Panic disorder can only be diagnosed in an individual who exhibits certain responses to having panic attacks that are considered to be out of proportion to the actual danger associated with them and/or inappropriate for the individual’s age (e.g., expectations regarding young children and responses to anxiety are much different than they are for adults). Thus, while the core symptom of panic disorder is recurrent panic attacks, the individual must also demonstrate a certain set of responses to these attacks in order to be formally diagnosed with panic disorder.
The American Psychiatric Association lists the specific symptoms that qualify for a panic attack. Formal panic attacks are defined by the presence of four or more of the specific symptoms.
- Heart palpitations, or a very rapid or pounding heartbeat
- Trembling and/or shaking, numbness, tingling sensations, jitteriness, chills, or even hot flashes
- Feeling short of breath, heaviness in the chest, or chest pain, which may feel like a heart attack
- Feeling lightheaded, dizzy, or as if one is about to faint
- Feeling as if one is going to choke, having abdominal pain, or being extremely nauseous
- Feeling detached, feeling as if one is about to die, or just feeling that one is losing control
Many individuals who experience repeated panic attacks or even first-time panic attacks may think they are having a heart attack or other life-threatening condition. Panic attacks often occur without any real provocation; however, they may also occur in response to some specific situation that is anxiety-provoking to an individual. In order for someone to be diagnosed with panic disorder, in addition to having recurrent panic attacks, they must also display at least one of the following behaviors:
- Demonstrate persistent concern or worry about additional panic attacks or their consequences for the duration of at least one month
- Demonstrate a significant dysfunctional change in their behavior that is related to their experience of panic attacks, such as avoiding situations that may cause them anxiety and trigger panic attacks
For example, someone who has a panic attack at work and then stops going to work or working altogether because they fear they may experience more panic attacks at work would likely be displaying the behaviors associated with panic disorder.