Panic Disorder With and Without Agoraphobia

What is Panic Disorder?

Panic attacks are sudden, short, and discrete feelings of fear or dread that are accompanied by physical symptoms such as heart palpitations, sweating, shortness of breath, chest pain, nausea, feeling dizzy or lightheaded, trembling or shaking, sweating, choking sensations, nausea, abdominal distress, numbness or tingling sensations, hot flashes or cold chills, and feelings of depersonalization and derealization. Panic Disorder is characterized by recurrent, unexpected panic attacks without reasonable cause that create great physical and psychological discomfort in individuals. Individuals with panic disorder worry about having future attacks and suffering the consequences. They fear that they will die, lose control, or go crazy as result of these symptoms. As a result, they often escape or avoid situations that they believe will cause them to have panic attacks or use unhelpful coping behaviors in an attempt to create a sense of safety. Continuous anxiety over the occurrence of panic attacks can often lead to the development of agoraphobia. Agoraphobia is the fear or avoidance of situations in which help may not be available or escape is difficult in the case of a panic attack. Common agoraphobic situations include shopping malls, bridges, elevators, and being home alone.

Typically, panic disorder first occurs in early adulthood and is twice as common in women. Six million American adults experience panic disorder in a given year. Panic disorder and agoraphobia run in families and are caused by a combination of genetic, temperament, biological, and psychological vulnerabilities. They can also be learned through early life experiences, specifically experiences which taught the individual to perceive the world as a dangerous place and their internal body sensations as harmful. Individuals with panic disorder tend to develop catastrophic interpretations of their body sensations, e.g., an increased heart rate will lead to a heart attack. Many of the situations that activate panic and agoraphobia were dangerous to our ancestors but are no longer dangerous, e.g., being in a public field made our ancestors more susceptible to predators like lions. Initial panic attacks may also be activated by stressful life situations such as leaving home, relationship conflict, or physical illness.