The essential feature of Panic Disorder is the presence of recurrent, unexpected Panic Attacks followed by at least 1 month of persistent concern about having another Panic Attack, worry about the possible implications or consequences of the Panic Attacks, or significant behavioral change related to the attacks.  

DSM-IV Criteria for - 

300.01 Panic Disorder without Agoraphobia

&

300.21 Panic Disorder with Agoraphobia 

Panic Disorder can be separated into one of two categories depending on the presence of Agoraphobia.  The criteria are the same except for criteria (B) presence of Agoraphobia and should be coded accordingly.

A) Both (1) and (2):

1. recurrent unexpected Panic Attacks  

2. at least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:

1. persistent concern about having additional attacks

2. worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy")

3. a significant change in behavior related to the attacks

B. Presence or Absence of Agoraphobia 

C. The Panic Attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).

D. The Panic Attacks not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations), Specific Phobia (e.g., on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives).

Panic Disorder treatment:

Successful treatment for Panic Disorder is well documented.

Cognitive-behavioral therapy (CBT) is the most popular and commonly used psychotherapy for Panic Disorder. CBT for Panic focuses on how thoughts, feelings, and behaviors develop into patterns that maintain the fear of having a panic attack. The intention of CBT is to use cognitive techniques to challenge unhelpful or distorted thoughts while using behavioral techniques to reduce the avoidance behaviors.  

One method of CBT treatment for panic disorder is Exposure Therapy. The CBT therapist works with the patient to identify the cues or situations that the patient has been avoiding due to their fear of panic attacks and they slowly expose the patient while teaching relaxation and cognitive techniques to lessen the anxiety. The overall goal of CBT treatment for the patient is to overcome the irrational fears and develop skills for lessening the intensity of the panic attacks to a manageable level for the patient.

Guided imagery is a relaxation technique often used with Panic Disorder. In this stress-relieving technique, the therapist reads a script to the patient to help the patient create thoughts and pictures in their mind where temperature, smells, sounds, landscapes, people, and sights, are comfortable and relaxing. It's like helping the patient create a mental vacation were they can find safety and peace away from the fear and panic.