A panic attack begins suddenly, and most often peaks within 10 - 20 minutes. Some symptoms may continue for an hour or more. A panic attack may be mistaken for a heart attack.
Panic attacks may include anxiety about being in a situation where an escape may be difficult (such as being in a crowd or traveling in a car or bus).
A person with panic disorder often lives in fear of another attack, and may be afraid to be alone or far from medical help.
People with panic disorder have at least four of the following symptoms during an attack:
Panic attacks may change behavior and function at home, school, or work. People with the disorder often worry about the effects of their panic attacks.
People with panic disorder may have symptoms of:
Panic attacks cannot be predicted. At least in the early stages of the disorder, there is no trigger that starts the attack. Recalling a past attack may trigger panic attacks.
Many people with panic disorder first seek treatment in the emergency room, because the panic attack feels like a heart attack.
The health care provider will perform a physical examination, including a psychiatric evaluation.
Blood tests will be done. Other medical disorders must be ruled out before panic disorder can be diagnosed. Disorders related to substance abuse should be considered, because symptoms can mimic panic attacks.
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Taylor CT, Pollack MH, LeBeau RT, Simon NM. Anxiety disorders: Panic, social anxiety, and generalized anxiety. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 32.
Pollack MH, Kinrys G, Delong H, Vasconcelos e Sá D, Simon NM. The pharmacotherapy of anxiety disorders. Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 41.
Stein MB, Goin MK, Pollack MH, Roy-Byrne P, Sareen J, Simon NM, et al. Practice guideline for the treatment of patients with panic disorder. Arlington, VA: American Psychiatric Association, 2009.
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