyroid and other possible conditions and tests on heart,

• Psychological evaluation about symptoms, fears or concerns, stressful situations, relationship problems, situations that are avoided, and family history. Fill

• At least 1 month many attacks with vegetative anxiety which occur in circum-

• Panic attacks are without restrictions on known and predictable situations

• There is no symptoms of anxiety between seizures (although anxiety may be

• Psychological or vegetative symptoms are primary manifestations of anxiety, and not secondary to other symptoms, such as crazy ideas or obsessive

• Anxiety must be limited to at least two of the following situations (or mainly to occur only in them): crowds, public places, travel from home, or unaccompa-

A single panic attack may only last a few minutes, up to 20–30 min, but can

• Anticipatory anxiety in between panic attacks, the patient feels anxiety and tension, because of a fear of having future panic attacks. This "fear of fear" is present most of the time, and can be extremely disabling in everyday life.

• Phobic avoidance of certain situations or environments. This avoidance may be based on the belief that the situation that is avoided caused the previous panic attack, or is a place where the escape is difficult or the help is unavailable in case of a panic attack. Taken to its extreme, phobic avoidance becomes

The causes have not been fully illuminated, although there are a number of

cause serious problems in the everyday life. This can also lead to:

**3. Causes of panic attacks and panic disorder**
