Panic disorder is characterized by unexpected and recurring panic attacks. A panic attack is a sudden surge of intense fear that can be so frightening that people may believe they are having a heart attack, losing control, going crazy, or even dying. After experiencing a panic attack, a person may become increasingly worried about having another one.
Symptoms of panic attack
The most common symptoms of panic disorder include several or most of these symptoms:
- Heart palpitations or accelerated heart rate
- Nausea or abdominal discomfort
- Sweating
- Feeling dizzy, lightheaded or faint
- Trembling or shaking
- Feelings of unreality (derealization)
- Feeling detached from oneself (depersonalization)
- Feeling short of breath
- Feelings of choking
- Chest pain or discomfort
- Fear of dying
- Fear of losing control or going crazy
- Numbness or tingling sensations
- Chills or hot flashes
You may be diagnosed with panic disorder if you experience recurrent panic attacks and at least one of the following for a month or longer:
- Persistent fear of having additional attacks
- Worry about the implications or consequences of the attacks
- A significant change in behavior related to the attacks
Panic attacks can be triggered by a specific situation, a scary thought, or come out of the blue. They typically begin suddenly, without warning and can strike at almost any time. Often the fear of having a panic attack can trigger an attack. Visits to an emergency room are very common.
Panic Disorder and Agoraphobia
Panic disorder can also exist with Agoraphobia. Agoraphobia is anxiety about being in places or in situations where a panic attack might develop, where escape might be difficult or embarrassing, and where help is not available. Agoraphobia can be triggered by a variety of situations including being outside the home alone, being far from home, being in a crowd, riding in an elevator, being in a large place like a shopping mall, and traveling in a bus, train, or car. Those who deal with Agoraphobia avoid these situations or endure them with marked distress or anxiety and often require a companion to accompany them outside of the home. People can even feel trapped in a parking structure, hair salon, market, in the middle row of a theater, or standing in line. A person with agoraphobia perceives that in these situations escape would be difficult or not fast enough.
People with panic disorder and agoraphobia will usually experience anticipatory anxiety prior to an event. They could worry for days, anticipating a panic attack and embarrassing themselves. They will contemplate not going and reasons to cancel. The more a person avoids situations the worse the disorder becomes.
I worked with a client who never left his house during the day. When we started working together it had been ten years since he saw the sun. His agoraphobia started because he suffered two panic attacks during the day. He felt safe to be outside only at night. After a year of therapy he is now able to leave his home whenever and wherever he desires.
Treatment of Panic Disorder
Treatment for Panic Disorder with or without Agoraphobia includes a combination of CBT, ACT, Exposure Therapy and/or Medication. As I discuss in The Anxiety Solution Series, once you learn skills and tools to stop your thoughts, calm your body, and face your fears, you’ll feel more confident, and your fear of having panic attacks will diminish.
