A panic attack is a discrete period of intense fear or discomfort, in which four or more of the following symptoms develop abruptly and reach a peak within ten (10) minutes:
a. palpitations, pounding heart, or accelerated heart rate
b. sweating
c. trembling or shaking
d. sensation of shortness of breath or smothering
e. feeling of choking
f. chest pain or discomfort
g. nausea or abdominal distress
h. feeling dizzy, unsteady, lightheaded, or faint
i. derealization (feelings of unreality) or depersonalization (being detached from oneself)
j. fear of losing control or "going crazy"
k. fear of dying
l. parasthesias (numbness or tingling sensations)
m. chill or hot flushes
Panic Disorder Criteria*
Panic disorder with or without agoraphobia is characterized by both (1) and (2).
1. Recurrent unexpected panic attacks (see definition above)
2. At least one of the attacks has been followed by 1 month (or more) of one (or more) of
the following:
a. persistent concern about having additional attacks (anticipatory anxiety)
b. worry about the implications of the attack or its consequences (eg, losing control,
having a heart attack, "going crazy")
c. a significant change in behavior related to the attacks (phobic avoidance)
In addition, the panic attacks are not due to:
a. the direct physiological effects of a substance
b. a general medical condition
c. another mental disorder
* Adapted from American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders 4th ed. Washington, DC: American Psychiatric Association; 1994:393-403
