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About 3 million Americans, women more than men, are likely to be afflicted with panic disorder. Three types of panic attack can be diagnosed. Unexpected panic attacks come “out of the blue” without warning and for no discernible reason. Situational panic attacks occur in specific situations, for example upon entering an elevator or a tunnel. Situationally pre-disposed panic attacks occur only sometimes in upsetting situations; for example, an individual may sometimes have a panic attack while driving, but not always. Many people diagnosed with panic attacks also suffer from major depression.

To be diagnosed with panic disorder, you must suffer at least two unexpected panic attacks, followed by at least one month of concern over having another attack. You may also be prone to situational panic attacks and worry about the physical and emotional consequences of your attacks. You may be convinced that the attacks you suffer indicate a serious illness and you will submit to frequent medical tests. Even after all the tests come back negative, you will probably remain worried that you do have a serious condition. You may even try to avoid the scene of a previous attack, hoping you can prevent another one.

The age of onset of panic disorder varies from adolescence to mid-thirties. Very few suffer from panic attacks in childhood.

Agoraphobia, or the fear of having a panic attack in a place from which you cannot escape, often coincides with panic disorder. You may refuse to leave your home, or develop a fixed “safe” route, such as between home and work, from which you cannot deviate. It may feel impossible to travel beyond what you consider your safety zone without suffering severe anxiety.

To diagnose your condition, your physician will probably ask you …

1. For no apparent reason do you have repeated, unexpected attacks during which you are overcome by intense fear or discomfort?

2. During this attack do you experience a pounding heart, sweating, trembling or shaking, shortness of breath, choking, chest pain, nausea or abdominal discomfort, “jelly” legs, dizziness, feelings of unreality or of being detached from yourself, fear of dying, numbness or tingling sensations, chills or hot flashes, or a fear of places you can’t escape from?

3. For at least one month following an attack have you felt persistent concern about having another one, having a heart attack, or “going crazy,” or have you changed your behavior so you won’t have another attack?

4. Does having to travel without a companion trouble you?