Panic disorder with agoraphobia Health Article

Definition

Panic disorder with agoraphobia is an anxiety disorder in which there are repeated attacks of intense fear and anxiety, and a fear of being in places where escape might be difficult, or where help might not be available in case of a panic attack.

Causes, incidence, and risk factors

The exact cause of panic disorder is unknown, but it has to do with many different factors. Panic disorder can occur with or without agoraphobia, but agoraphobia develops in more than a third of cases.

Agoraphobia may be a learned behavior, because it involves a fear of having panic attacks in unprotected settings. Sometimes, panic attacks occur in areas where they have happened in the past.

Panic disorder can occur in children, but it usually starts at around age 25. It can affect middle-aged and older adults as well. Studies have shown that women are 2 to 3 times more likely than men to be affected.

Symptoms

Panic attacks involve short periods of intense symptoms, such as those listed below, which peak within 10 minutes after they start:

• Chest pain or discomfort
• Choking
• Dizziness or faintness
• Fear of being out of control
• Fear of dying
• Fear of "going crazy"
• Hot flushes or chills
• Nausea or other stomach distress
• Numbness or tingling
• Palpitations
• Shortness of breath
• Sweating
• Trembling

Symptoms of agoraphobia include:

• Anxiety about being in places where escape might be difficult
• Avoiding situations with great stress or anxiety about having a panic attack
• Becoming house-bound for long periods
• Fear of being alone
• Fear of losing control in a public place
• Feeling detached or separated from others
• Feeling helpless and dependent on others

Signs and tests

If your panic disorder has not been diagnosed, you may feel as if you are dying. Often, people will go to an emergency room or other urgent care center because they think they are having a heart attack.

A physical examination and psychological evaluation can help diagnose this condition.

The symptoms can be physical and the condition can be misdiagnosed. That's why it is important to rule out any medical disorders, such as problems involving the heart, hormones, breathing, nervous system, and substance abuse. These conditions can occur with panic disorders.

Which tests are done depends on the symptoms.