Whilst no single cause has been found, a number of factors are thought to contribute to the development of panic disorder and its associated symptoms. These factors include:
• Stressors in adulthood: Stressors such as the death of a loved one, physical illness and injury, and social conflicts might trigger panic disorder.
• Stressors in childhood: Childhood maltreatment and other early life stress has been associated with the development of panic disorder. Both direct and indirect experiences of physical illness in childhood, particularly respiratory conditions (e.g., asthma), may also play a role.
• Cognitive factors: People with panic disorder are thought to have a higher sensitivity to internal bodily sensations (e.g., heart rate, breathing patterns) and misinterpret any changes in these sensations as being life threatening. This increased sensitivity and the negative thoughts that follow are thought to trigger and contribute to panic symptoms.
• Smoking: Cigarette smoking can serve as a risk factor in the development of panic disorder and may contribute to the experience of panic attacks.
• Substance use: The use of stimulants both illicit (e.g., cocaine) and licit (e.g., caffeine) is associated with an increased risk of panic attacks.
• Temperament: Personality factors, such as being highly anxious, tense, moody, and self-conscious, may also play a role in the development of panic disorder.
• Neurobiological factors: Studies suggest that in individuals with panic disorder, fear circuitry in the brain may be oversensitive and be triggered by events that pose no threat to the person.
• Genetic factors: People who have a first-degree relative with panic disorder have an increased chance of developing the disorder.