What Is a Panic Disorder with Agoraphobia?
People who have a panic disorder, also known as anxiety attacks, experience sudden
attacks of intense and overwhelming fear that something awful is about to
happen. Their bodies react as if they’re in a life-threatening situation. These
attacks come without warning and often strike when the person is in a
million adults have a panic disorder. Anyone can develop the disorder.
However, it is more common in women than in men.
Symptoms typically first appear at about age 25.
Agoraphobia usually involves a fear of being caught in a place
where “escape” would not be easy, or would be embarrassing. This includes:
You may begin to avoid the places and situations where you had a
panic attack before, for fear it might happen again. This fear can keep you
from traveling freely or even leaving your home.
The Symptoms of Panic Attacks and Agoraphobia
The symptoms of a panic attack often feel the strongest in
the first 10 to 20 minutes. However, some symptoms can linger for an hour or
more. Your body reacts as if you were truly in danger when you experience a
panic attack. Your heart races, and you can feel it pounding in your chest. You
sweat and may feel faint, dizzy, and sick to your stomach.
You may become short of breath and may feel as if you’re
choking. You may have a sense of unreality and a strong desire to run away. You
may fear you’re having a heart attack, or that you’re going to lose control of
your body, or even die.
You will have at least four of the following symptoms when
experiencing a panic attack:
- feelings of danger
- need to flee
- heart palpitations
- sweating or chills
- trembling or tingling
- shortness of breath
- a choking or tightening sensation in the throat
- chest pain
- nausea or stomach discomfort
- a feeling of unreality
- fear that you are losing your mind
- fear of losing control or dying
Agoraphobia usually involves fear of places that would be
difficult to leave or find help if a panic attack occurs. This includes crowds,
bridges, or places like planes, trains, or malls.
Other symptoms of agoraphobia include:
of being alone
of losing control in public
feeling of detachment from others
that your body or the environment is not real
What Causes a Panic Attack with Agoraphobia?
The specific cause of panic attacks is unknown. However,
some evidence suggests that there may be a genetic aspect involved. Some people
diagnosed with the disorder do not have other family members with the disorder,
but many do.
Stress may also play a role in bringing on the disorder.
Many people first experience attacks while going through intensely stressful
periods. This could include:
- the death of a loved one
- job loss
- another circumstance that causes your normal
life to be disrupted
Development of Attacks
Panic attacks tend to come on with no warning. As more
attacks occur, the person tends to avoid situations they view as potential
triggers. A person with a panic disorder will feel anxious if they think they
are in a situation that could cause a panic attack.
How Is Panic Disorder with Agoraphobia Diagnosed?
The symptoms of panic disorder with agoraphobia can be
similar to those of other conditions. Therefore, correctly diagnosing a panic
disorder can take time. The first step is to visit your doctor. They will
perform a thorough physical and psychological evaluation to rule out other
conditions that have some of the same symptoms as panic disorders. These
conditions could include:
- a heart problem
- hormone imbalance
- substance abuse
Clinic makes the point that not everyone who has panic attacks has a panic
disorder. According to the Diagnostic
and Statistical Manual of Mental Disorders (DSM), you must meet
three criteria for a diagnosis of panic disorder:
- you frequently have unexpected panic attacks
- you have spent at least a month worrying about
having another panic attack
- your panic attacks are not caused by alcohol or
drugs, another illness, or another psychological disorder
The DSM has two criteria for the diagnosis of agoraphobia:
- fear of being in places that would be difficult
or embarrassing to get out of if you had a panic attack
- avoidance of places or situations where you fear
you might have a panic attack, or experiencing great distress in such places
Be completely honest with your doctor about your symptoms to
obtain an accurate diagnosis.
How Is Panic Disorder with Agoraphobia Treated?
Panic disorder is a real disease that requires treatment. Most
treatment plans are a combination of antidepressant medications and
psychotherapy like cognitive-behavior therapy (CBT). However, your doctor may
treat you with medication or CBT alone. Most people are able to successfully
manage their panic attacks with treatment.
Two types of psychotherapy are common for the treatment of
panic disorder with agoraphobia.
You will learn about agoraphobia and panic attacks in
cognitive behavioral therapy (CBT). This therapy focuses on identifying and understanding
your panic attacks, then learning how to change your patterns of thought and
In CBT, you’ll typically:
- be asked to do some reading on your condition
- keep records between appointments
- complete some assignments
Exposure therapy is a form of CBT that helps you reduce your
responses to fear and anxiety. As the name implies, you’re gradually exposed to
situations that cause fear. You’ll learn to become less sensitive to these
situations over time, with the help and support of your therapist.
Eye movement desensitization and
EMDR also has been reported to be useful in treating panic
attacks and phobias. EMDR simulates the rapid eye movements (REM) that happen
normally when you are dreaming. These movements affect the way the brain
processes information and can help you see things in a way that is less
Four types of medication are commonly used to treat panic
disorder with agoraphobia.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are a type of antidepressant. They are usually the first
choice of medication for treating panic disorder. Common SSRIs include:
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
SNRIs are another class of antidepressant and are considered
as effective as SSRIs in treating anxiety disorders. These tend to have more
side effects than SSRIs. Side effects include:
- upset stomach
- sexual dysfunction
- increased blood pressure
are drugs that promote relaxation and reduce the physical symptoms of anxiety.
They are often used in the emergency room to stop a panic attack. These drugs
can become habit-forming if taken for a long time or at a high dose.
These are effective in treating anxiety but can cause significant
side effects, such as:
- blurred vision
- urinary retention
- a sudden drop in blood pressure upon standing
Take these medications exactly as prescribed. Do not change
your dosage or stop taking any of these without first consulting your doctor.
It may take a few tries to get the medication that is
exactly right for you. Your doctor will help you do this.
Be sure to tell your doctor about any side effects you are
experiencing so they can make the necessary adjustments. Do not stop taking
your medication without talking to your doctor. This can cause other health
Coping with Your Condition
It can be difficult to live with a chronic condition. Talk
to your doctor about support groups in your area. Many people find support
groups helpful because it allows them to connect with people that have the same
condition as them.
It may take some time for you to find a therapist, support
group, or medication dosage that helps you manage your symptoms. Be patient and
work with your doctor to make a treatment plan that works best for you.