PANIC DISORDER

Panic Disorder is characterised by recurrent and unexpected panic attacks with persistent concern about having another panic attack (panic attacks on their own without ongoing fear of another one or without agorophobic avoidance are not disorders.)
Although panic attacks can be very frightening they are often overlooked.
They can be attributed to something else such as breathlessness. For example, they become associated with something like giving the baby a bath and are therefore put down to anxiety associated with this. They might result in someone behaving in an unusual slightly hysterical manner.
Physical causes such as cardiac arrhythmia, thyrotoxicosis, should be considered in the differential diagnosis.

See information for women on Panic Disorder.

Core Features of a Panic Attack

Symptoms

(i) Physical symptoms:

sweating
shaking or trembling
heart racing or pounding
sensation of choking
sensation of shortness of breath
chest pain or discomfort
nausea or abdominal discomfort
numbness or tingling sensations (paresthesia)
chills or hot flushes

(ii) Psychological symptoms:

a sense of being disconnected from oneself (depersonalisation)
a sense of being disconnected from ones environment (derealisation)
fear of dying
fear of loosing control
fear of 'loosing ones mind'

Symptoms of a Panic Attack come on within minutes usually reaching a peak within 10 minutes.

Core Features of Agorophobia

Agorophobia is a combination of anxiety and avoidance.

The anxiety involves being in either places or situations from which escape might be difficult, or embarrassing, or in which help is not readily available, should panic symptoms or a panic attack develop.

Avoidance refers to avoiding the feared situations or places or only tolerating them with support.

The avoidance and anxiety are not better accounted for by another disorder such as a specific phobia or social phobia.

Core Features of Panic Disorder (In adults)

Duration: Recurrent unexpected Panic Attacks and at least one of the attacks has been followed by 1 month (or more) of one (or more) of the following :

persistent concern about having additional attacks
worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, going crazy)
a significant change in behaviour related to the attacks

Agorophobia: Panic Disorder is made as a diagnosis with, or without, Agorophobia where there is avoidance of situation(s) in which recurrence of a panic attack is feared. These situations commonly include being home alone, supermarkets or crowded places.

Exclusion Features:

the Panic Attacks are not due to the direct physiological effects of another illness or a substance or
the Panic Attacks are not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations),