Panic disorder diagnosis

There is no medical test used to diagnose panic disorder. Your healthcare provider will likely take a holistic look at your mental and physical health when diagnosing your condition. They may begin by ruling out other conditions, such as heart problems or thyroid problems, which may present with symptoms similar to those of panic attacks. In order to provide the right diagnosis^[21], your healthcare provider may:

• Conduct a physical exam
• Request blood testing to check your thyroid function or electrocardiogram to analyze your heart
• Conduct or recommend a psychological evaluation that takes into account your signs and symptoms, concerns, family history, relationships, and any outside stressors or contributing factors

Mental health specialists will likely consult the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5, published by the American Psychiatric Association) to diagnose panic disorders and attacks. The DSM-5 describes panic disorder as being characterized by “recurrent and unexpected panic attacks” that are not caused by “the direct physiological effects of a substance (e.g., a drug of abuse or a medication) or a general medical condition.” In addition, people with panic disorder experience one or both of the following:

• “Persistent concern about additional attacks or their consequences”—chronic fear of future panic attacks or their symptoms
• “A significant maladaptive change in behavior related to the attacks”—the adoption of unhealthy coping mechanisms in response to panic attacks

The DSM-5 defines a panic attack as “an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and during which time four or more of the following symptoms occur.” The characteristic symptoms of panic attack listed by the DSM-5 are:

• Palpitations, pounding heart, or accelerated heart rate
• Sweating
• Trembling or shaking
• Sensations of shortness of breath or smothering
• Feeling of choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, unsteady, lightheaded, or faint
• Derealization (feelings of unreality) or depersonalization (being detached from oneself)
• Fear of losing control or “going crazy”
• Fear of dying
• Paresthesias (numbness or tingling sensation)
• Chills or heat sensations

Per the DSM-5, the self-reported presence of at least four of these symptoms during a period of intense fear or discomfort constitutes a panic attack. You may not need to receive an official diagnosis of panic disorder or panic attack to receive treatment. Additionally, treatment can be effective with or without a diagnosis.