What is the diagnosis for a 35-year-old man experiencing recurrent episodes of palpitations, diaphoresis, and fear of going crazy?

The symptoms described—a 35-year-old man experiencing recurrent episodes of palpitations, diaphoresis (sweating), and fear of going crazy—are characteristic of panic disorder. This condition is marked by spontaneous and unexpected panic attacks, which are intense periods of overwhelming fear or discomfort that typically include physiological symptoms like a racing heart and sweating, as well as psychological symptoms, such as a fear of losing control or going insane. Often, individuals may develop a fear of having additional panic attacks, which can lead to avoidance behaviors and impact their daily functioning.

The episodic nature of the symptoms, particularly the combination of physical manifestations (palpitations, sweating) and the intense fear associated with the episodes, aligns closely with panic disorder, distinguishing it from other anxiety-related conditions listed.

While generalized anxiety disorder involves persistent and excessive worry about various aspects of life, it does not typically present with the acute and intense episodes seen in panic disorder. Social anxiety disorder focuses on fear related to social situations, and agoraphobia is characterized by a fear of being in places where escape might be difficult or help unavailable, usually leading to avoidance of such situations. In contrast, panic disorder specifically involves the recurrent, unexpected appearance of panic attacks themselves.