There is no one clear cause of Panic Disorder. However most people report identifiable stressors in the months before their first panic attack including a wide array of possibilities such as relationship problems, work stress, overwhelming time commitments, health issues, death in the family, negative reactions to drugs or alcohol, lack of sleep, poor diet or excessive caffeine use.

Underlying potential risk factors include a history of smoking, asthma or other respiratory problems as well as negative childhood experiences like physical or sexual abuse, separation anxiety and a history of “fearful spells” or anxiety attacks that are less intense than panic attacks.  

Proneness to experiencing negative emotions and sensitivity to anxiety, i.e. believing that anxiety symptoms are harmful can also contribute to the likelihood of developing panic disorder. It is believed that multiple genes confer vulnerability to panic disorder. There is an increased risk for panic disorder among offspring of parents with anxiety, depressive and bipolar disorders.