Tests and diagnosisBy Mayo Clinic staff
To help pinpoint a diagnosis for your symptoms, you'll likely have several exams and tests. Your doctor or other health care provider must determine if you have panic attacks, panic disorder or another condition, such as heart or thyroid problems, that resembles panic symptoms.
You may have:
- A complete physical exam
- Blood tests to check your thyroid and other possible conditions and tests on your heart, such as an electrocardiogram (ECG or EKG), to help determine how well it's functioning
- An evaluation by your doctor or mental health provider to talk about your symptoms, stressful situations, fears or concerns, relationship problems, and other issues affecting your life
You may fill out psychological self-assessments and questionnaires. You also may be asked about alcohol or other substance abuse.
Diagnostic criteria for panic disorder
Not everyone who has panic attacks has a panic disorder. To be diagnosed with panic disorder, you must meet these criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association:
- You have frequent, unexpected panic attacks.
- At least one of your attacks has been followed by one month or more of ongoing worry about having another attack; ongoing fear of the consequences of an attack, such as losing control, having a heart attack or "going crazy" or significantly changing your behavior, such as avoiding situations that you think may trigger a panic attack.
- Your panic attacks aren't caused by substance abuse, a medical condition or another mental health condition, such as social phobia or obsessive compulsive disorder.
For some people, panic disorder may include agoraphobia — avoiding places or situations that cause you anxiety because you fear not being able to escape or get help if you have a panic attack.
If you have panic attacks but not a diagnosed panic disorder, you can still benefit from treatment. If panic attacks aren't treated, they can get worse and develop into panic disorder or phobias.
- Panic attack. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed March 6, 2012.
- Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Washington, D.C.: American Psychiatric Association; 2008. Accessed March 7, 2012.
- Panic disorder. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/anxiety-disorders/panic-disorder.shtml. Accessed March 6, 2012.
- Answers to your questions about panic disorder. American Psychological Association. http://www.apa.org/topics/anxiety/panic-disorder.aspx. Accessed March 6, 2012.
- Practice guideline for the treatment of panic disorder, Second edition. Arlington, Va.: American Psychiatric Association. http://psychiatryonline.org/content.aspx?bookid=28§ionid=1680635. Accessed March 6, 2012.
- Inositol. National Medicines Comprehensive Database. http://naturaldatabase.com. Accessed Feb. 20, 2012.
- Smits JA, et al. The interplay between physical activity and anxiety sensitivity in fearful responding to carbon dioxide challenge. Psychosomatic Medicine. 2011;6:498.
- Saeed SA, et al. Exercise, yoga and meditation for depressive and anxiety disorders. American Family Physician. 2010;8:981.
- Panic disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed March 6, 2012.
- Katon W, et al. Panic disorder: Epidemiology, clinical manifestations, and diagnosis. http://www.uptodate.com/index. Accessed March 7, 2012.
- Roy-Byrne PP. Pharmacotherapy for panic disorder. http://www.uptodate.com/index. Accessed March 7, 2012.
- Whiteside SP (expert opinion). Mayo Clinic, Rochester, Minn. April 24, 2012.
- Moore KM (expert opinion). Mayo Clinic, Rochester, Minn. May 17, 2012.
- Fluoxetine (Prozac, Prozac Weekly), paroxetine (Paxil, Paxil CR, Pexeva) and sertraline (Zoloft), alprazolam (Xanax), clonazepam (Klonopin) and lorazepam (Ativan). Micromedex Healthcare Series. http://www.micromedex.com. Accessed March 8, 2012 and May 23, 2012.