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More than 3 million adults in the U.S. (1.6 percent) will be affected by panic disorder. The disorder typically begins in young adulthood, though older people and children can also be affected. Women are affected twice as frequently as men. People with panic disorder often experience brief episodes of intense fear which are accompanied by more than one physical symptom (such as heart palpitations and dizziness) that occur repeatedly and unexpectedly in the absence of any external threat. These are known as "panic attacks" and characterize panic disorder. It is thought that panic attacks happen when the brain's normal mechanism for reacting to a threat - the so-called "fight or flight" response - is inappropriately aroused. It is common for people with panic disorder to also feel anxious about the possibility of having another panic attack and therefore avoid situations in which they believe the attacks will occur again. Anxiety regarding the possibility of another attack, and the avoidance behaviors it causes, can lead to significant impairment of daily functioning.