A 36-year-old woman comes to the emergency department with a chief complaint of “I think that I am going crazy.” She states that for the past three months, she has been experiencing sudden episodes of palpitations, sweating, trembling, shortness of breath, chest pain, dizziness, and feeling as if she is going to die. She states that the first time this happened was when she was walking down the street, not thinking about “anything in particular.” The episode lasted approximately 15 minutes, although the patient says that it felt like it lasted much longer. Since that time, she has had similar episodes once or twice a day that have occurred unexpectedly in different situations.
As a result, she finds herself worrying almost constantly about when she is going to have another attack. She denies having any other symptoms. She has been to the emergency department twice in the past two…
