Unexpected panic attacks recur. A panic attack is an abrupt surge of intense fear or discomfort that rapidly reaches a peak.
DSM-5-TR · anxiety disorder
Could I have panic disorder?
Panic disorder is recurrent unexpected panic attacks followed by persistent concern about further attacks or behavioural changes intended to avoid them. Diagnosis is not based on one isolated impression: DSM-5-TR requires a specific pattern of symptoms, sufficient duration and clinically significant distress or impairment.
4/13 + ≥ 1 month
DSM-5-TR
What are the DSM-5-TR criteria?
The points below summarise the diagnostic requirements that define the disorder.
Diagnostic criteria — paraphrased
At least four of the thirteen panic symptoms occur during an attack.
After at least one attack, for one month or longer, the person remains strongly concerned about further attacks or their consequences and/or changes behaviour in an attempt to prevent them.
The attacks are not attributable to a substance, medication or medical condition.
They do not occur only in situations better explained by another mental disorder.
Diagnostic reference: DSM-5-TR (American Psychiatric Association, 2022). Wording intentionally paraphrased and concise.
The 13 possible panic-attack symptoms
A panic attack includes at least four of these symptoms.
Palpitations, racing heart or pounding heartbeat.
Sweating.
Trembling or shaking.
Shortness of breath or a feeling of smothering.
Feeling of choking.
Chest pain or discomfort.
Nausea or abdominal distress.
Dizziness, unsteadiness, light-headedness or feeling faint.
Chills or heat sensations.
Numbness or tingling.
Derealization or depersonalization.
Fear of losing control or “going crazy.”
Fear of dying.
Differential diagnosis
Panic attack, panic disorder or agoraphobia?
A panic attack can occur in many disorders and is not a diagnosis by itself. Panic disorder requires recurrent unexpected attacks followed by persistent concern or behavioural change. Agoraphobia involves fear of several situations from which escape may feel difficult or help may be hard to obtain.
Clinical assessment
How is the diagnosis made?
Diagnosis is based on clinical interviewing, the history of symptoms, their frequency and duration, the situations that trigger them, and their functional impact. It is also important to determine whether another mental disorder, a substance, medication or medical condition better explains the presentation. Standardised questionnaires can support the assessment.
Anxiety disorders
Explore the other anxiety disorders
Anxiety symptoms can look similar across disorders. A central question is often what triggers the fear and what the person is actually afraid will happen.
Are you trying to understand the nature of your anxiety?
An emotional and personality assessment can help clarify the type and intensity of anxiety, conditions that may look similar, and the most appropriate next steps.
