The essential feature of panic disorder is the presence of recurrent panic attacks followed by at least one month of persistent concern about having another panic attack, or worry about the possible implications or consequences of the panic attack or a significant behavioral change related to the attacks.
The essential feature of a panic attack is a period of intense fear or discomfort that’s accompanied by at least four of the following symptoms which develop abruptly and reach a peak within 10 minutes:
- Palpitations, pounding heart, or accelerated heart rate
- Trembling or shaking
- Sensations of shortness of breath or smothering
- Feeling of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, lightheaded, or faint
- Feeling of unreality or being detached from oneself
- Fear of losing control or going crazy
- Fear of dying
- Numbness or tingling sensations
- Chills or hot flushes
If there are fewer than four of these symptoms this is referred to as “limited symptom attacks.”
Panic attacks are often accompanied by a sense of imminent danger or impending doom and an urge to escape.
An unexpected panic attack is one that occurs “out of the blue.” An expected panic attack occurs after exposure to a specific situation that creates anxiety.
Rule out physiological effects of a substance such as caffeine intoxication or a general medical condition such as hyperthyroidism and rule out another mental disorder.