Panic disorder is characterized by recurrent and unexpected panic attacks (see below) and at least one panic attack has been followed by 1 month or more of persistent concern about additional attacks, worry about the implications of the attack or its consequences, and/or a significant change in behavior related to the attacks. These symptoms must cause a high level of distress or impairment in functioning (social, occupational, or other important areas).

Panic Attack: A discrete period of intense fear or discomfort, in which four or more of the following symptoms developed abruptly and reached a peak within 10 minutes:

1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feeling of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, lightheaded, or faint
9. Derealization (feelings of unreality) or depersonalization (being detached from oneself)
10. Fear of losing control or “going crazy”
11. Fear of dying Paresthesias (numbness or tingling sensation)
12. Chills or hot flushes.