Etiology (Biopsychosocial Model)

Biological: Dysregulation of noradrenergic and serotonergic systems.

Psychological: Anxiety sensitivity, catastrophic thinking.

Social: Stressful life events, modeling from caregivers.

Symptoms & Diagnosis (Mnemonic: STUDENTS FEAR 3Cs)

• S - Sweating
• T - Trembling or shaking
• U - Unsteady (dizziness)
• D - Derealization/depersonalization
• E - Excessive heart rate (palpitations)
• N - Nausea or abdominal distress
• T - Tingling sensations
• S - Shortness of breath/smothering

• F - Fear of dying or losing control
• E - Chills or hot flushes
• A - Accelerated heart rate
• R - Recurrent unexpected attacks

• 3Cs - Concerns about implications, Consequences, Change in behavior

Treatment

CBT: First-line treatment, including interoceptive exposure techniques.

Pharmacotherapy: SSRIs are preferred; benzodiazepines may be used for acute relief.

Psychoeducation: For patient and caregivers to understand and manage the disorder.

Breathing retraining: To help control hyperventilation and panic symptoms.