A patient describes episodes of intense fear. Before revealing the answer, decide what distinguishes a panic attack from a phobic reaction.

Ask whether the fear has a specific, consistent, identifiable trigger that can be avoided, or whether it can occur unpredictably, without any specific external trigger. A phobia is defined by a specific trigger — the anxiety is consistently provoked by a particular object or situation and can be managed, in principle, by avoiding it. A panic attack can occur unpredictably and without a specific external trigger, though panic attacks can also occur in response to a feared situation, which is exactly why the two are sometimes confused: a phobic patient can certainly have a panic attack when confronted with their specific feared trigger, but a panic attack occurring with no trigger at all cannot be a phobic reaction.