There are more than a dozen physical or emotional sensations that a person can experience during a panic attack. Not everyone experiences all of them, and people with panic disorder may report different feelings when having an attack.
If not recognized and treated, panic disorder can be devastating because it can interfere with relationships, schoolwork, employment and normal development. It is not uncommon for a person with panic disorder to experience an anxious feeling even between attacks. People with panic disorder will begin to avoid situations where they fear an attack may occur or situations where help might not be available. This happens with both adults and children with panic disorder.
For example, a child may be reluctant to go to school or be separated from her parents. Not all children who express separation anxiety do so because they have panic disorder, and it can be very difficult to diagnose. But when properly evaluated and treated with a combination of medication and cognitive-behavioral therapy, children with panic disorder usually respond well. It is recommended that a family physician or pediatrician first evaluate children and adolescents with suspected panic. If no other physical illness or condition is found as a cause for symptoms, a comprehensive evaluation by a child and adolescent psychiatrist should be obtained.
Brain scans and blood tests are not effective in diagnosing panic disorder.
Questions formulated by The Anxiety Disorders Association of America can help an individual determine whether he is experiencing panic disorder. These include:
- Are you troubled by repeated and unexpected “attacks” of intense fear or discomfort for no apparent reason?
- During such attacks, do you experience at least four of the following symptoms?
- pounding heart
- trembling or shaking
- shortness of breath
- chest pain
- nausea or abdominal discomfort
- “jelly” legs
- a feeling of unreality or being detached from yourself
- fear of losing control
- going crazy
- fear of dying
- numbness or tingling sensations or chills or hot flashes
- Do you have a fear of places or situations where escape or getting help might be difficult, such as a crowded room or traffic jam?
- Do you have a fear of being unable to travel without a companion?
- For at least one month following an attack, have you felt persistent:
- concern about having another attack?
- worry about going crazy?
- need to change your behavior to accommodate the attack?
In summary, panic disorder results from having panic attacks. Panic attacks are episodes that come “out of the blue.” They peak within a few minutes and cause feelings of terror and alarming physical symptoms.
People often are convinced during the attack that they are dying and describe a panic attack as the most distressing experience that they have ever had. As a natural response, people dread the next attack and often avoid places or situations where they have had panic attacks.