Panic Disorder Symptoms

Please see our separate note on Treatment, Mental Disorders and Basic Science for important caveats on the role and definition of diagnostic criteria.

Symptoms of Panic Disorder

According to the DSM, "The essential feature of Panic Disorder is the presence of recurrent, unexpected Panic Attacks...followed by at least 1 month of persistent concern about having another Panic Attack, or worry about the possible implications or consequences of the Panic Attacks, or a significant behavioral change related to the attacks" (p. 433). (Note that panic attacks are often called 'anxiety attacks' in popular parlance.) The following specific diagnostic criteria are reproduced verbatim (except for codings and page references) from the DSM-IV TR (where 'IV TR' indicates fourth edition, text revision), page 440 for Panic Disorder Without Agoraphobia and page 441 for Panic Disorder With Agoraphobia.

Diagnostic Criteria for Panic Disorder Without Agoraphobia

A. Both (1) and (2):

1. recurrent unexpected Panic Attacks
2. at least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:
   1. persistent concern about having additional attacks
   2. worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy")
   3. a significant change in behavior related to the attacks

B. Absence of Agoraphobia

C. The Panic Attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).

D. The Panic Attacks not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations), Specific Phobia (e.g., on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives).

Diagnostic Criteria for Panic Disorder With Agoraphobia

A. Both (1) and (2):

1. recurrent unexpected Panic Attacks
2. at least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:
   1. persistent concern about having additional attacks
   2. worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy")
   3. a significant change in behavior related to the attacks

B. The presence of Agoraphobia

C. The Panic Attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).

D. The Panic Attacks not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations), Specific Phobia (e.g., on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives).

Special note on counselling and panic/anxiety: Anxiety disorders, especially including panic, are among the types of distress which are most successfully treated with counselling and psychotherapy. The Managing Editor has a special interest in cognitive approaches to counselling for panic and anxiety, as well as counselling for obsessive-compulsive disorder. See MyTherapist.com for details.