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Rahul is a 41-year-old male who was referred by his family doctor with
breathing difficulties. Rahul's physician was unable to find a medical
explanation for his symptoms, which left Rahul feeling confused, stressed, and
angry. Over the last 6 months, Rahul has had several instances where he felt an
intense fear that would reach a peak within a few minutes. During these
instances, he would also experience sweating, heart palpitations, chest pain and
discomfort, and shortness of breath. At times, Rahul worried that might die. As a
result, Rahul has persistent worry about having another attack. In addition, he
has begun to avoid unfamiliar places and people where it may be difficult to get
help in the event of another panic attack. The panic and associated avoidance are
significantly impacting Rahul's life as he has been turning down social
invitations, making excuses to stay at home whenever possible, and relying on
his wife to drive their children to their various activities. Although she was
understanding at first. Rahul's wife has grown frustrated with what she perceives
as his irrational fears.​