ABSTRACT
Subjectively, the feeling of panic is described as a rush of “apprehension, fear, or terror ... or feelings of impending doom’’ that is distinguished from a high level of general anxiety by its sudden onset, usually within 10 minutes. The intense fright which often accompanies the first experience of panic is evident from the recollections of patients assessed at our Phobia and Anxiety Disorders Clinic; 81% of a group of 99 patients recalled that they left the situation or activity in which they were engaged, and approximately 25% attended an emergency medical facility or contacted a doctor or nurse, in response to their first panic attack. The extent to which avoidance patterns develop alongside panic attacks varies considerably both across individuals, and within individuals across time. Agoraphobia with panic (panicdisorder with agoraphobia, DSM-III-R) is assigned as a diagnosis when anticipatory anxiety concerning the attacks results in reluctance to leave the house or to enter places in which panic is expected to occur. Anticipatory anxiety is commonly present in panic disorder, but is not associated with marked avoidance of specific situations.
