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.

Chronic Fatigue Diagnosis

Myalgic Encephalomyelitis, more commonly known as Chronic Fatigue Syndrome is a disorder or groups of disorders that is characterized by the onset of fatigue that persists for more than 6 months. It is characterized by a host of symptoms that range from muscle and joint pains to decreased ability to perform even the least demanding activities.

This syndrome is diagnosed by examining the symptoms of an individual against two groups of symptoms which are commonly demonstrated by CFS patients.

The first sign that healthcare professionals look for is the persisting chronic fatigue that is not related to any other condition that results to exhaustion. Tolerance to fatigue among CFS patients is very low, thus they get severely exhausted after performing even the simplest and least demanding of tasks. In fact, it is not uncommon for CFS patients to move from one place to another without feeling drained.

Most of them also get sick for several days to several weeks after performing minor activities. Most of them also exhibit flu-like symptoms after performing low intensity tasks.

The second criteria for establishing the presence of Chronic Fatigue Syndrome is the onset of four of any of the following symptoms: myalgia or muscle pains, arthralgia or joint pains in multiple locations, head aches of more serious severity, persistent soar throat which recurs, tenderness of the cervical and axillary lymph nodes, impaired short-term memory and concentration, malaise which is experienced after physical exertion, and sleep disturbance.

Other symptoms that healthcare professionals look for are abdominal pain, bloating, dizziness, nausea, chronic cough, chest pains, shortness of breath, dryness of the mouth and eyes, weight loss, onset of minor and major psychological problems such as depression, anxiety, irritability and panic attacks, diarrhea, alcohol intolerance and skin and tingling sensations.

Diagnosis is facilitated only after all conditions that are known to produce the aforementioned symptoms are ruled out. In general, healthcare professionals encounter difficulty in diagnosing chronic fatigue syndromes due to the similarities and generality of symptoms it presents. Apart from the fact that fatigue is a common result of many diseases, it is also a very common sign of most chronic conditions. CFS also presents no symptoms that are visible and obvious enough for easy identification.

On top of these, there are also no diagnostic and laboratory tests that can help in establishing the presence of the disorder. Patients of CFS also display varying symptoms and level of severity which makes most patient experience differences in symptoms and severity. However through exclusion of the following factors, most doctors can arrive at a diagnosis:

1. The presentation of identifiable conditions that result to fatigue and decreased level of activities. Most doctors look for symptoms of hypothyroidism, a condition wherein the thyroid produces lower levels of thyroid hormones. Other notable conditions that may exhibit symptoms similar with CFS are lupus, Lyme disease, multiple sclerosis, bipolar disorder, mononucleosis or kissing disease, depression and diabetes.

2. The usage of medications that result to fatigue. Obviously, there are a number of medications, drugs and substances that can cause physical exhaustion.

3. Recurrence of previous diseases, disorders and illness that can produce extreme exhaustion such as cancer.

4. Substance abuse, more specifically excessive alcohol consumption.

5. Obesity which is defined as having a Body Mass Index (BMI) or more than 45.