Agoraphobia With Panic Attacks

Written by April Khan and Elizabeth Boskey, PhD | Published on July 16, 2012
Medically Reviewed by George Krucik, MD

What is Agoraphobia with Panic Attacks?

A panic attack is a feeling of sudden fear that does not have a reasonable cause. This causes symptoms such as a fast heartbeat and chest pain. If you have multiple panic attacks in different settings, you are said to have a panic disorder.

Agoraphobia is a symptom that may accompany panic disorder. It is often described as a fear of being in public. However, that is not entirely accurate. Agoraphobia makes you want to avoid situations that remind you of having a panic attack. This may make you afraid of leaving home. It might also make you fear certain places.

Symptoms of Agoraphobia with Panic Attacks

Panic attacks do not always lead to agoraphobia. Agoraphobia may be more preventable if attacks are treated right away.

Some symptoms of panic attacks are:

  • 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
  • being unable to swallow
  • stomach discomfort

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

Causes of Agoraphobia with Panic Attacks

The exact causes of panic disorder with agoraphobia are not fully understood. However, it usually comes from having repeated panic attacks. People who have had previous panic attacks may be afraid of having another panic attack. They may start to avoid situations that could cause such attacks. This fear causes agoraphobia to form.

Panic disorder, panic attacks, and agoraphobia usually start in the late teens or early twenties. However, they can occur at any age. Panic disorder is more common in women than men.

Diagnosing Agoraphobia with Panic Attacks

When a person has a panic attack, it can be very scary. They may think they are having a heart attack or going crazy. A doctor 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 doctor will also look for physical signs that could cause your symptoms. You may be tested for heart, lung, or nervous system disorders. If you are diagnosed with a panic attack, you will probably be referred to a psychologist. They can help determine the cause of your panic attack.

Treatment Options for Agoraphobia with Panic Attacks

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 the person understand the distorted feelings they 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 CBT 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.

Medication

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 are 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.

Complications of Agoraphobia with Panic Attacks

Some medications used to treat panic attacks and agoraphobia are habit-forming. You should not stop these drugs without doctor supervision. Other complications of these drugs can include:

  • suicidal feelings
  • depression
  • increased risk of alcohol and drug abuse.

Prognosis of Agoraphobia with Panic Attacks

Most people recover well with treatment involving both medication and CBT. If you have panic disorder, don’t be afraid to ask for help.

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