These are good questions. For a number of reasons, measuring panic attacks and the severity of panic disorder is tricky. These questions stump the experts too at times. According to the Diagnositic and Statistical Manual of the American Psychiatric Association (DSM-IV), a panic attack is a "discrete period of intense fear or discomfort" accompanied by 4 or more of the symptoms listed in the panic attack form. So, strictly speaking, if you are experiencing a discrete period of intense fear accompanied by 4 or more of the other symptoms, its a panic attack.
One problem, of course, is what if you only experience 3 of those symptoms but your fear is very intense? Does that mean you are not having a panic attack? The DSM-IV standard may not be adequate to describe everyone's experience of panic.
The experience of a panic attack is a pretty personal and subjective. What is intense for one person may not be intense for another. What one person experiences as an increase in heart rate might be experienced by another person as butterflies. You may not have the same absolute standards as other people for what is a panic attack. Thats okay. Your experience may be different.
Fortunately, most people seem to be pretty good at distinguishing their "background" level of anxiety from a panic attack, even if they are pretty anxious all day. For starters, use a fear rating of 10 to describe the fear you experienced during the worst part of the worst panic attack you ever had, then rate your background anxiety and fear during panic attacks relative to that.
The other good news is that once you decide what you are going to record as a panic attack in your diary, you can start keeping track of your progress. The key is to try to stay consistent over time, so that your definition of what a panic attack is for you, doesn't change to much over time. Its hard to see progress if you start calling what you used to call mild attacks, really bad ones. Fortunately most people don't have this trouble. Most people remember very well what 'really bad' was.
Hope this helps.
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Anne-Marie, Site Administrator
