Panic disorder with agoraphobia is an anxiety disorder in which a person has attacks of intense fear and anxiety. There is also a fear of being in places where it is hard to escape, or where help might not be available.
Agoraphobia usually involves fear of crowds, bridges, or of being outside alone.
This article discusses panic disorder with agoraphobia. For information on panic disorder itself, see also: Panic disorder
Agoraphobia; Anxiety disorder- agoraphobia
The exact causes of panic disorder and agoraphobia are unknown. Because panic attacks often occur in areas or situations where they have happened in the past, panic may be a learned behavior. Agoraphobia sometimes occurs when a person has had a panic attack and begins to fear situations that might lead to another panic attack.
Anyone can develop a panic disorder, but it usually starts around age 25. Panic disorder is more common in women than men.
Panic attacks involve short periods of intense anxiety symptoms, which peak within 10 minutes. Panic attack symptoms can include:
With agoraphobia, you avoid places or situations because you do not feel safe in public places. The fear is worse when the place is crowded.
Symptoms of agoraphobia include:
People who first experience panic sometimes fear they have a serious illness, or are even dying. Often, people will go to an emergency room or other urgent care center because they think they are having a heart attack.
A physical examination and psychological evaluation can help diagnose panic disorder. It is important to rule out any medical disorders, such as problems involving the heart, hormones, breathing, nervous system, and substance abuse. Which tests are done to rule out these conditions depends on the symptoms.
The goal of treatment is to help you feel and function better. The success of treatment usually depends in part on how severe the agoraphobia is.
The standard treatment approach combines cognitive-behavioral therapy (CBT) with an antidepressant medication.
CBT involves 10 to 20 visits with a mental health professional over a number of weeks. CBT helps you change the thoughts that cause your condition. It may involve:
You may also be slowly exposed to the real-life situation that causes the fear to help you overcome it.
A healthy lifestyle that includes exercise, enough rest, and good nutrition can also help be helpful.
Most patients can get better with medications or behavioral therapy. However, without early and effective help, the disorder may become more difficult to treat.
Call for an appointment with your health care provider if you have symptoms of panic attacks or agoraphobia.
Early treatment of panic disorder can often prevent agoraphobia.
Taylor CT, Pollack MH, LeBeau RT, Simon NM. Anxiety disorders: panic, social anxiety, and generalized anxiety. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 32.