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Panic disorder is characterized by recurrent, unexpected panic attacks � sudden surges of intense fear or discomfort peaking within minutes � accompanied by persistent concern about future attacks.
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Panic disorder is characterized by recurrent, unexpected panic attacks � sudden surges of intense fear or discomfort peaking within minutes � accompanied by persistent concern about future attacks. Dr. Ruja Shrestha (NMC 19766, Experienced clinical practice in psychiatry and mental health) evaluates panic disorder at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, Opposite of Yak & Yeti Hotel, Kathmandu 44600, Nepal — evidence-based, medically reviewed.
Panic disorder involves recurrent panic attacks, which are discrete episodes of intense fear or discomfort with symptoms such as palpitations, sweating, trembling, shortness of breath, chest pain, and fear of dying or losing control. Between attacks, individuals develop persistent worry about future attacks and maladaptive behavioral changes (avoidance). Panic disorder affects approximately 2-3% of the population and often co-occurs with agoraphobia, depression, and other anxiety disorders.
Diagnosis is clinical, based on DSM-5 or ICD-11 criteria: recurrent unexpected panic attacks followed by at least one month of persistent concern about future attacks or maladaptive changes in behavior. The Panic Disorder Severity Scale (PDSS) is a validated measure. Medical evaluation should exclude cardiac, pulmonary, endocrine, and neurological causes of episodic symptoms (thyroid dysfunction, cardiac arrhythmia, pheochromocytoma).
Cognitive-behavioral therapy (CBT) is first-line, focusing on cognitive restructuring of catastrophic misinterpretations of bodily sensations and interoceptive exposure. SSRIs (sertraline, paroxetine) and SNRIs (venlafaxine) are first-line pharmacotherapy. Benzodiazepines may be used short-term for acute management but carry dependence risk. Combination of CBT and medication is effective for moderate to severe cases.
Management is individualized and discussed with benefits, limitations, and follow-up.
Limiting caffeine and stimulant intake, maintaining regular sleep and exercise, stress management, and early treatment of anxiety symptoms. Avoiding catastrophic thinking about bodily sensations reduces the risk of developing panic disorder following isolated panic attacks.
No. Panic attacks are extremely distressing but are not medically dangerous. However, they can mimic heart attacks, so new or atypical chest pain should be medically evaluated to exclude cardiac causes.
Panic disorder is characterized by discrete, unexpected panic attacks and persistent worry about future attacks. Other anxiety disorders (GAD, social anxiety) involve more continuous worry without the episodic pattern of panic attacks.
Agoraphobia involves fear or avoidance of situations where escape might be difficult or help unavailable during a panic attack (public transport, enclosed spaces, crowds). It can occur with or without panic disorder.
Yes � Dr. Jitendra Prasad Yadav (NMC 8029) provides panic disorder assessment and treatment at Kathmandu Neurology Clinic & Cognitive Center.
CBT is highly effective, with response rates of 70-90%. Most individuals show significant improvement within 8-15 sessions. Medication can be combined for moderate to severe cases.
Comprehensive psychiatric evaluation for mood, anxiety, psychosis, and other mental health concerns, including medication assessment and long-term care planning.
Structured, evidence-based cognitive behavioral therapy for anxiety, depression, insomnia, and related conditions.
Evaluation and management of generalized anxiety, panic disorder, social anxiety, and phobias.
Generalized anxiety disorder (GAD) involves persistent, excessive worry about everyday matters that is difficult to control and may cause physical symptoms.
Obsessive-compulsive disorder (OCD) is characterized by intrusive, persistent thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that are time-consuming and cause significant distress.
Social anxiety disorder (social phobia) is characterized by marked fear or anxiety about social situations in which the individual may be scrutinized by others, leading to avoidance or endurance with intense distress.
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Understanding Anxiety Disorders: Types, Symptoms, and Evidence-Based Approaches
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Panic Attacks: Understanding, Coping, and Treatment Options
What panic attacks are, how they differ from anxiety, immediate coping strategies, and evidence-based treatments that can reduce their frequency and severity.
Content on this website is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified healthcare professional. Always seek the advice of your physician or other qualified provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. In case of a medical emergency, contact emergency services immediately. No doctor–patient relationship is established by use of this site or by contacting the clinic through the site.
Reviewed by Dr. Jitendra Prasad Yadav • Last reviewed: 2026-09-04
Content is educational and aligns with standard medical references; individual evaluation may vary. External links provide context and do not imply endorsement.
Doctor — medically reviewed
Dr. Ruja Shrestha
Consultant Psychiatrist & CBT Therapist • MBBS, MD (Psychiatry) • NMC 19766
This condition guide was medically reviewed by Dr. Ruja Shrestha.
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