ANXIETY: Defining Panic Disorder (Panic Attacks)

A Panic Attack is defined as the abrupt onset of an episode of intense fear or discomfort, which peaks in approximately 10 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 flushes.

There are three types of Panic Attacks:
1. Unexpected
 – the attack “comes out of the blue” without warning and for no discernable reason.
2. Situational – situations in which an individual always has an attack, for example, upon entering a tunnel.
3. Situationally Predisoposed – situations in which an individual is likely to have a Panic Attack, but does not always have one. An example of this would be an individual who sometimes has attacks while driving.

Panic Disorder

Panic Disorder is diagnosed when an individual suffers at least two unexpected Panic Attacks, followed by at least 1 month of concern over having another attack. Sufferers are also prone to situationally predisposed attacks. The frequency and severity of the attacks varies from person to person, an individual might suffer from repeated attacks for weeks, while another will have short bursts of very severe attacks.

The sufferer often worries about the physical and emotional consequences of the Panic Attacks. Many become convinced that the attacks indicate an undiagnosed illness and will submit to frequent medical tests. Even after tests come back negative, a person with Panic Disorder will remain worried that they have a physical illness. Some individuals will change their behavioral patterns, avoiding the scene of a previous attack for example, in the hopes of preventing having another attack.

Agoraphobia often, but not always, coincides with Panic Disorder. Agoraphobia is characterized by a fear of having a panic attack in a place from which escape is difficult. Many sufferers refuse to leave their homes, often for years at a time. Others develop a fixed route, or territory, from which they cannot deviate, for example the route between home and work. It becomes impossible for these people to travel beyond what they consider to be their safety zones without suffering severe anxiety.

The age of onset of Panic Disorder varies from late adolescence to mid-thirties. Relatively few suffer from the disorder in childhood.