What Is Panic Disorder: Causes And Treatment

Panic Disorder is a mental health condition characterized by sudden and repeating episodes of intense fear or discomfort, known as panic attacks. These attacks peak within minutes and are often followed by physical symptoms such as heart palpitations, breath shortness, dizziness, or abdominal distress.

The causes of panic disorder involve a combination of genetic predisposition, life stress, a stress-sensitive temperament, and changes in brain function. Environmental factors and personal experiences, such as trauma, also play a crucial role in the beginning of panic disorder.

Treatment for panic disorder involves a combination of mental therapy, such as cognitive behavioral therapy CBT, and medication, such as antidepressants and benzodiazepines.

What Is Panic Disorder?

Panic disorder is a clinical condition within the spectrum of anxiety disorders, characterized by recurrent and unexpected intense fear known as panic attacks. Panic disorder is seen more in teenagers. According to findings from the National Comorbidity Survey Replication conducted between 2001 and 2003, an estimated 2.3% of teenagers had panic disorder, and 2.3% had severe impairment.

Symptoms of panic disorder in teenagers include palpitations, chest pain, breathlessness, dizziness, and overwhelming feelings of dread or fear of impending doom. Sometimes, these symptoms are so severe that the child fears they are experiencing a heart attack or other life-threatening health crises.

A complex combination of biological and environmental factors influences panic disorder. Genetically, some teens have a predisposed sensitivity to stress, which is made worse by certain brain functions. 

Neurologically, panic disorder is associated with dysregulation in the brain regions that control the fight-or-flight response, such as the amygdala and prefrontal cortex. This dysregulation leads to an exaggerated response to perceived threats, triggering the intense physical symptoms of fear or a panic attack.

Physiologically, during a panic attack, the body’s acute stress response activates, leading to the release of stress hormones like adrenaline and cortisol. This hormonal release causes a rapid increase in heart rate and breathing, redirecting blood flow to muscles and altering digestive processes — all preparing the body to either fight or flee from danger. 

Over time, repeating panic attacks leads to further psychological distress, such as anticipatory anxiety and phobic avoidance behaviors. This distress potentially impacts a child’s ability to function in daily life. The significant effects of panic disorder on both the body and the brain make it crucial to treat, manage, and reduce its impacts.

What Causes Panic Disorder In Teens?

Panic disorder in teens is caused by a complex interplay of genetic, biological, psychological, and environmental factors, each contributing to the manifestation and seriousness of the disorder. The following are the causes of panic disorder in teens:

1. Genetic Factors

Genetic predisposition plays a role in panic disorder. Teenagers with a family history of anxiety disorders are more likely to develop panic disorder, showing that it is hereditary. 

2. Biological factors

Abnormalities in neurotransmitter systems, particularly those involving serotonin and norepinephrine, affect mood and stress responses. Its effects make some teenagers more prone to anxiety and panic. 

Dysfunction in the brain circuits that regulate fear and emotions, such as the amygdala and the hippocampus, also makes teens genetically predisposed to panic attacks.

3. Psychological Factors

Mental health factors are significant in the development of panic disorder. Adolescents with panic disorders have a heightened sensitivity to bodily sensations and an increased tendency to misinterpret these sensations as doom. 

For example, a slight increase in heart rate may be perceived as a heart attack, triggering intense fear and subsequent panic. This misinterpretation and the fear of fear itself increase the risk of attacks and anxiety about future episodes.

4. Environmental Factors

Stressful life events, such as the death of a loved one, major life changes, or traumas, increase the chances of triggering panic disorder in vulnerable teens. Ongoing stress, such as school-related pressure or chronic health issues, also worsens this condition. 

The interaction between these stressful environmental conditions and a child’s biological and psychological makeup leads to the development of panic disorder. 

What Are The Signs Of Panic Disorder In Teenagers?

Panic disorders are very frightening, especially for teens, and significantly affect daily life. The following are some common signs and symptoms associated with panic disorder:

  • Recurrent Panic Attacks: Panic disorder comes with frequent, unexpected panic attacks that often occur without a predictable trigger.
  • Physical Symptoms During Attacks: Physical signs of panic disorder include heart palpitations, sweating, trembling, sensations of shortness of breath, feelings of choking, chest pain, nausea, lightheadedness, chills, numbness, and feelings of unreality or detachment from oneself.
  • Fear of Future Attacks: People experiencing panic disorder have a persistent concern or worry about having more panic attacks or their consequences (e.g., losing control, having a heart attack, or “going crazy”).
  • Behavior Changes: Panic disorder causes a significant change in behavior related to the attacks, such as avoiding situations thought to trigger an attack (e.g., driving, crowded places, being alone).
  • Physical and Emotional Exhaustion: After a panic attack, the child feels very fatigued or washed out, which is a result of the intense physical strain experienced during a panic attack.

How Is Panic Disorder Treated In Teens?

Panic disorder is treated using multiple approaches set up to meet the specific needs of the child. The treatment is based on the seriousness and frequency of the teen’s panic attacks and overall health and preferences. The following are treatments for panic disorder: 

1. Psychotherapy

One of the most effective forms of psychotherapy for panic attacks is Cognitive Behavioral Therapy (CBT). CBT helps teenagers identify and change the thought patterns and behaviors that trigger their panic attacks. 

Other psychotherapy treatments, like exposure therapy, teach teens to gradually face and gain control over the situations and sensations that provoke their anxiety. It helps reduce the frequency and seriousness of their attacks. Other forms of panic disorder therapy include;  

  • Psychodynamic therapy
  • Mindfulness-based interventions

These therapies are beneficial in addressing the underlying emotional issues contributing to panic attacks.

2. Medication

Various types of medications are used to manage symptoms of panic disorder in teens. Selective serotonin reuptake inhibitors (SSRIs), like fluoxetine and sertraline, are commonly prescribed because of their effectiveness and safety profile.

Benzodiazepines are also used in the short term to reduce severe symptoms quickly; however, they have a potential for dependency and addiction. They are to be prescribed with caution. Other medications for panic disorders include; 

  • Serotonin-norepinephrine reuptake inhibitors (SNRIs) 
  • Tricyclic antidepressants

These medications depend on the child’s circumstances and under medical supervision and prescription. 

3. Lifestyle Adjustments

Lifestyle adjustments like regular physical activity, maintaining a healthy diet and ensuring adequate sleep reduce the frequency and seriousness of panic attacks. Stress management techniques and yoga also help teenagers regulate their stress levels and enhance their overall emotional resilience. 

It is also vital to avoid stimulants like caffeine and nicotine, which increase the chances of anxiety symptoms.

Each panic disorder treatment strategy is often more effective when combined with others. So, affected teens need to see a healthcare practitioner to find the most effective treatment plan for their specific needs.

What Are The Impacts Of Panic Disorder?

Panic disorder has several heavy impacts on a child’s life. It affects various aspects of their life. The following are the impacts of panic disorder on teenagers:

  • Psychological Impact: Teenagers with panic disorder experience constant worry about future attacks, leading to chronic anxiety and heightened vigilance against symptoms. These worries worsen into phobias, particularly in places or situations where previous attacks occurred. According to Lepine, J. P. et al.’s 1993 research, 42 out of 100 patients with panic disorder examined had a history of attempting suicide.
  • Physical Health: Frequent activation of the body’s stress response leads to physical symptoms like headaches, dizziness, and gastrointestinal issues. Over time, chronic stress impacts cardiovascular health.
  • Social Functioning: The fear of having a panic attack in public makes these teens avoid social interactions or even public spaces.
  • Quality of Life: The unpredictability of panic attacks diminishes a child’s overall quality of life. It makes it difficult to enjoy activities or relax and sometimes leads to depressive symptoms due to feelings of helplessness and isolation.

How Does Panic Disorder Affect A Teenager’s Life?

Panic disorder leads to persistent worry and avoidance behaviors in teenagers. This isolation restricts personal freedom, impacts social interactions, and reduces overall quality of life. 

Can A Teen With Panic Disorder Live A Normal Life?

Yes, teens with panic disorder can live an everyday and fulfilling life with appropriate treatment. Effective management through therapy, medication, and lifestyle changes greatly reduces the frequency and intensity of panic attacks. 

Can panic disorder in teenagers be a sign of emerging mood disorders?

In teenagers, panic disorder might sometimes be an early indicator of mood disorders such as depression or bipolar disorder. Teenagers with panic disorder might also display significant mood swings, which can be a challenge to distinguish from typical teen moodiness. It’s essential to observe whether mood changes are accompanied by other symptoms like persistent sadness, withdrawal from social activities, or erratic behavior, which could indicate a mood disorder.

At What Age Do Panic Attacks Start?

Panic attacks start at any age, but they most commonly begin in late adolescence and end in early adulthood. However, panic disorder can still start later in life, though these occurrences are less common. 

What Is The Best Medicine For Panic Attacks For Teens?

The best medicine for panic attacks depends on the child’s specific symptoms, medical history, and response to treatment. Selective serotonin reuptake inhibitors (SSRIs), like fluoxetine, sertraline, and paroxetine, are often considered first-line medications because they are generally safe for teens and well-tolerated. 

Author: Shantel Sullivan Ed.D., LCSW
Dr. Shantel Sullivan, Ed.D., LCSW, serves as the CEO of Bright Path with a rich background in residential adolescent treatment, adult outpatient services, and academia, leveraging over a decade of licensed social work experience in New York and North Carolina. Her academic credentials include a BA in Sociology, an MSW and a graduate certificate in addictions counseling from the University of New England, culminating in a doctoral degree in Educational Leadership focused on transformational leadership. Beyond her clinical expertise, Dr. Sullivan contributes to the field as a national speaker, educator, and editor of the Bright Path Teen Mental Health Blog, committed to enhancing access to evidence-based mental health care for adolescents and their families.
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