Creighton University

Panic Disorder is diagnosed in people who experience spontaneous, seemingly out-of-the-blue panic attacks and are preoccupied with the fear of it happening again. The attacks occur unexpectedly, sometimes even while a person is asleep.

A panic attack is defined as the abrupt onset of intense fear that reaches a peak within a few minutes and includes at least four of the following symptoms:

• a feeling of imminent danger or doom
• the need to escape
• palpitations
• sweating
• trembling
• shortness of breath or a smothering feeling
• a feeling of choking
• chest pain or discomfort
• nausea or abdominal discomfort
• dizziness or lightheadedness
• a sense of things being unreal, depersonalization
• a fear of losing control or "going crazy"
• a fear of dying
• tingling sensations
• chills or hot flashes
   

Since many of the symptoms of panic disorder mimic those found in illnesses like heart disease, thyroid problems and breathing disorders, people with panic disorder often make multiple visits to emergency rooms or doctors' offices, convinced they have a life-threatening illness. It often takes months or years and lots of frustration before getting a proper diagnosis. Many people with panic disorder don't know they have a real and treatable disorder. Some are afraid or embarrassed to tell anyone, including their doctors and loved ones, about what they are experiencing for fear of being thought of as a hypochondriac. Instead, they suffer in silence, distancing themselves from friends, family and others who could be helpful.

Complicating the picture is the fact that panic disorder often co-occurs with other mental and physical disorders, including other anxiety disorders, depression, irritable bowel syndrome, asthma or substance abuse. This may further increase the difficulty in getting a proper diagnosis.

Agoraphobia

Some people with panic disorder begin avoiding places or situations where they previously had a panic attack, in anticipation of it happening again. These people have agoraphobia. They typically avoid public places where immediate escape might be difficult, such as shopping malls, public transportation or large sports arenas. Their world may become smaller and smaller, as they are constantly on guard for the next attack. Some will develop a fixed route, or territory, from which they cannot deviate. It may become impossible for these people to travel beyond what they consider to be their safety zones without suffering severe anxiety. About one in three people with panic disorder develops agoraphobia. 

Source: Anxiety Disorder Association of America www.adaa.org