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Causes of Panic Disorder

Not much is known about the reasons why some people and not others will develop Panic Disorder. Having close relatives with this condition increases one's chances of having the disorder, and so genetic factors are suspected to be involved. However, no specific genes have been clearly identified, and it is thought that more than half of the risk of developing this condition stems from non-genetic factors [ref].

Individuals who in childhood endured traumas or disruptions in the attachment bonds with their parents are also at an increased risk for developing Panic Disorder [ref], but this pattern is common to many psychiatric conditions and is not unique to Panic Disorder.

According to Cognitive-Behavioral theory [ref], Panic Attacks are triggered when a person notices themselves having certain uncomfortable body sensations, which were caused by anxiety, but then misinterprets these as a sign that they are having a serious medical emergency. For example, someone who is anxious may start to breathe more heavily or feel their heart racing, and may conclude from these symptoms that they might be having a heart attack. These catastrophic misinterpretations only increase the person's anxiety, which then intensifies those incomfortable body sensations, thus leading to a vicious circle that culminates in a full-blown Panic Attack.

Furthermore, the Cognitive-Behavioral model suggests that people who develop Panic Disorder tend to see themselves as not having much ability to alter or influence threat-related situations, which includes their Panic Attacks [ref]. This leads them to remain perpetually frightened and wary of their Panic Attacks, and thus to panic each time they feel the symptoms coming on. This feeling of powerlessness or lack of control can lead individuals to try to avoid all situations where they may expect Panic Attacks to occur, or where they feel that it would be hard to escape or find help if necessary. This could then lead to Agoraphobia.

A Psychodynamic theory of Panic Disorder [ref] focuses on the fact that Panic Attacks are very often experienced as coming out-of-the-blue, totally spontaneously and without warning, and that affected individuals often have trouble making the connection between their physical symptoms of anxiety and whatever issue it was that was making them anxious or tense in the first place. Not being aware of why these symptoms are occuring makes them feel more ominous and threatening, turning them into the focus of the person's fears.

It can thus be helpful to look back at the precise circumstances that have triggered a person's Panic Attacks, especially their first one, in order to try to determine what may be some of the underlying conflicts or issues. Often times it is not only fear, but also anger and frustration that triggers the Panic Attacks. Individuals with Panic Disorder may have difficulty acknowledging just how angry and upset they really are about certain issues in their lives, and so instead of being aware of these emotions, all they will focus on are the accompanying unpleasant physical sensations.

 

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Diagnosis

Course & Prevalence