Symptoms and Diagnosis

Panic Disorder is characterized by repeated unexpected panic attacks (anxiety attacks). Panic attacks are often described as a sudden onset of intense apprehension, fearfulness or terror, often accompanied by feelings of impending doom.

Panic disorder is characterized by panic attacks - acute episodes of terror accompanied by a sudden barrage of symptoms, including at least four of the following.

• Terror – a sense that something unimaginably horrible is about to happen and one is powerless to prevent it
• Racing or pounding heartbeat
• Chest pains
• Dizziness, light-headedness, nausea
• Difficulty breathing
• Tingling or numbness in the hands
• Flushes or chills
• Sense of unreality
• Fear of losing control, going "crazy," or doing something embarrassing
• Fear of dying

Panic symptoms often mimic symptoms of a heart attack or other life-threatening medical conditions. As a result the diagnosis of panic disorder is frequently not made until extensive and costly medical procedures fail to provide a correct diagnosis or relief. They can occur spontaneously, with no apparent trigger. In fact, they can even begin during sleep. Attacks usually last for a few minutes, sometimes longer, yet they often feel like an eternity for the patient.

All too often, patients with panic disorder experience such extreme distress that they repeatedly visit emergency departments or other health care professionals. With each panic attack they may fear dying from heart attack, or they may fear suffering from a respiratory problem, neurological disorder, or gastrointestinal condition. They may also fear that they are losing control or becoming psyhotic.

When a person has repeated panic attacks and feels severe anxiety about having another attack, he or she has panic disorder. Panic disorder tends to worsen over time if not effectively treated.

Many people with panic disorder develop intense anxiety between episodes. A common effect of recurring attacks is avoidance of situations associate with their attacks (such as in supermarkets or other everyday situations). Agoraphobia is characterized by persistent avoidance of places or situations in which the person feels trapped, fears another attack may occur, or fears that help would be unavailable if needed.

This avoidance may eventually become so debilitating that some individuals become completely housebound. Agoraphobic avoidance can include avoiding elevators, crowds, busy streets, traveling, using public transportation, driving, or being alone.