We all experience anxiety in life. And most people have experienced flushes of panic in particularly stressful moments, like right before stepping on stage for a performance or taking a make-or-break test. Some of us have even had a particularly frightening "out of the blue" panic attack. But only a few people--about 3.5% of the total population--go on to develop panic disorder. So the question is, what is happening for those relatively few people who do develop panic disorder? Years of empirical and observational research in this area has told us that the answer is actually quite simple: fear. Panic disorder doesn't arise from the panic symptoms themselves, which are frightening but actually harmless, but rather from a person's fear of those symptoms as being something dangerous and life threatening. Once they experience panic symptoms, certain people develop a inescapable horror of them because they are convinced that they lead to terrible things like mortification, insanity, death and doom.
Researchers have compiled evidence suggesting that it is a complex combination of both biological and psychological vulnerabilities that makes certain people especially prone to developing panic disorder. The term many researchers use for this is "anxiety sensitivity" (Dr. Richard McNally, Panic Disorder: A Critical Analysis, 1994). People who have high anxiety sensitivity are simply far more afraid of panic sensations than others are. They react to them with intense fear. This can intensify the panic attacks themselves and make someone prone to having more of them because they are (often unconsciously) on pins-and-needles, alert to every tiny bodily sensation that might signal an oncoming panic attack.
While high anxiety sensitivity may be a part of some peoples' normal dispositions, panic disorder is not a condition that anyone has to live with when effective exposure-based cognitive behavioral treatments are available.