Panic disorder is classified as an anxiety disorder in DSM-5. According to the guidelines, in order to be diagnosed with panic disorder, you must experience unexpected panic attacks on a regular basis.
DSM-5 What is there to say about panic disorder? How does the diagnosis method in DSM-5 compare to the previous version of the manual? The update includes clarification on the types of panic attacks and how agoraphobia is related to panic disorder.
What is DSM-5?
The Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (APA) is a system used to diagnose mental illness in the United States. DSM contains diagnostic criteria used by mental health professionals to classify and describe each known mental illness.
The DSM released in 2013 was the first major update since 1994. The fifth edition (DSM-5) has many changes, including some updates to the diagnosis of panic disorder.
The system is not without controversy. Many diseases have overlapping symptoms. Some professionals question the effectiveness of this classification system, while others believe that its application is highly subjective.
Despite these reservations, diagnosis is usually necessary for treatment, research, and insurance reimbursement. Many professionals believe that this system is much better than no system at all.
How DSM-5 diagnoses panic disorder
The diagnostic criteria for panic disorder are defined in DSM-5. It is an anxiety disorder, mainly based on the occurrence of panic attacks, which are recurring and often unexpected.
In addition, at least one month or more after a panic attack, people worry that they will have more panic attacks and cause them to change their behavior. This usually includes avoiding situations that might trigger a panic attack.
It is important to note that the diagnosis of panic disorder must exclude other underlying causes of the panic attack (or feel like an event):
- The onset is not due to a direct physiological effect of a substance (such as drug use or drugs) or a general medical condition.
- Another mental disorder cannot better explain these attacks. These may include social phobia or other specific phobias, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) or separation anxiety disorder.
Define a panic attack
Since panic attacks are the key to the diagnosis of panic disorder, they are clearly defined and specific. This is where the updates in DSM-5 are significant.
The previous version (DSM-IV) divided panic attacks into three categories: situational restraint/prompt, situational susceptibility, or accident/non-prompt. DSM-5 simplifies the classification of panic attacks by providing only two very clear categories: expected and unexpected panic attacks.
The expected panic attack is related to a specific fear, such as flying. Unexpected panic attacks have no obvious triggers or clues and may happen suddenly. According to DSM-5, a panic attack is characterized by the following four or more symptoms (the presence of less than four symptoms can be regarded as a limited symptom panic attack):
- Palpitations, rapid heartbeat, or increased heart rate
- Trembling or trembling
- Feeling of shortness of breath or choking
- Feeling of suffocation
- Chest pain or discomfort
- Nausea or abdominal discomfort
- Feeling dizzy, unstable, dizzy, or fainting
- Feeling unreal (disintegration of reality) or separation from oneself (disintegration of personality)
- Fear of losing control or going crazy
- fear death
- Numbness or tingling (paresthesia)
- Chills or hot flashes
Agoraphobia and panic disorder
In previous versions of DSM, agoraphobia was related to panic disorder. With the DSM-5 update, agoraphobia is now an independent, codable diagnosis. This is one of the biggest differences in the update.
In an update on agoraphobia, DSM-5 stated that a person must experience intense fear or anxiety in at least two situations. These include going out in public places, open spaces, and crowds-basically anywhere outside of your home.
It also stated that avoidance behavior must be exhibited. This is due to the fear of being in a situation that may cause a panic attack or anxiety, in which case it may not be possible to get help or escape.
It is important to know that the symptoms of panic disorder may mimic many other anxiety disorders and/or medical conditions. Only your doctor or mental health professional can diagnose panic disorder.
Panic Disorder Discussion Guide
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Anxiety disorders such as panic disorder are one of the most common mental health conditions, but only about 20% of people with anxiety symptoms seek treatment. Because anxiety disorders are more common in women than men, experts now recommend that clinicians screen women and girls 13 and older for anxiety disorders.
When seeking professional help to evaluate your symptoms and possibly make a diagnosis, remember that honesty is the key. You might even see a therapist and then decide to see another therapist. Remember to do what you feel comfortable with.
Although it may be difficult to discuss your feelings at first, remember that your doctor will help you at any time, and talking publicly about your condition is the first step in controlling your symptoms in a healthy way.