Diagnosis of Panic Disorder

For a diagnosis of PD to be made, the patient must have recurrent unexpected or spontaneous attacks and experience at least four of the following symptoms:

• palpitations
• sweating
• trembling
• shortness of breath
• choking feelings
• chest pain or discomfort
• nausea
• dizziness
• fear of losing control or going crazy
• fear of dying
• numbness or tingling
• chills or hot flushes

Some people only experience a couple of these symptoms in which cases the episodes are called limited symptom attacks

Panic can occur during sleep so sufferers wake in distress; these nocturnal attacks may be confused with nightmares and night terrors but sleep recordings show they are quite distinct.

Patients with PD may initially go to their doctor to report symptoms associated with heart problems, such as palpitations, shortness of breath and chest pain.  In most cases the panic nature of the symptoms makes diagnosis easy but in people with prior heart disease it can be difficult to determine whether a patient’s symptoms reflect panic attack or true cardiac disease.   

Panic attacks can also occur in some other anxiety disorders, particularly Social Anxiety Disorder (SAD) and Post-Traumatic Stress Disorder (PTSD).