People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. They can’t predict when an attack will occur, and many develop intense anxiety between episodes, worrying when and where the next one will strike. Between episodes, they feel a persistent, lingering worry that another attack could come any minute. When a panic attack strikes, your heart most likely pounds, and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have chest pain or smothering sensations, a sense of unreality, or fear of impending doom or loss of control. You may genuinely believe you’re having a heart attack or stroke, losing your mind, or on the verge of death. Attacks can occur any time, even during non dream sleep. Most attacks average a couple of minutes, but occasionally, they can go on for up to 10 minutes. In rare cases, they may last an hour or more. 

Panic disorder is often accompanied by other conditions, such as depression or alcoholism, and may spawn phobias, which can develop in places or situations where panic attacks have occurred. For example, if a panic attack strikes while you’re riding an elevator, you may develop a fear of elevators and start avoiding them. Some people’s lives become greatly restricted–they avoid normal, everyday activities such as grocery shopping, driving, or even leaving the house. They may be able to confront a feared situation only if accompanied by a spouse or other trusted person. Basically, they avoid any situation they fear would make them helpless if a panic attack occurred. When people’s lives become so restricted by the disorder, as happens in about one third of all people with panic disorder, the condition is called agoraphobia. A tendency toward panic disorder and agoraphobia runs in families. Nevertheless, early treatment of panic disorder can often stop the progression to agoraphobia.