Panic Disorder

In this "journey through anxiety," we have noted that anxiety disorders involve exaggerated fear or anxiety relative to the situation. Fear and anxiety are emotions we naturally experience under certain circumstances, but when these emotions are excessive and repetitive, they might fall under the definition of a disorder. Panic is also a form of fear, and to distinguish it from general fear or anxiety, the diagnostic manual (DSM-5) provides specific criteria.

A panic attack is a sudden onset of intense fear or discomfort that peaks within minutes. It is characterized by at least four of the following symptoms:

• Tachycardia (palpitations)
• Sweating
• Trembling or shaking
• Shortness of breath (dyspnea)
• Feeling of choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Dizziness, unsteadiness, light-headedness, or faintness
• Chills or hot flashes
• Paresthesias (numbness or tingling sensations)
• Derealization (feelings of unreality) or depersonalization (being detached from oneself)
• Fear of losing control or "going crazy"
• Fear of dying

An isolated panic attack is not sufficient to diagnose Panic Disorder. Instead, Panic Disorder is characterized by recurrent and unexpected panic attacks. "Recurrent" means more than one, and "unexpected" means the trigger is not immediately apparent. If a panic attack is expected (i.e., triggered by a known cause), it does not fall under Panic Disorder, but it remains a psychological symptom. If this causes significant distress, it should prompt the individual to consider discussing it with a professional.

According to the DSM-5, Panic Disorder is defined not only by recurrent and unexpected panic attacks, but also by at least one of the attacks being followed by a month of persistent worry or maladaptive behavior changes related to the attack. There is no better alternative explanation for the diagnosed disorder.

Sources:

• American Psychiatric Association (2013) - Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
• Bernhill, J. W. (2014) - DSM-5 Clinical Cases.

I also recommend watching this video.

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