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Panic Disorder and Agoraphobia


What is Panic Disorder:

Panic disorder is characterized by a sudden onset of recurrent physical sensations called a panic attack. Individuals who suffer from panic disorder regularly experience a panic attack, or rushes of intense fear, anxiety, or discomfort, that seemingly come from out of the blue for no apparent reason. Importantly, not everyone who experiences panic attacks will develop panic disorder. During a panic attack, an individual may experience several physical symptoms such as dizziness, shortness of breath, heart palpitations, or numbness.

Often, there is a persistent fear of when the next panic attack might occur, and afflicted individuals will try to avoid or escape situations they have come to associate with panic attacks. Panic attacks can result in frequent visits to medical facilities and frequent absences from work or school. Panic disorder affects roughly 2%-3% of adolescents and 2%-3% of adults in the general population. It can appear at any age, but most often develops by young adulthood.

What is Agoraphobia:

Agoraphobia involves the experience of intense fear or anxiety in a wide range of situations, such as when using public transportation, being in open spaces or enclosed spaces, standing in line or being in a crowd, or being away from home alone. Individuals with Agoraphobia may worry that something terrible will happen in these situations, or they may fear that they will not be able to escape or get help in the event that they experience panic-like or incapacitating symptoms. In extreme cases, Agoraphobia can cause individuals to become homebound and dependent on others for basic needs. Agoraphobia affects approximately 2% of adolescents and 2% of adults in the general population. Agoraphobia typically develops in late adolescence or early adulthood, although it can occur at any age.

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Panic Disorder Symptoms Include:

  • Chills or hot flushed
  • Pounding heart, chest pain, or discomfort
  • Fear of dying or having a heart attack
  • Sweating and/or trembling
  • Nausea
  • Shortness of breath or smothering sensations
  • Feeling faint
  • Feeling detached from self
  • Numbness

Agoraphobia Symptoms Include:

Agoraphobia includes avoiding many of the following situations or places:

  • Expressway traffic
  • Physical exercise
  • Crowds
  • Large gatherings
  • Middle seats
  • Airplanes/mass transit
  • Group activities

Panic Disorder and Agoraphobia Treatment:

Treatment for panic disorder and Agoraphobia includes exposure practices inducing the physical symptoms associated with panic until a patient gets used to them and stops feeling anxious, which is called Interoceptive Exposure. Exposure therapy can also include the practice of overcoming the fears posed by real-life situations that usually end with avoidance. Exposures occur in the office and out of the office, as necessary, to approximate the most real situations. This means your therapist will accompany you during shopping, driving, exercise, or other activities where panic takes place. Cognitive therapy can also be used to help identify and change fearful or catastrophic beliefs that underlie anticipatory anxiety. (CBT) can be administered in individual or group formats. It is short-term (e.g., 20 sessions) and problem-focused. The most studied psychotherapy for depression, CBT has the largest weight of evidence for its efficacy.

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