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Tests and diagnosis
By Mayo Clinic staffTo 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.
Tests and exams you may have include:
- Physical exam. This may include measuring height and weight; checking vital signs, such as heart rate, blood pressure and temperature; listening to the heart and lungs; and examining the abdomen.
- Laboratory tests. These may include a complete blood count (CBC) as well as thyroid tests and other blood tests. You may also have tests on your heart, such as an electrocardiogram to help determine how well your heart is functioning.
- Psychological evaluation. A doctor or mental health provider will talk to you about your symptoms, such as what they feel like, how often they occur, when they occur and how long you've had them. You'll also be asked about stressful situations in your life, fears or concerns you have, relationship problems and other issues affecting your life. You may fill out psychological self-assessments and questionnaires. And you may be asked about substance or alcohol abuse.
Diagnostic criteria for panic disorder
Not everyone who has panic attacks has a full-blown panic disorder. To be diagnosed with panic disorder, you must meet the criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
These are the diagnostic criteria for panic disorder:
- You have frequent, unexpected panic attacks.
- At least one of your attacks has been followed by one month or more of persistent worry about having another attack; persistent fear of the consequences of an attack, such as losing control, having a heart attack or "going crazy"; or a significant change in your behavior, such as avoiding situations that you think may trigger a panic attack.
- Your panic attacks aren't caused by substance abuse or another mental health condition, such as social phobia or agoraphobia.
If you have panic attacks but not a full-blown 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 Jan. 14, 2010.
- Hollander E, et al. In: Hales RE, et al., eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Association; 2008. Accessed Jan. 14, 2010.
- Ciechanowski P, et al. Overview of panic disorder. http://www.uptodate.com/home/index.html. Accessed Jan. 14, 2010.
- Panic disorder. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/anxiety-disorders/panic-disorder.shtml. Accessed Jan. 14, 2010.
- Davies RD. Panic attacks and panic disorder. In: Jacobson JL, et al. Psychiatric Secrets. 2nd ed. Philadelphia, Pa.: Hanley & Belfus, Inc.; 2001. http://www.mdconsult.com/das/book/body/178504199-14/0/1167/34.html?tocnode=49274996&fromURL=34.html#4-u1.0-B1-56053-418-4..50017-0_289. Accessed Jan. 14, 2010.
- Answers to your questions about panic disorder. American Psychological Association. http://www.apa.org/topics/anxiety/panic-disorder.aspx. Accessed Jan. 14, 2010.
- American Psychiatric Association Practice Guidelines for the Treatment of Psychiatric Disorders. Arlington, Va.: American Psychiatric Association. http://www.psychiatryonline.com/pracGuide/pracGuideTopic_9.aspx. Accessed Jan. 14, 2010.
- Kinrys G, et al. Natural remedies for anxiety disorders: Potential use and clinical applications. Depression and Anxiety. 2009;26:259.
- Saeed SA, et al. Herbal and dietary supplements for treatment of anxiety disorders. American Family Physician. 2007;76:549.
- Hall-Flavin, DK (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 16, 2010.
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