Diagnosing Panic Disorder

DSM-IV-TR Diagnostic Criteria

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) by the American Psychiatric Association is the system used in the United States to classify, describe and diagnosis mental disorders. This system is not without controversy. Many disorders have overlapping symptoms, making it difficult to reach a diagnosis within the parameters outlined in the DSM. Some professionals feel this type of classification system is not really scientific, and that such diagnosis is greatly subjective.

Despite these conceptions, a diagnosis is often necessary for insurance reimbursement and this system is far better than no system at all.

Panic Attack

According to DSM-IV-TR, a panic attack is characterized by four or more of the following symptoms:

  1. palpitations, pounding heart, or accelerated heart rate
  2. sweating
  3. trembling or shaking
  4. sensations of shortness of breath or smothering
  5. feeling of choking
  6. chest pain or discomfort
  7. nausea or abdominal distress
  8. feeling dizzy, unsteady, lightheaded, or faint
  9. feelings of unreality (derealization) or being detached from oneself (depersonalization)
  10. fear of losing control or going crazy
  11. fear of dying
  12. numbness or tingling sensations (paresthesias)
  13. chills or hot flushes

The presence of fewer than four of the above symptoms may be considered a limited-symptom panic attack.

Panic Disorder

The diagnostic criteria for panic disorder is defined in the DSM-IV-TR as follows:

Recurrent unexpected panic attacks and at least one of the attacks have been followed by 1 month (or more) of one (or more) of the following:

    If the above criteria are met, the diagnosis is further clarified by the presence or absence of agoraphobia (such as Panic Disorder with Agoraphobia or Panic Disorder without Agoraphobia).

    Only a Professional Can Diagnose Panic Disorder

    It is important to know that the symptoms of panic disorder may mimic many other anxiety disorders and/or medical conditions. Only your doctor or mental health professional can diagnose panic disorder.


    American Psychiatric Association. "Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision" 2000 Washington, DC: Author.

    Continue Reading