Reference no: EM133365988

Margaret wakes up in the middle of the night drenched in sweat. Her heart is pounding, she feels dizzy, and there is a shooting pain emanating from her chest. Margaret thinks she is dying and quickly dials 9-1-1. Paramedics arrive and rush her to a hospital where she undergoes a battery of tests. The tests come back negative for any cardiovascular issues, and the doctor believes her symptoms may be psychological in nature. Deeply offended by this suggestion she returns home and tried to pretend the whole ordeal did not happen. Over the next few weeks, Margaret keeps having occasional attacks where her chest tights and hurts, she sweats, feels dizzy and has a shortness of breath where she had to sit for several minutes to compose herself. One afternoon while giving a presentation at her office one of these episodes occurred. She tried to power through, but her coworkers could all see that she was not okay. Deeply embarrassed, Margaret took the rest of the day off. Margaret started to develop a concern that these "episodes" might return. She tried to think of what may be causing them but could not find any connection. The first one she had was while she was asleep, she had one while exercising, one while driving, one while working from home, and then the most recent during the presentation she was giving. Over the ensuing couple of weeks Margaret spent less and less hours at work, arriving late and leaving early. Margaret figured if she spent less time there, she had less of a chance of having an episode there. But it happened again while she was on a conference call and once again, she had to excuse herself and go home early. This time she made arrangements with her boss to work exclusively from home as her fear started to change; now she was afraid that she'd have one of these embarrassing episodes and wouldn't be able to quickly get away from "gawking eyes" and find a safe place to have the episode. A year later and Margaret has managed to cope with these attacks by only leaving her house one day to go to work, she has made arrangements for her groceries and other necessities to be delivered to her so she doesn't have to leave her home. She still has these "episodes" and fears not knowing when they'll strike but her biggest fear is not knowing if she'll find a place to have these episodes when they occur, so she figured it best to stay at home for as long as she can.

If you were Margaret's therapist, what would you diagnose her with? Explain the rationale of the diagnosis(es) in a few sentences making sure to identify all required symptoms. As part of your answer please make sure you identify all symptoms Margaret reported having as part of each panic attack.