Panic Attack Test Panic Attack Test By submitting this form, you are opting in for a phone call to setup a free consultation. Step 1 of 9 11% Panic attacks occur unexpectedly, and can be highly debilitating. Sometimes these panic attacks lead to avoidance of an activity or environment which the sufferer has associated with a feeling of panic from their past. This avoidance could potentially lead to more severe and disabling disorders such as agoraphobia. Panic Disorder is diagnosed in people who experience spontaneous panic attacks and are preoccupied with the fear of a recurring attack.Sometimes I have a sudden surge of overwhelming fear that comes without warning.Sometimes I have a sudden surge of overwhelming fear that comes without warning. Never Rarely Sometimes Often Very Often I experience severe heart palpitations.I experience severe heart palpitations. Never Rarely Sometimes Often Very Often How many times have you been to the ER for chest pains caused by anxiety and panic attacks?How many times have you been to the ER for chest pains caused by anxiety and panic attacks? Never Once Twice More than twice During a panic attack, how distressing are they?During a panic attack, how distressing are they? Mild Moderate Severe During the last week, have you been afraid that additional panic attacks will occur?During the last week, have you been afraid that additional panic attacks will occur? Not at all Mild Moderate Nearly Constant During the last week, how much has your anxiety been interfering with your normal functioning (work, family life, and relationships)?During the last week, how much has your anxiety been interfering with your normal functioning (work, family life, and relationships)? None Slightly Significantly Extremely How many panic attacks do you experience monthly?How many panic attacks do you experience monthly? 1 2 Greater than 2 None During the last week, have you been avoiding people, places or experiences for fear that a panic attack will occur?During the last week, have you been avoiding people, places or experiences for fear that a panic attack will occur? No, I’m not fearing or avoiding people, places or experiences Yes, I am avoiding people, places or experiences Have you ever been diagnosed with any of the following conditions?Have you ever been diagnosed with any of the following conditions? Social Anxiety Generalized Anxiety Disorder Obsessive-Compulsive Disorder Post-Traumatic Stress Disorder Other Name* First Last Email* Phone*CommentsThis field is for validation purposes and should be left unchanged.
