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Symptoms and Diagnosis of
Panic Disorder
Physical Symptoms:
- Palpitations, pounding heart, or accelerated heart rate
- Sweating
- Trembling or shaking
- Sensations of shortness of breath or smothering
- Feeling of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, lightheaded, or faint numbness or tingling
- Chills or hot flushes
Emotional Symptoms
- Feelings of unreality or feeling detached from yourself or the world
- Fear of losing control and/or going crazy
- Fear of dying
Behavioural Symptoms
- Avoidance of places that bring on panic attacks
- Overactivity and restlessness
- Poor concentration and ability to focus
Types of Panic Attacks
Panic attacks can be unexpected or can occur in relation to an environmental trigger. While recurrent, unexpected panic attacks are the defining feature of panic disorder, the other types may occur in the context of either panic disorder or other anxiety disorders.
Unexpected Panic Attacks
The onset of this form of panic attack is not associated with a situational trigger. It appears to occur for no reason at all. This type of panic attack is an essential feature of Panic Disorder. It can wake the person at night.
Environment Triggered Panic Attacks
An environment trigger can lead to the onset of a panic attack. It may do so on every occasion or just sometimes.
At least two unexpected panic attacks are required for the diagnosis of Panic Disorder, but most people have more. Panic Disorder can disrupt an individual’s life, impacting on their lifestyle even during periods when panic attacks are absent. Many people with Panic Disorder become anxious about all treatment interventions.
Panic Disorder is diagnosed as either “with agoraphobia” (anxiety about being in specific places or situations where escape might be difficult , or where help may not be available in the event of a panic attack) or “without agoraphobia” (panic attacks not necessarily linked to specific places or situations). Up to one in every two individuals with Panic Disorder also have agoraphobia.
Some individuals with Panic Disorder develop avoidant behavior to reduce the risk of suffering a panic attack, and this behavior may meet criteria for a diagnosis of panic disorder with agoraphobia. For example, an individual may avoid grocery shopping because of fear of having a panic attack and the feelings of helplessness that accompany it.
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