A panic attack is a feeling of sudden fear that doesn’t have a reasonable cause. This causes symptoms such as a fast heartbeat and chest pain.
Agoraphobia is a type of anxiety disorder that may occur by itself or can accompany other types of anxiety disorders such as phobias, panic disorder, or social anxiety disorder. It’s often described as a fear of being in public, although this isn’t an entirely accurate description. Agoraphobia makes you want to avoid situations because of the fear that “escape” from these situations may be difficult. People also often fear that help may not be available if the person develops panic-like symptoms or other incapacitating or embarrassing symptoms. This may make you afraid of leaving home. It might also make you fear certain places.
Panic attacks don’t always lead to agoraphobia. Agoraphobia may be more preventable if attacks are treated right away.
Some symptoms of panic attacks include:
- chest pain
- an intense feeling of fear
- fear of dying or losing your mind
- hot flashes and cold chills
- racing heart
- rapid breathing and shortness of breath
- shaking or trembling
- paresthesia (numbness or tingling sensations)
- derealization (the feelings of unreality)
- depersonalization (feeling detached from oneself)
- being unable to swallow
- stomach discomfort
- fear of losing control or “going crazy”
- fear of dying
When agoraphobia is present, you may also have symptoms such as:
- feeling surreal
- quick temper
- fear of public places
- fear of leaving your home
- symptoms of depression
- feeling isolated
- fear of being alone
The exact causes of panic attacks with agoraphobia aren’t fully understood. It usually comes from having repeated panic attacks. If you have had previous panic attacks you may be afraid of having another panic attack. You may start to avoid situations that could cause such attacks. This fear can contribute to the development of agoraphobia.
Panic attacks, and agoraphobia usually start in the late teens or early twenties. They can occur at any age. Panic disorder is more common in women than men.
When you have a panic attack, it can be very scary. You may think you’re having a heart attack or going crazy. Your health care provider will diagnose a panic attack if you have these symptoms and there isn’t an obvious physical cause. Signs of drug use, alcohol use, or medication side effects are used to rule out a panic attack.
Your health care provider will also look for physical signs that could cause your symptoms. You may be tested for heart, lung, or nervous system disorders. If you’re diagnosed with a panic attack, you’ll probably be referred to a mental health professional. Your mental health professional can help determine the cause of your panic attack.
There are a number of treatment options for panic attacks. They vary based on the cause and severity of the symptoms. People are usually treated with both medication and cognitive behavioral therapy.
Cognitive Behavioral Therapy (CBT)
CBT is a special form of therapy. It works to change the way a person with panic disorder feels about their condition. In addition, CBT helps you understand the distorted feelings you have during a panic attack. In general, 10 to 20 sessions of CBT are recommended. Therapy may continue until you can return to places that cause anxiety without having an attack.
A cognitive behavioral therapist can help you retrain the way you think about scary situations. This helps reduce your fear and the symptoms of agoraphobia. You’ll also learn stress reduction and relaxation techniques. Deep breathing and meditation can help soothe anxiety that, if left untreated, could cause a panic attack.
Medications can be prescribed to combat feelings of anxiety. These medications are used for people who have been diagnosed with agoraphobia or panic disorder. They’re not usually prescribed after having a single panic episode.
Some medications used for panic disorders include:
- Selective serotonin reuptake inhibitors (SSRI) (antidepressants): Medications in the SSRI class are FDA-approved to treat depression. They are also used to combat feelings of anxiety and other mood-altering experiences. Those effects can help them treat panic disorder and agoraphobia. Commonly prescribed SSRIs are Celexa (citalopram), Paxil (paroxetine), Zoloft (sertraline), and Prozac (fluoxetine).
- Serotonin-norepinephrine reuptake inhibitors (SNRI): This is another class of antidepressants. Commonly prescribed SNRIs are Cymbalta (duloxetine) and Effexor (venlafaxine).
- Benzodiazepines: These drugs reduce anxiety. They work quickly to relieve you of panic symptoms. However, they can be addictive. Therefore, they are usually prescribed only for a short time. Xanax (alprazolam), Valium (diazepam), and Klonopin (clonazepam) are some examples.
Some medications used to treat panic attacks and agoraphobia are habit-forming. You shouldn’t stop these drugs without health care provider supervision. Other complications of these drugs can include:
- suicidal feelings
- increased risk of alcohol and drug abuse
Most people recover well with treatment involving both medication and CBT. If you have panic disorder, don’t be afraid to ask for help.