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Panic disorder has been found to run in families, and this may mean that inheritance plays a strong role in determining who will get it. However, many people who have no family history of the disorder develop it.

Heredity, other biological factors, stressful life events, environment, and thinking in a way that exaggerates relatively normal bodily reactions are all believed to play a role in the onset of panic disorder. Often the first attacks are triggered by physical illnesses, a major life stress, or certain medications. Some people who tend to take on excessive responsibilities may develop a tendency to suffer panic attacks. PTSD patients also show a much higher rate of Panic Disorder than the general population. The exact cause or causes of panic disorder are unknown and are the subject of intense scientific investigation.

Studies in animals and humans have focused on pinpointing the specific brain areas involved in anxiety disorders such as panic disorder. Fear, an emotion that evolved to deal with danger, causes an automatic, rapid protective response that occurs without the need for conscious thought. It has been found that the body's fear response is coordinated by a small but complicated structure deep inside the brain called the amygdala. Eating disorders have also been linked to have caused panic attacks in several people.

Hypoglycemia may also cause panic attacks. In this condition the receptors for insulin do not respond properly to insulin, interfering with the transport of glucose across the membranes of cells. The brain depends on a steady supply of glucose — its only source of energy. When there is a sudden fall in blood sugar levels the brain sends a hormonal signal to the adrenal glands to produce adrenaline. This hormone functions to raise blood sugar levels by converting glycogen into glucose, thus preventing brain starvation, but it is also a panic hormone that is responsible for attacks of fear. The non-drug treatment for this is the adoption of the hypoglycemic diet.[1]

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