Panic disorder is a very common anxiety disorder, often misunderstood even by doctors in other specialties. Panic attacks manifest as sudden episodes of physical symptoms accompanied by intense fear of death, fainting, or losing one's mind.

A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause for the fear. Panic attacks can be extremely frightening. During a panic attack, you may believe you are losing control, having a heart attack, or even dying.

Diagnostic criteria according to DSM-5:
A. Recurrent unexpected panic attacks: A panic attack is a sudden wave of intense fear or distress that reaches its peak within minutes, during which four (or more) of the following symptoms occur:
1. Palpitations, heart palpitations, or a racing heartbeat.
2. Sweating.
3. Trembling or shaking.
4. Shortness of breath or a feeling of suffocation.
5. Feelings of being choked. 6. Chest pain or discomfort.
6. Nausea or abdominal tightness.
7. Dizziness, unsteadiness, lightheadedness, or fainting.
8. Chills or a feeling of heat.
9. Paresthesia (numbness or tingling sensation).
10. Derealization (feeling unreal) or depersonalization (disconnection from oneself).
11. Fear of losing control or "going crazy."
12. Fear of dying.

B. At least one attack is followed one month (or more) by one or both of the following:

1. Persistent worry or anxiety about further panic attacks or their consequences (e.g., losing control, having a heart attack, or "going crazy").

2. A significant, maladaptive change in behavior related to the attacks (e.g., behaviors designed to avoid panic attacks, such as avoiding exercise or unfamiliar situations).
C. The disorder is not attributable to the physiological effects of a substance (e.g., drug abuse, medication) or another medical condition (e.g., hyperthyroidism, car exhaustion).

D. The disorder is not better explained by another mental health disorder.

Contributing Factors to Panic Disorder

1. Major life stressors, such as the death or serious illness of a loved one.
2. A traumatic event, such as sexual assault or a serious accident.
3. Major life changes, such as divorce or the birth of another child.
4. Smoking or excessive caffeine consumption.
5. A history of physical or sexual abuse in childhood.
6. Genetic predisposition.
7. Brain changes: Panic attacks can be linked to changes in brain chemistry, particularly in anxiety-related chemicals such as serotonin.
8. A family history of panic attacks or panic disorder.

Interceptive Exposure Therapy
1. Hyperventilate for 1 minute. Breathe deeply and rapidly.
2. Hold your breath and close your nose for 30 seconds.
3. Draw in a deep breath. Then breathe out rapidly and shallowly into your chest for 1 minute.
4. Rock your head from side to side for 30 seconds.
5. Rotate around your axis for 30 seconds. Then do not hold onto anything or sit still.
6. Tens up all the muscles in your body for 1 minute, or alternatively, hold a push-up position for 1 minute.
7. Step up and down for 1 minute.
8. Put your head between your legs for 30 seconds, then stand up quickly.
9. Stare at the same point for 2 minutes. Focus intensely without blinking.
10. Stare at a (fluorescent) light for 30 seconds, then stare at a blank wall.