This article explains why a person might have their first panic attack, and what causes Panic Disorder even among those with "ordinary" or "normal" lives.

Though panic is a normal, human response to danger, some people experience "attacks" of panic repeatedly, even when there is no danger present. When medical and other causes of panic attacks are ruled out, Panic Disorder may be diagnosed. There is no single cause for Panic Disorder, but rather, there is a combination of contributing factors.

Heredity in Panic Disorder

Panic Disorder is hereditary though studies of identical twins show that not everyone who inherits a predisposition for panic disorder will go on to develop symptoms. This means that heredity is not the only cause.

Childhood Circumstances in Panic Disorder

Certain childhood circumstances are usually present in people who eventually develop panic disorder. Some Panic Disorder sufferers have experienced:

• childhood trauma, neglect, or abandonment;
• parental alcoholism;
• loss of a parent due to death or divorce.

Even if a person’s childhood was perfectly happy, uneventful, and “normal”, certain parenting styles can contribute to Panic Disorder. Some of these parenting styles are fairly commonplace:

• parents who have too-high standards and expectations for their children;
• perfectionistic or overly critical parents;
• parents who are overly fearful and anxious;
• parents who, either consciously or unconsciously, try to suppress their children's efforts to gain mastery and assert themselves.

Cumulative Stress Over Time

It is thought that if the hereditary factor and one or more childhood circumstances are in place, people who experience cumulative stress over time may go on to develop Panic Disorder. The cumulative stress over time might be caused by a series of actual stressful life events, occurring in close proximity to each other.

Even in the absence of stressful life circumstances, cumulative stress over time can be caused by certain personality styles or patterns of thinking. Perfectionism is one example. People with this personality style may not even realize that they are under stress, because this is simply the way they have always been. They don’t realize that their thoughts are negative and stress-inducing to the degree that they actually are.

The Panic "Trigger" vs. the Cause of Panic

Usually there is a stressful life event that precedes a person's first panic attack, like a move, a marriage, a new job, surgery, or a death. Like the straw that broke the camel's back, this event is seen as a panic trigger, not a cause. For example, a new job itself doesn’t cause Panic Disorder or panic attacks. But if the hereditary factor and childhood circumstances are in place, and stress has accumulated and built up over time, the stress of a new job can perhaps trigger an attack of panic.

When the causes of Panic Disorder are understood in this way, it becomes clear that the development of Panic Disorder is not much different than many other health conditions in which stress plays a role. And like many other health conditions, Panic Disorder can be successfully treated.

Not everyone who has a panic attack will go on to develop Panic Disorder. However, early treatment of panic attacks is a good idea so that complications, like the development of phobias, including agoraphobia (fear of panic attacks,) can be prevented.

Comprehensive Treatment Is Best

Since there are a number of contributing factors to panic disorder, treating it involves a comprehensive approach. Medications combined with cognitive-behavioral therapy with a Panic Disorder treatment specialist usually yield the best results, though many people are successfully treated with cognitive-behavioral therapy without ever taking medication.

Anyone experiencing troubling symptoms should consult a medical or mental health professional. This article is for general information only and is not intended to be personal mental health advice, diagnosis or treatment.