Ask the patient if she is having any thoughts of death or suicide.
The patient should be asked directly if she is having suicidal thoughts. One way to approach this situation is with a phrase such as, Sometimes people with panic feel so much discomfort that they start having thoughts of suicide. Have you had any of these thoughts? Panic attacks are a short-term risk factor for suicide. Asking a patient about suicidality will not cause them to be more likely to commit suicide. Referral to a psychiatrist is not necessary to evaluate for suicidality.