If you suspect that you might suffer from panic disorder, answer the questions below, print out the results and share them with your health care professional.
Are you troubled by the following?
|Yes No||Repeated or unexpected “attacks” during which you suddenly are overcome by intense fear or discomfort for no apparent reason|
If yes, during an attack did you experience any of these symptoms?
|Yes No||Pounding heart|
|Yes No||Trembling or shaking|
|Yes No||Shortness of breath|
|Yes No||Chest pain|
|Yes No||Nausea or abdominal discomfort|
|Yes No||"Jelly" legs|
|Yes No||Fear of losing control or "going crazy"
|Yes No||Fear of dying|
|Yes No||Numbness or tingling sensations|
|Yes No||Chills or hot flushes|
As a result of these attacks, have you…
|Yes No||experienced a fear of places or situations where getting help or escape might be difficult, such as in a crowd or on a bridge?|
|Yes No||felt unable to travel without a companion?|
For at least one month following an attack, have you…
|Yes No||felt persistent concern about having another one?|
|Yes No||worried about having a heart attack or “going crazy”?|
|Yes No||changed your behavior to accommodate the attack?|