What Are Panic Disorder and Agoraphobia?

Almost everyone feels anxious at times. But a panic attack involves such a high level of that it can feel as if you are having a heart attack, going insane, or losing control of yourself. During a panic attack, you may have physical symptoms such as shortness of breath, tingling sensations, ringing in your ears, a sense of impending doom, trembling, a feeling of choking, chest pain, sweating, and heart pounding.

A 'Panic Disorder' is present when a person has recurring, unexpected panic attacks, is afraid of having more or worried about their meaning, and makes changes in his or her behavior as a result such as avoiding many situations. Many patients who have panic disorder also experience “agoraphobia.” Agoraphobia is fear of places or situations where a panic attack may occur or from which escape might be difficult. For example, people with agoraphobia avoid being out alone, going to supermarkets, traveling in trains or airplanes, crossing bridges, being at heights, going through tunnels, crossing open fields, and riding in elevators.

According to some theories, many situations that can trigger panic attacks were truly dangerous earlier in human evolution. For example, being trapped in a tunnel could lead to suffocation or collapse; heights might be dangerous; in open fields, an individual was more susceptible to predators (such as lions or wolves); public places might have brought our ancestors into contact with hostile strangers. Many of the fears involved in panic disorder and agoraphobia are reminiscent of these earlier instinctive and adaptive fears. However, these situations are not dangerous today. The fear response has become a 'false alarm'.

In any given year, 30% to 40% of the general population will have a panic attack. However, most of these people will not interpret their panic as a signal of catastrophic danger, and thus will not go on to develop panic disorder or agoraphobia.

Initially, a panic attack is usually activated by a stressful situation, such as leaving home, marital/ couple conflict, surgery, new responsibilities, or physical illness. These sensations of physical arousal (heavy breathing, sweating, dizziness, pounding heart, and so on) may be misinterpreted as signals of catastrophic danger—for example, a person may focus on the increase in heart rate and jump to the conclusion that he or she is about to have a heart attack. As a result, the person may develop “hypervigilance” (that is, an excessive focus on physical sensations), which can result in increasedarousal (increased physical sensations and worry). This arousal triggers further catastrophic misinterpretations, which we call “false alarms” because they signal that danger is imminent when it really is not.

Treatment

Some people incorrectly believe that panic disorder is a result of deep-seated psychological problems. Of course, anyone with or without panic may have deeper problems, but panic disorder and agoraphobia are not necessarily related to deeper psychological problems. You may become depressed, dependent, and self-critical because you have panic disorder—but panic, in itself, can be treated effectively without long-term therapy. Cognitive Behavioural Therapy has been shown to be more effective in treating panic disorder than medication.

Medical check-up

Before the diagnosis of panic disorder it can be useful to see your physician in order to rule out medical causes for these symptoms, such as hyperthyroidism (too much thyroid hormone) or other rare causes. It is important to keep in mind that panic disorder is much more common than these rare phyical causes. Some people also have a huge intake of caffeine (Tea. coke, coffee..) and this can contribute to symtoms of a fast heart-beat, sweating, feeling dizzy etc.