A patient describes fear about the future. Before revealing the answer, decide what distinguishes anxious foreboding from a panic attack.

Ask about the time course: is this a sustained background state, present continuously over days or weeks, or a discrete, rapidly peaking episode? Anxious foreboding is a sustained background sense of dread about the future, oriented toward an unspecified coming misfortune. A panic attack is a discrete, time-limited episode of intense anxiety with a rapid onset, typically resolving within twenty to thirty minutes, in contrast to that more sustained state. Both involve unpleasant anticipatory anxiety, but one is a persistent mood-like quality and the other a sharply bounded episode.