Panic disorder with agoraphobia

Definition

Panic disorder is an Anxiety disorder characterized by repeated and unexpected attacks of intense fear and anxiety.

Panic attacks are usually not related to a particular situation and typically peak within ten minutes of onset. The anxiety experienced by patients with social and specific phobias is usually expected or cued to a recognized stimulus.

Agoraphobia refers to a fear of being in places where escape might be difficult, or where help might be unavailable in case of a panic attack.

Causes, incidence, and risk factors

The exact cause of panic disorder is unknown, but it is associated with multiple physiological factors. Panic disorder can occur with or without agoraphobia, but agoraphobia develops in more than one-third of cases.

The development of agoraphobia may involve learned behavior, because it reflects a fear of experiencing panic attacks in unprotected settings. Sometimes, panic attacks are associated with the areas where they have happened in the past.

Studies have reported lifetime prevalence rates of 1.5 to 5% for panic disorder. Panic disorder can occur in children, but the average age of onset is 25 years old. Panic disorder affects middle-aged and older adults as well. Studies have shown that women are 2 to 3 times more likely to be affected.

Symptoms

Panic attacks involve limited periods of intense symptoms, such as those listed below, which peak within 10 minutes of their onset:

• Shortness of breath
  
• Dizziness or faintness
  
• Palpitations
  
• Trembling
  
• Sweating
  
• choking
  
• nausea or other abdominal distress
  
• Numbness or tingling
  
• Chest pain or discomfort
  
• Hot flushes or chills
  
• Fear of dying
  
• Fear of being out of control
  
• Fear of "going crazy"
  

Symptoms of agoraphobia include:

• Anxiety about being in places where escape might be difficult
  
• Avoiding or enduring situations with marked stress or anxiety about having a panic attack