Self-Help Information: Panic & Agoraphobia
What is Panic Disorder?
In Panic Disorder, brief episodes of intense fear are accompanied
by multiple physical symptoms (such as heart palpitations and
dizziness) that occur repeatedly and unexpectedly in the absence of
any external threat.
These "panic attacks" are believed to occur when the brain’s normal
mechanism for reacting to a threat – the so called "flight or fight"
response – becomes inappropriately aroused. Most people with Panic
Disorder also feel anxious about the possibility of having another
panic attack and avoid situations in which they believe these
attacks are likely to occur. Anxiety about another attack, and the
avoidance it causes, can lead to disability in Panic Disorder.
Symptoms of Panic Attacks
During a panic attack, some or all of the
following symptoms occur:
Terror – a sense that something
unimaginably horrible is about to happen and one is
powerless to prevent it
Racing or pounding heartbeat
Chest pain
Dizziness, lightheadedness, nausea
Difficulty breathing
Tingling or numbness in the hands
Flushes or chills
Sense of unreality
Fear of losing control, going "crazy",
or doing something embarrassing
Fear of dying
Initial Panic Attack
Typically, a first panic attack comes "out of
the blue", occurring while a person is engaged in some ordinary
activity like driving a car or walking to work. Suddenly, a barrage
of frightening and uncomfortable symptoms strikes the person. These
symptoms often include terror, a sense of unreality, or a fear of
losing control. These symptoms usually last several seconds, but may
continue for several minutes and gradually fade over the course of
about an hour. People who have experienced a panic attack can attest
to the extreme discomfort they felt and to their fear that they had
been stricken with some terrible, life-threatening disease or were
"going crazy". Initial panic attacks may occur when people are under
considerable stress, such as overwork or from the loss of a family
member or close friend. The attacks may follow surgery, a serious
accident, illness, or childbirth. Excessive consumption of caffeine
or use of cocaine or other stimulants or medicines, can also trigger
panic attacks. Some people who have one panic attack, or an
occasional attack, never develop a problem serious enough to affect
their lives. For others, however, the attacks continue and cause
much suffering.
Panic Disorder
In Panic Disorder, panic attacks recur and the
person develops an intense apprehension of having another attack.
This fear – called anticipatory anxiety or fear of fear – can be
present most of the time and interfere with the person’s life even
when a panic attack is not in progress. In addition, the person may
develop irrational fears, called phobias, about situations where a
panic attack has occurred. For example, someone who has had a panic
attack while driving may be afraid to get behind the wheel again,
even to drive to the grocery store. People who develop panic-induced
phobias will tend to avoid situations that they fear will trigger a
panic attack, and their lives may be increasingly limited as a
result.
Agoraphobia
Panic Disorder may progress to where the
person becomes afraid of being in any place or situation where
escape might be difficult or help unavailable in the event of a
panic attack. This condition is called Agoraphobia and affects about
a third of people with panic disorder. Typically, people with
Agoraphobia fear being in crowds, standing in line, entering
shopping malls, or riding in cars. Often, they restrict themselves
to a ‘zone of safety" that may include only the home or
neighborhood. Any movement beyond this zone creates mounting
anxiety. Sometimes a person with Agoraphobia is unable to leave home
alone, but can travel if accompanied by a particular family member
or friend. Even when they restrict themselves to "safe" situations,
most people with Agoraphobia have occasional panic attacks.
Treatment for Panic Disorder
Treatment can bring significant relief to 70
to 90 percent of people with Panic Disorder, and early treatment can
help keep the disorder from progressing to the later stages where
Agoraphobia may develop. Before undergoing treatment for Panic
Disorder, a person should undergo a medical examination to rule out
other possible causes of the symptoms. Several effective treatments
have been developed for Panic Disorder and Agoraphobia. A treatment
should be selected according to the individual needs and preferences
of the person. Cognitive-Behavioral Therapy is a combination of
cognitive therapy which can modify or eliminate thought patterns
contributing to the patient’s symptoms, and behavioral therapy which
aims to help the patient to change his or her behavior. When
indicated, a prescription medication is used both to prevent panic
attacks or reduce their frequency and severity, and to decrease the
associated anticipatory anxiety. Many believe that a combination of
medication and Cognitive-Behavioral Therapy represents the best
treatment of Panic Disorder.
Causes of Panic Disorder
Though we do not know for sure what causes
Panic Disorder, it is probable that there are multiple causes. Both
genetics and brain biochemistry have been implicated as factors.
(The above information was condensed from a
public domain brochure produced by the National Institute of Mental
Health. For the full text of the brochure, visit the NIMH website at
www.nimh.nih.gov).
Recommended Books to Read
An End to Panic: Breakthrough
Techniques for Overcoming Panic Disorder, 2nd
Edition. Elke Zuercher-White, Oakland, CA: New
Harbinger, 1998. This workbook begins with a
discussion of recognizing and understanding panic
attacks and when to consider medication for panic.
Following a discussion of the physiology of fear and
panic, the author focuses on ways to cope with panic
through breathing retraining, changing thoughts and
beliefs, and coping with phobias secondary to panic.
Worksheets and exercises are presented.
Coping with Panic: A Drug-Free
Approach to Dealing with Anxiety Attacks. George A. Clum, Belmont, CA: Brooks/Cole, 1990. This book
begins with an examination of panic and its causes
and symptoms. The author then discusses coping
strategies people naturally acquire for dealing with
panic and discusses how to develop better coping
techniques. The primary focus is cognitive, focusing
on changing catastrophic ways of thinking. Avoiding
the feared situation and its relationship to
Agoraphobia are discussed, followed by an
elaboration of ways to eliminate these avoidance
strategies.
Panic Disorder and
Agoraphobia: A Guide. Obsessive Compulsive
Information Center, Madison Institute of Medicine,
1998. This pamphlet describes the symptoms and
causes of panic and agoraphobia. It then describes
the treatment options, with an emphasis on
medication.
Need Additional Help?
Washington State University College of Veterinary Medicine
Counseling and Wellness Services offer free individual counseling for these and
related issues for veterinary students (WSU Veterinary Students ONLY). For more
information or to schedule an appointment call or e-mail:
Carolyn Wyatt PhD
ADBF 1035
335-0774
cwyatt@vetmed.wsu.edu
NOTE: The information contained in these self help
documents is not to be used as a substitute for professional care. Neither the
authors, Washington State University nor the College of Veterinary Medicine
assume liability for injury incurred by following the information presented in
these self-help documents
Last Edited: Mar 07, 2007 2:58 PM
