Panic
(4-3-06)

DSM-IV defines a panic episode as a discrete period of intense fear or discomfort during which at least four of the following develop abruptly (criterion paraphrased):

1. increased heart rate

2. sweating

3. trembling or shaking

4. sensations of shortness of breath/smothering

5. feeling of choking

6. chest pain or discomfort

7. nausea or abdominal distress

8. feeling dizzy, unsteady, lightheaded, or faint

9. derealization (feelings of unreality) or depersonalization (being detached from oneself)

10. fear of losing control or going crazy

11. fear of dying

12. paresthesias (numbness or tingling sensations)

13. chills or hot flashes

ICD-10 discusses attacks of severe anxiety (panic) in the context of defining Panic Disorder (F41.0): "sudden onset of palpitations, chest pain, choking sensations, dizziness, and feelings of unreality (depersonalization or derealization) are common. There is also, almost invariably, a secondary fear of dying, losing control, or going mad." (World Health Organization, 1992, p. 139).