2. Sweating.
3. Trembling or shaking.
4. Sensations of shortness of breath or smothering.
5. Feelings of choking.
6. Chest pain or discomfort.
7. Nausea or abdominal distress.
8. Feeling dizzy, unsteady, light-headed, or faint.
9. Chills or heat sensations.
10. Paresthesias (numbness or tingling sensations).
11. Derealization (feelings of unreality) or de personalization (being detached from oneself).
12. Fear of losing control or “going crazy.”
13. Fear of dying.
Note: Culture-specific symptoms (e.g., tinnitus, neck soreness, headache, uncontrollable
screaming or crying) may be seen. Such sym ptoms should not count as one of the four
required symptoms.
Features
The essential feature of a panic attack is an abru pt surge of intense fear or intense discomfort
that reaches a peak within minutes and during wh ich time four or more of 13 physical and cog-
nitive symptoms occur. Eleven of these 13 sy mptoms are physical (e.g., palpitations, sweat-
ing), while two are cognitive (i.e., fear of losing control or going crazy, fe ar of dying). “Fear of
going crazy” is a colloquialism often used by indivi duals with panic atta cks and is not in-
tended as a pejorative or diagnostic term. The term within minutes  means that the time to peak