Panic Attacks: Between Panic Disorder and Agoraphobia

For most people, dealing with life stressors job changes, moving, pregnancy, birth of a child, death of a loved one etc. do not result to anxiety and panic attacks. However, to those who are vulnerable to emotional stress, such situations may lead to panic attacks even if these events happened way back in their life. The reason for this is still not fully understood but it is believed that one major cause of panic attacks is extended period of stress (not by a few days of tension but by several months of constant worrying and unprocessed emotions).

The chances of having an attack are even greater when a panic-prone person receives unnecessary stress such as additional tasks at work or additional responsibility at home. Instead of performing normally under regular circumstance, the additional load can put more pressure that can lead to more stress which can be a catalyst for an attack.

What is panic disorder?

It is commonly believed that panic attacks happen out of the blue, without any reason. It can happen to anyone at any point in their life. Many people experience one episode of panic attack. However, others go on to suffer from panic disorder. Panic disorder is characterized by several episodes of panic attacks related to past traumatic experiences, existing stress (mentioned above) or something else.

Many attacks last for not more than 30 minutes but the effects of panic disorder can leave lasting effects. People suffering from panic disorder experience emotional stress and excessive fear due to the memory of past attacks. This negative memory has a negative impact to self-confidence and self-esteem, which can lead to the disruption of everyday activities and normal living. While the causes of panic disorder vary from person to person, all conditions lead to these symptoms:

Anticipatory anxiety or the fear of having future attacks. This can have a detrimental effect to the sufferer since they cannot relax and they always feel anxious and tensed in between attacks.

Phobic avoidance is characterized by avoiding situations or events in the belief that the situation may cause panic attack. Phobic avoidance can also be avoiding places where help is unavailable during emergency situation.

What is agoraphobia?

Agoraphobia is traditionally believed to involve fear of open spaces or public places. Literally means “fear of the marketplace,” agoraphobia is now believed to be a result of panic attacks.

People diagnosed with agoraphobia show different symptoms. But common to all agoraphobics is avoidance either being in public places or being alone. This is actually a character of phobic avoidance (one distinct symptom of panic disorder). The difference, however, is that the effects of agoraphobia can significantly limit the person’s normal activities. Thus, what sets agoraphobia apart from panic disorder is the amount of activities that the person avoids.

People with panic disorder stay generally active, although there are specific situations that they tend to avoid. On the other hand, agoraphobics limit their activities because of fearful thoughts. These fearful thoughts can be very damaging the person’s life as well as his relationship to others.

Either way, both conditions are the result of panic attacks. Hence, it is always best to know the things you can do in order to prevent panic attacks from recurring and worsening. On the first sign of attack, seek for professional help.

Understanding Anxiety and Anxiety Attacks

Anxiety is a normal, healthy feeling that is experienced by everyone. It is the body’s way of reacting to stimulus that pushes us to either “fight” or “flight” over a situation. However, when anxiety attacks are chronic, severe, and irrational, and begin to affect the health of a person (physically, psychologically and emotionally), it already becomes a problem that must be addressed immediately. There is a thick line between healthy and unhealthy anxiety attacks. Unfortunately, the demarcation line is almost ignored that normal anxiety crosses into the territory of anxiety disorders.

Types of Anxiety Disorder

There are six different types of anxiety disorder, each has its own characteristics: generalized anxiety disorder, panic disorder, phobia, post-traumatic stress disorder, social anxiety disorder, and obsessive-compulsive disorder.

Generalized anxiety disorder (GAD) is a chronic worry or fear over almost everything without even knowing why. They feel anxious from day to day activities and are troubled that bad things will happen. People with GAD show symptoms such as stomach upset, fatigue, restlessness, and insomnia.

Panic disorder is repeated, unexpected panic attacks, and fears that panic episodes will likely to happen. People with panic disorder are likely to have agoraphobia, or fear of being in places where help or escape will be difficult in case of another panic attack. People with agoraphobia are also afraid of being trapped in confined places such as an airplane or crowded areas such as a shopping mall.

Phobia is excessive, irrational, and exaggerated fear over simple things that generally present little or no danger. Common phobias are heights, snakes, spiders, dark, and flying. People with phobias tend to avoid the things they are afraid of in order to escape anxiety attacks. However, avoidance only strengthens the phobia.

Post-traumatic stress disorder is an anxiety disorder that happens after a life-threatening or a traumatic event. People with PTSD show symptoms such as hyper-vigilance, avoiding situations or places that remind them about the event, nightmares and flashbacks about the things that happened, startling easily, and isolation.

Social anxiety disorder or social phobia is fear of being seen negatively by others or fear of getting humiliated in public by other people. Social anxiety is often mistaken as an ordinary extreme shyness. People with this kind of disorder usually isolate themselves from others or event and places where crowd usually gathers. Stage fright is the most common type of social anxiety.

Obsessive-compulsive disorder or OCD is a condition where a person has unwanted behavior or thoughts which appear to be impossible to control. People with OCD can have certain obsession such as worries that they might hurt someone or that they have forgotten to turn the lights off. They can also have uncontrollable compulsion. The most common is washing of hands repeatedly.

Do you experience anxiety attacks?

Are you always worried, tense, and on the edge?

Do you feel like you are in danger whenever you are in confined places?

Are you afraid of mingling with strangers, meeting new friends or even meeting relatives?

Do you feel that something bad or catastrophic will happen if certain things are not done according to plan?

Do you experience worry, fear and anxiousness that affect your relationship, work, healthy, and other responsibilities?

Do you feel irrational fear but couldn’t shake it?

Does your anxiety force you to avoid everyday situations and activities?

Panic Attacks What Would Happen If You Do Not

Panic Attacks What Would Happen If You Do Not Get Treatment

At the onset of panic attacks or disorder, it is best to go see your doctor immediately and have it evaluated as this will not only give you a clear understanding of what condition you are undergoing but this could also prevent the aggravation of the disorder. Here are several possible scenarios if you do not get panic attacks intervention immediately:

Agoraphobia. Contrary to public belief, agoraphobia is not the fear of closed spaces. It is actually fear of public places basing from the Greek root word “agora” which means market or marketplace. Agoraphobics fear interaction with people especially in places where they expect to experience episodes of panic or anxiety. Panic attacks and agoraphobia are often closely connected as these disorders exhibit identical symptoms such as shortness of breath, the sensation of dying or going crazy, and the feeling of having heart attack.

Over-dependence on psychotherapeutic medications specifically anti-anxiety disorder medications. People suffering from panic attacks and could not get hold of themselves are often helped by medications to control their symptoms. But for those who cannot muster enough initiative to resolve their condition without having to rely on medications are often enclosed within the idea of medication as the ultimate solution against panic attacks.

While over-dependence on medication to control the symptoms of panic attacks is not the same as addiction to the medications, this behavior still poses serious possible problems since those people who become dependent on drugs oftentimes fail to utilize other more effective treatments. They can also become too dependent that they would fail to function properly without the necessary dosage of particular drugs.

Further, although dependence on medications is not an entirely negative solution, in fact for some people it is the most effective, it should be remembered that it is not the only solution. There are less intensive, less invasive, but equally appropriate and effective therapies and methods that are typically overlooked due to too much dependence on panic attack drugs.

Depression. 20% of panic attack patients are likely to commit suicide, a typical outcome of depression, at one time or another, says research. The connection between panic attacks and depression can be viewed from several different standpoints. According to an explanation for example, depression develops from a person’s exhaustion caused by chronic anxiety that typically accompany such attacks.

Another explanation purports to the fact that those people with panic attacks and also have developed serious cases of agoraphobia are prevented from socializing with other people and from doing the things that they previously enjoyed, leading to a general feeling of isolation and unhappiness. This further leads to the development of episodes of depression.

Diabetes. It is not uncommon to find people who are suffering from panic attacks and also have indications of comorbid disorders, an example of which is diabetes. Research shows that people with diabetes and who also experienced intermittent episodes of panic attacks are less likely to live quality lives and are also more likely to develop complications. Among people with diabetes, panic attacks as well as depression impede them from efficiently monitoring and controlling their blood glucose level.

Substance abuse. Chronic misuse of alcohol and other unhealthy substances is a coping mechanism against negative conditions such as behavioral disorders. So long as the condition that caused the chronic use of substances exists, in this case panic attacks, the negative resolution will persist.

Panic Attack: Signs, Symptoms, Panic Disorder and Agoraphobia

A panic attack is a sudden surge of overwhelming fear and anxiety, usually without any clear reason and without warning. It can happen to anyone regardless of age, health and status. Many attacks are a one-time occurrence, but some people experience recurring episodes. Recurring episodes are often caused by a “trigger” like speaking in front of a crowd or doing a presentation at work. Panic attacks may be a part of another disorder such as depression, panic disorder, or social phobia. These, however, are generally harmless, but sufferers still feel that their life is in danger. Either way, panic attacks are treatable.

Signs and Symptoms

A panic attack can happen anytime, but it usually happens when you are away from home. You may be at a store shopping, at work preparing for a presentation, in a class, driving, walking down the street or even during asleep.

The signs and symptoms develop quickly and usually arrive at its peak in 10 minutes. The majority of panic attacks do not last for more than 30 minutes and it rarely lasts for more than an hour.

A person during an attack shows these signs and symptoms:

Increased heartbeat or palpitation
Chest pain
Hyperventilation or shortness of breath
Stomach churning, upset stomach
Trembling and shaking
Muscle tension
Sweating
Dizziness and light-headedness
Hot or cold flashes
Tingling sensation or numbness
Fear of dying, going crazy or losing control
Feeling detached from the surroundings

Panic Disorder

A panic attack may happen just once without any problem or complication. And there is almost no reason to be concerned if you have one or two episodes. But those who have experienced several episodes usually develop panic disorder.

Recurring panic attacks along with persistent anxiety for future attacks and major changes in behavior can be considered as panic disorder. There are two symptoms of panic disorder: (1) phobic avoidance and (2) anticipatory anxiety.

Phobic avoidance – When you begin to avoid certain things or situations based on the belief that it would trigger another attack. It can also be avoiding situations that have caused the previous attack. You may also avoid places or situations where escape is difficult and help is unavailable, like riding an elevator or an airplane. Extreme case of phobic avoidance may lead to agoraphobia.

Anticipatory anxiety The “fear of fear” or the fear of having future panic attacks. The person manifesting this symptom is usually tensed and anxious. When ignored, the condition can be disabling.

Panic disorder with agoraphobia

Agoraphobia is traditionally believed as fear of open places or public places, thus, it literally means “fear of the marketplace.” However, now it is believed that agoraphobia is fear of experiencing panic attack in a place where help is difficult or where escape would be difficult.

People with agoraphobia tend to avoid the following situations or activities:

Being away from home

Driving

Confined places where there is a possibility of being trapped (elevator, theaters, public transportation, stores)

Going out with “unsafe” person or someone he or she is not comfortable being with.

Places where it would be embarrassing to have a panic attack like parties and other social gatherings.

In severe cases, people with agoraphobia see their home as the only safe place.