Panic disorder is characterized by recurrent unexpected panic attacks, along with fear of having additional attacks. A panic attack is a sudden rush of intense fear or discomfort, accompanied by at least four of the following symptoms:
- Accelerated heart rate or heart palpitations
- Sweating
- Trembling or shaking
- Shortness of breath or smothering sensations
- Feelings of choking
- Chest discomfort or pain
- Nausea or abdominal distress
- Dizziness, light-headedness, or faintness
- Chills or heat flashes
- Numbing or tingling sensations
- Feelings of unreality (derealization) or being detached or “out of body” (depersonalization)
- Fear of “going crazy” or losing control
- Fear of dying
Having panic attacks does not necessarily mean the child or adolescent has panic disorder. To receive a diagnosis of panic disorder, the child or adolescent must also experience a month or more of at least one of the following:
- Persistent worry about having another panic attack or the possible consequences of another panic attack (such as having a heart attack or losing control)
- Problematic changes in behavior related to the attacks (such as avoiding exercise or certain situations because they might trigger a panic attack)
Panic disorder is only diagnosed when at least some of the panic attacks are not expected (“out of the blue”). If the child or adolescent only has panic attacks in specific situations, like when giving a class presentation, panic disorder would not be diagnosed.