About Panic Attacks & Agoraphobia

Panic Attacks

Panic attacks are different from normal anxiety and phobias.  The term “panic attack” is reserved for a particularly intense form of anxiety that peaks rapidly and usually lasts less than half an hour.  About 30% of people report having experienced a panic attack at some point in their lives.  When panic attacks are a regular occurrence, someone may be said to suffer from “panic disorder”, which can occur on its own but often becomes associated with a problem called “agoraphobia”, described below.  Research suggests that 4.7% of people will meet the diagnosis of panic disorder (with or without agoraphobia) during their lifetime, and a further 1.3% will exhibit agoraphobia alone, without panic disorder  (NCS-R).  Rates for panic disorder are 60% higher, and for agoraphobia 30% higher, among women than men (Roth & Fonagy, 2005, p. 152).  However, research reviewing 13 separates studies has found that on average 71% of people are panic-free following CBT for panic disorder, which is a good success rate for a clinical trial of this kind (Clark & Beck, 2010, p. 325).

Panic attacks may appear to happen “out of the blue” or, especially in social phobics, to be triggered by particular situations or events.  Panic attacks are potentially diagnosed if four or more of the following symptoms occur during the periods of anxiety,

1. Chest pain or other chest discomfort.
2. Chills or hot flushes.
3. Choking sensations.
4. Derealisation (feeling unreal) or depersonalisation (feeling detached from oneself).
5. Dizzy, lightheaded, faint, or unsteady feelings.
6. Fear of dying.
7. Fears of loss of control or becoming insane.
8. Heart racing, pounding, or skipping beats.
9. Nausea or other abdominal discomfort.
10. Numbness or tingling.
11. Sweating.
12. Shortness of breath or smothering sensation.
13. Trembling.

People often automatically interpret these sensations as signs of imminent catastrophe, e.g., fainting, having a stroke or heart attack, or having a “nervous breakdown.”  However, panic attacks are relatively common and basically quite harmless.  They put no more strain on your body than moderate exercise would and are not usually associated with particularly severe mental health problems or “breakdowns”.  Although people sometimes feel very faint and disoriented, panic attacks are very rarely associated with fainting because blood pressure actually increases during panic attacks, whereas fainting requires it to decrease.  The feared catastrophes associated with the feelings of panic are therefore typically harmless and illusory, although the experience itself may seem very unpleasant and the anxiety caused is very real.  Panic attacks are sometimes associated with problems like hyperventilation (over-breathing) during anxiety, which may create the unpleasant sensations experienced.  Older approaches to therapy fared very poorly with panic attacks but in the 1980s a modern cognitive-behavioural therapy (CBT) for panic attacks was introduced, which has since been proven by numerous studies to have a very high success rate.

Agoraphobia

“Agoraphobia” literally means, in Greek, fear of the marketplace (not fear of “open spaces” as is commonly assumed) and it is typically defined as the fear of being in situations where “escape”, to perceived safety, would be embarrassing or difficult.  It’s very often associated with panic attacks and therefore typically takes the form of fearing and avoiding situations where one wouldn’t want to suffer a panic attack, e.g., standing in queues, being in elevators or crowded trains, sitting in the middle of a cinema row, walking through a busy crowded street, etc.

People who suffer from agoraphobia tend to plan “escape routes”, e.g., by sitting at the back of a class, near the exit, in case they want to leave quickly.  They may also feel the need to be accompanied by another person, a “chaperone” such as a partner or spouse, when entering anxiety-provoking situations because this creates more of a feeling of “safety”.  Agoraphobia may occur with or without panic attacks but most often the two problems are closely associated and go together; indeed 95% of agoraphobics report having frequent panic attacks.

Blog Articles About Panic Attacks & Agoraphobia

• Panic Attacks: Some Initial Questions May 1, 2011
  These questions can be used to prepare yourself to have cognitive therapy for panic attacks. They should be used in conjunction with a trained therapist.The post Panic Attacks: Some Initial Questions appeared first on Cognitive-Behavioural Therapy in London. […]
  Solutions: London Cognitive-Behavioural Therapy (CBT)