Understanding Agoraphobia and Panic Disorder

According to the The Royal Australian and New Zealand College of Psychiatrists, approximately 1 to 2 % of the general population are affected by panic disorder and agoraphobia each year. While the causes are not fully understood, there is a definite connection to major life events such as a death, birth of a child or moving to a new town.

Signs and Symptoms of Panic Disorder

Panic disorder is diagnosed when a person suffers from repeated, unexpected panic attacks. These are characterized by experiencing four or more of the following symptoms in the space of ten minutes:

• Pounding heart/palpitations
• Chest pain
• Sweating
• Tremors and shakiness
• Shortness of breath
• Feeling of choking
• Nausea
• Dizziness and feeling faint
• Fear of losing control
• Fear of dying
• Chills or hot flushes
• Numbness or tingling

Panic disorder is diagnosed when these symptoms are followed by prolonged fears of having another attack and worries about health. The fear often leads to a significant change in behavior.

How is Agoraphobia Related to Panic Disorder

The Royal Australian and New Zealand College of Psychiatrists define agoraphobia as anxiety about "being in places or situations from which escape might be difficult or in which help may not be available in the event of having a panic attack."

People with panic disorder avoid certain situations for fear of experiencing a panic attack. Places avoided commonly include public transport, shopping malls, queues and confined areas.

Self Help for Panic Disorder and Agoraphobia

Severe cases need medical diagnosis and treatment but there are a number of ways for people to manage anxiety.

Manage and reduce anxiety by breathing slowly and deliberately. Try saying the word relax while breathing out. Relaxation training helps a person to stay calm and reduces the side effects of living in a state of tension.

Exercise is often avoided as it increases heart rate and breathing which are symptoms of a panic attack. It is essential to overcome this by doing gentle exercise such as walking and later build up to more strenuous things.

Exposure to the things feared is a big part of recovery. If a person fears shopping, she could start with trips to a small neighborhood store with a trusted friend. Do this for several days or a couple of weeks and then try visiting a busier area.

Professional Treatments for Panic Disorder and Agoraphobia

The Royal Australian and New Zealand College of Psychiatrists take a three-pronged approach to treatment:

• Cognitive Behavioral Therapy
• Anti-depressant medication
• Benzodiazepine medication

Cognitive Behavioral Therapy (CBT) involves educating a person about anxiety and the fight or flight response of the body. Panic triggers are identified and the person is trained to relax and breathe properly. With the help of a therapist, fears are faced and journeys made to desensitize the person. This may involve using public transport, exercising or visiting a cinema. CBT is the most effective long-term form of treatment.

Antidepressants have been proven effective in treating panic disorder. There are several varieties available and the doctor will discuss the patient's situation and decide which is best for him. The drugs are normally started at a low dosage and increased until the optimum effect is obtained.

Benzodiazepines are medications that help a person to relax without causing sleep. They reduce tension and have been used with success in treating panic disorder.

It takes time to recover from panic disorder and agoraphobia and a combination of treatments is often prescribed. With perseverance and careful monitoring, it is possible to make a full recovery and go on to lead a life free of inappropriate anxiety.

Recommended reading: Panic Disorder and Agoraphobia, The Royal Australian and New Zealand College of Psychiatrists, 2005, RANZCP