What Is Panic Disorder? DSM 5 Diagnostic Guidelines

Reviewed by Whitney White, MS CMHC, NCC., LPC

Published 01/14/2021

“Panic” is an everyday word. People use it to describe reactions to things like realizing they left their key in the car or their child wandered into the street. But as serious as some of these panic-provoking situations are, this type of panic is not the same as panic disorder. Found in the DSM 5, panic disorder diagnostic criteria help mental health professionals assess whether someone has this mental condition.

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What Is Panic Disorder?

Panic disorder is a type of mental illness. More specifically, it’s a kind of anxiety disorder. This condition's primary feature is having panic attacks in certain situations, experiencing anxiety about having another panic attack and avoiding panic-provoking situations.

How Do You Know If You Have Panic Disorder?

If you feel a sense of panic often, you might worry that you have panic disorder. There are two things you can do to find out – panic disorder screening and diagnosis.

Screening For Panic Disorder

Screening tests are designed to find out if a problem might exist. Examples of standard screening tests include mammograms, blood pressure checks, and dental checkups, to name a few. If the test comes back negative, you can relax and stop worrying you might be ill. But suppose the test reveals you have a problem. In that case, your doctor will either make a diagnosis immediately or run more tests to be sure.

The same is true of a panic disorder screening test. With this simple online test, you click the answers that describe your thoughts, feelings, and behaviors. You get results quickly and know whether you have significant symptoms of panic disorder. If so, you can take that information to whoever you go to for treatment.

Getting A Diagnosis

Once you realize you might have panic disorder, the next step is talking to a psychiatrist or counselor. They can give you a formal diagnosis if it’s needed for your insurance. Or, if you’re not using insurance, they can give you an unofficial diagnosis. Either way, they know more about helping you if they know what your mental illness is.

You can make diagnosis easier and more accurate if you put in some thought before seeing a mental health professional. For example, you can keep a journal of your panic attacks and fears about panic attacks. Have your writings handy at your first appointment with your therapist or doctor.

What Does The DSM 5 Say About Panic Disorder?

When someone diagnoses you with panic disorder, they typically rely on the panic disorder diagnostic criteria to make sure the diagnosis is right for you. The current version of the manual that contains this information is the DSM-5. Within the DSM-5, there are three main entries related to panic: panic attack, panic disorder, and agoraphobia with panic disorder. Here’s what the manual says about each.

Criteria For Panic Attacks

Because panic attacks are a feature of panic disorder, it makes sense to consider the symptoms and diagnostic criteria for a panic attack. DSM 5 lays out the details about what a panic attack looks like when it happens and under what conditions it occurs.

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Physical Symptoms

Some symptoms listed in the DSM 5 for a panic attack are physical sensations or actual physical changes during an attack. These are intense and come on suddenly. They reach a peak within 10 minutes.

  • Heart palpitations, rapid heartbeat, or pounding heart
  • Sweating
  • Shaking or trembling
  • Feeling like you’re short of breath
  • Feeling like you’re choking
  • Chest pain
  • Nausea
  • Dizziness, feeling unsteady, faint, or lightheaded
  • Numbness or tingling
  • Chills or heat sensations

Emotional And Cognitive Symptoms

The list continues with emotional feelings and thoughts that happen just as rapidly and intensely as the physical symptoms.

  • Feeling that things aren’t real or that you’re detached from yourself
  • Fear of dying
  • Fear of going crazy or losing control

Criteria For Panic Attacks

The DSM-5 gives guidelines for using the above list of symptoms. If you have a total of four or more symptoms from the list of physical and emotional/cognitive symptoms, your experience has met the criteria for a panic attack.

Criteria For Panic Disorder

The DSM V panic disorder outline refers to the symptoms of panic attacks. In panic disorder, one or more panic attacks are followed by at least a month of fear that another panic attack will happen. Or, maybe you change your behavior to avoid these things you fear after one or more panic attacks. Then, you could also be diagnosed with panic disorder.

Panic Disorder And Agoraphobia

Agoraphobia is a mental disorder that can happen along with the panic disorder. The idea is, if you have both, you get two diagnoses. In the DSM-5, agoraphobia is described as a condition in which the person fears situations where they might not get help if they began to panic. In this sense, the two conditions are related. Here’s what the DSM-5 says about agoraphobia.

Types Of Fears In Agoraphobia

Agoraphobia is defined as an irrational and excessive fear of unfamiliar or open spaces. If you have agoraphobia, you might fear embarrassment. Or, you might fear the symptoms of a panic attack, even though you’ve never had one.

People with agoraphobia avoid public places if they think they might not be able to escape. If you have panic disorder with agoraphobia, DSM 5 states that panic attacks happen in those same unfamiliar, open places. Having at least two of the following fears may indicate you have agoraphobia.

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  • Traveling by public transportation like a bus, train, or airplane
  • Being in an open space
  • Being in an enclosed space, like a theater or store
  • Being in a crowd or standing inline
  • Being outside your home alone

Agoraphobia Diagnostic Criteria

For agoraphobia, DSM 5 lists more criteria in addition to the presence of at least two of the above fears.

  • You almost always feel anxiety or fear in the same types of situations.
  • Your fear is out of proportion to the danger of the situation within its cultural context.
  • You have these fears and avoid them for at least six months.
  • The fear causes you significant distress or impairs your ability to function.

Agoraphobia With Panic Disorder

Within the DSM-V guidelines, the requirements for recurrent and unexpected panic attacks remain the same for panic disorder as they did for agoraphobia with panic disorder. Also, one or more episodes are followed by at least one month of one or both of the following: either the person consistently has a concern about additional attacks or changes their behavior to avoid attacks.

Keeping Track Of Your Symptoms

Either before you talk to a mental health professional or while you’re in treatment, it’s a good idea to start recording your symptoms of panic disorder. It helps if you systematically take your notes.

One way to accomplish this is to use a calendar and write down your symptoms on it. Check through the DSM panic disorder list of panic attack symptoms and record each one you experienced. Because you’re writing on the calendar, you don’t have to make separate notes about what day they happened.

You also need to take notes about the situation and location where the panic attack happened. If you notice that you’re avoiding situations and places to keep from having panic attacks, write that down on the calendar, too. You can also make notes about the thoughts and feelings you experience between attacks.

Bring this calendar with you when you meet with someone who is going to assess your condition. This information will be helpful during the diagnosis process. It can also help guide treatment if you are receiving medications or psychotherapy to deal with your panic disorder.

What Can You Do About Panic Disorder?

Getting a diagnosis may be the first step in overcoming your panic disorder. You will likely need an official diagnosis for a doctor to prescribe medications or health insurance to pay for treatment. You don’t necessarily have to seek a diagnosis if you don’t want to do so. You can get psychotherapy without it if you don’t go through insurance. Online counseling is an affordable option. Even if you choose not to seek a formal diagnosis, knowing that your problem is panic disorder can be beneficial.

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Treatments for panic disorder include medications and psychotherapy. This disorder's types of medication include SSRI antidepressants, SSNRI antidepressants, beta-blockers, and benzodiazepines. A psychotherapy technique called Cognitive Behavioral Therapy has proven effective for people with panic disorder. Using CBT, their therapist can teach them new ways to think about and react to the situations that bring up their anxiety.

Conclusion

Panic disorder is an anxiety disorder characterized by panic attacks. If you think you might have this disorder, you can take a screening test to check for symptoms. You can then compare the list of symptoms from the DSM-5 with the symptoms you’re having during panic attacks. The more you learn about panic disorder, the easier it is to talk about what’s happening to you. Also, you can explain your experiences better to others. And that will prepare you to speak with a mental health professional to seek official or unofficial diagnosis and treatment.