Of the adrenergic nervous system’s many functions, one, the “fight or flight” response, has served humans well. This response occurs whenever one encounters a dangerous situation in which one’s survival depends upon either an aggressive stance or a more passive stance, such as fleeing the scene. Both situations call for the potential for a great deal of strenuous, physical work to be done. For an organism to complete either of these tasks successfully, massive amounts of neurotransmitters such as epinephrine, norepinephrine, and cortisol are released quickly throughout the circulatory system. The neurotransmitters then have direct and indirect effects on almost all major organ systems.
When the adrenergic nervous system is forced into excessive stimulation both in intensity and duration, numerous negative consequences can result, especially when this system did not need to be activated at all. Some of these negative consequences include possible increased cardiovascular risk, such as hypertension and heart disease, and direct psychiatric effects, such as depression and suicide. In addition, excessive cortisol production/release has been shown to result in decreased brain size.
When the adrenergic nervous system is continuously being activated in patients with untreated panic disorder, the indirect results are decreased enjoyment in daily activities, decreased work, and increased disability. Increased utilization of health services can occur from both an acute need, such as seen with an increased number of emergency room visits, and in ongoing needs, such as in seeking diagnostic help and treatment for many chronic manifestations of panic attacks.The costs incurred by unrecognized panic disorder have been examined for patients in primary care settings and have been found quite high.