What is the pathophysiology of panic disorder?

The pathophysiology of panic disorder is primarily associated with an increased catecholamine surge from the sympathetic nervous system. During a panic attack, the body experiences a heightened state of arousal and activates the 'fight or flight' response, leading to this surge of catecholamines, particularly norepinephrine and epinephrine. This surge can explain many of the physical symptoms associated with panic attacks, such as palpitations, sweating, trembling, and feelings of impending doom.

While decreased serotonin levels, dopamine imbalances, and increased cortisol levels can be involved in other psychiatric disorders or stress responses, they do not specifically account for the acute physiological changes observed during panic attacks. The role of catecholamines is central to understanding the acute anxiety and panic experienced in panic disorder, making it the correct explanation for its pathophysiology.