[Medical Q&A] Panic disorder: How much do you know about those sudden clinical symptoms?

Author: Wang Jinxiang, The Second Affiliated Hospital of Xinxiang Medical College

Reviewer: Guo Yanxiang, deputy chief physician, Shaanxi Province (Xi'an) Mental Health Center

Panic disorder is also known as acute anxiety disorder. Its main characteristics are sudden, unpredictable, recurring, and intense panic experiences that generally last 5 to 20 minutes, accompanied by a sense of impending death or loss of control. Patients often experience fear and terror of a catastrophic outcome, accompanied by symptoms of autonomic dysfunction.

(1) Panic attack: When the patient is not in a particularly fearful situation, he or she suddenly feels a sudden tension, fear, terror, or even panic. At this time, the patient has a sense of loss of control, impending death, and impending disaster. The patient's muscles are tense, he or she is restless, trembling all over, or weak all over. He or she is often accompanied by symptoms of autonomic dysfunction such as sweating, chest tightness, dyspnea, tachycardia, headache, dizziness, numbness of the limbs, and paresthesia. Panic attacks usually start quickly and end quickly, usually lasting from a few minutes to tens of minutes, but may recur suddenly soon after. The patient remains conscious during the attack.

(2) Anticipatory anxiety: Patients remain in fear during the interval between attacks, worrying about another attack.

(3) Avoidance behavior: Most patients have persistent anxiety and concern about the recurrence of panic attacks, fear the adverse consequences of the attacks, and have behavioral changes related to the attacks. For example, when patients are in certain places or situations that may induce panic attacks, these places or situations make patients feel that once a panic attack occurs, it will be difficult to escape or find help, so patients will avoid these situations.