Patient: Description of the condition (onset, main symptoms, hospital visited, etc.): Once in a few months, I suddenly felt that I could not live, I felt like I was dying, I could not concentrate on anything, I was restless, my chest was swollen, my mind was not clear, I had cold sweats, my legs were weak, and afterwards it was like I was not drunk, I could not tell how uncomfortable it was. But I can walk normally, even run, and I will be fine after a sleep. I took heart pills but they didn’t work, and I felt restless. I went to the hospital to rule out a heart attack. Please give an answer to Dr. Xu in his busy schedule, is it anxiety or other reasons. I feel fearful and uneasy for several days after each attack. Thank you! Quanzhou Third Hospital Psychiatric Department Xu Guoan: The diagnosis cannot be made online. According to the situation you provided, if indeed there is no physical illness, then panic disorder is more likely. Panic disorder is a neurological disorder in which recurrent panic attacks are the main primary symptom. Such episodes are not limited to any particular context and are unpredictable in nature. Panic attacks as secondary symptoms are seen in many different psychiatric disorders, such as phobic neurosis and depression, and should be differentiated from certain physical disorders, such as epilepsy, heart attack, endocrine disorders, etc. (1) Meet the diagnostic criteria of neurosis; (2) Panic attack should meet the following 4 items: ① no obvious trigger, no specific context, and unpredictable attack; ② no obvious symptoms in the interval between attacks, except for fear of having another attack; ③ strong fear, anxiety, and obvious autonomic symptoms during the attack, and often depersonalization, reality dissolution, near-death fear, or loss of control (4) The seizure starts suddenly, reaches its peak quickly, and the patient is clearly conscious during the seizure and can recall it afterwards. Severity Criteria】The patient feels pain because it is unbearable and cannot be relieved. Criteria for the course of the disease] At least three panic attacks within a month, or anxiety secondary to fear of re-occurrence lasting for one month after the first attack. [Exclusion criteria] (1) Exclude panic attacks secondary to other psychiatric disorders such as phobias, depression, or somatoform disorders; (2) Exclude panic attacks secondary to somatic diseases such as epilepsy, heart attack, pheochromocytoma, hyperthyroidism, or spontaneous hypoglycemia.