While most people have occasional periods of anxiety and stress from time to time, some people suffer from severe, debilitating, and unpredictable experiences of fear that cause them to have symptoms such as feeling as if they are having a heart attack, like they have lost their ability to breathe, or even that they are going to die. People that have these kinds of experiences are having panic attacks and may be suffering from a clinical condition called panic disorder. Panic disorder and other mental disorders are diagnosed by mental health professionals using a diagnostic manual called the DSM-5*. Symptoms of panic disorder are described using DSM-5 criteria in this article.

Panic attacks are defined as a sudden overwhelming feeling of fear that occurs without warning and may erupt when no real danger is present. A panic attack typically lasts less than 10 minutes and dissipates within half an hour. For a professional to make the diagnosis, the patient must describe four or more of the following symptoms during the panic attack:

  • Rapid heartbeat
  • Excessive sweating
  • Shaking or trembling sensations
  • Smothering sensations or shortness of breath
  • Choking sensations
  • Discomfort in the chest
  • Abdominal discomfort or nausea
  • Feelings of dizziness, lightheartedness, or that the individual is going to faint
  • Chills or hot flashes
  • Tingling of the hands, feet, or other body parts
  • Feeling that the person is unreal, or that things around them are unreal
  • Fear of dying, fear that they are going to go crazy or lose control
  • Choking sensations
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, lightheaded, or faint
  • Chills or heat sensations

A patient with panic disorder has panic attacks with some regularity. They may become worried about the possibility of having more attacks, or they may alter their behavior in an attempt to avoid the chance of having an unwanted attack. Sometimes people with panic disorder may avoid social situations or other environments where panic attacks have occurred in the past to try to maintain control of their symptoms. If this avoidance becomes severe, the person may develop a related condition called agoraphobia. In agoraphobia, the person will go to great lengths to avoid certain situations such as shopping malls, elevators, bridges, or airports. In severe cases, the individual may be unable to leave the house. Work, school, relationships, and overall quality of life can be severely impacted as a result of either panic disorder or agoraphobia.

If you or a loved one is suffering from symptoms of panic disorder, treatments are available to help decrease the severity of these symptoms and assist in getting back to normal functioning. Psychotherapy, specifically cognitive behavioral therapy (CBT) is widely used to control symptoms of panic disorder. Medications are also useful as a treatment for panic disorder. Certain medications can partially or entirely block panic attacks. Effective medication management allows the psychotherapist and patient to work on overcoming anxiety, depression, relationship problems, substance abuse, and other related problems.

* American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association, Arlington, VA.