In panic disorder, patients experience anticipatory fear, worry about panic attacks, discrete periods of unexpected panic attacks that usually peak within 10 minutes, and phobic avoidance. According to the DSM-IV-TR, patients must also experience 4 or more of the following symptoms to qualify for a diagnosis of panic disorder: chills, paresthesias, hot flushes, fear of losing control, fear of dying, shortness of breath or feeling smothered, palpitations, chest discomfort, sweating, trembling/shaking, or gastrointestinal distress. Individuals who experience agoraphobia with panic disorder characteristically avoid entering embarrassing situations in which a panic attack may occur.8 Patients who have social phobia experience fear of social performance and worry about exposure to others.8