Exposure therapy for panic disorder with agoraphobia includes exposure to the situations you fear and avoid is also included in treatment. As in exposure therapy for specific phobias, you face the feared situation until the panic begins to go away. Through this experience, you learn that the situation isn’t harmful and that you have control over your emotions.
Some research suggests that people who have panic disorder might be very sensitive to sensory experiences (such as sunlight, smells and changes in the weather), but there's not enough evidence yet to say for sure. Also it's not clear whether having a high level of sensitivity to these sorts of things is something that might cause you to develop panic disorder, or whether it may be an effect of having it.
Panic disorder affects 2-3% of people every year in the United States and Europe, with varying rates depending on race and ethnicity. On average, Native American Indian populations experience panic disorder at higher rates than non-Latino white Americans. In contrast, African Americans, Latinos, Caribbean Blacks, and Asian Americans all experience the disorder at lower rates than non-Latino white Americans. In addition, it has been well established than females are twice as likely to be diagnosed with panic disorder than males (Asnaani, Gutner, Hinton, & Hofmann, 2009; McLean, Asnaani, Litz, & Hofmann, 2011). A number of factors (e.g., biological influences, temperament, exposure to stressors and trauma, cognitive factors, and environmental factors) have been identified as possibly influencing sex differences in rates of panic disorder (McLean & Anderson, 2009). However, no one theory has been determined so the underlying reason for sex differences in rates of panic disorder remains unknown.
The avoidance behaviors associated with agoraphobia can greatly restrict a person’s life. People with agoraphobia often develop groups of feared situations that are related. For example, many people with agoraphobia become extremely upset and uncomfortable in areas where there are many people in a confined space. This fear may limit them from standing in line at a store, going to a movie theater, or traveling on an airplane. Other commonly feared situations for people with agoraphobia include forms of travel, being alone, and open spaces. These fears may result in an inability to even leave their homes.
Unexpected Panic Attacks: These panic attacks occur suddenly without any obvious cause or indication. When an unexpected panic attack occurs, a person can be completely relaxed before symptoms develop. This type of panic attack doesn't accompany any conscious internal cues, such as having fearful thoughts, feelings of intense dread and anxiety, or uncomfortable physical sensations. Unexpected attacks also don't occur with external cues, such as specific phobias or being exposed to a frightening event or situation.
Anxiety disorders increase one's chances for suffering from other medical illness, such as cardiovascular disorders, including obesity, heart disease and diabetes. More specifically, increased body weight and abdominal fat, high blood pressure, and greater levels of cholesterol, triglycerides, and glucose have all been linked to anxiety. While it is still unclear what causes the high co-morbidity between anxiety and bad physical health outcomes, research suggests that changes in underlying biology that is characteristic of anxiety may also facilitate the emergence for these other physical health outcomes over time. For example, changes in stress hormones, autonomic responses, as well as heightened systemic inflammation are all associated with anxiety disorders and negative health outcomes. These shared physiological states suggest a shared underlying biology and that anxiety maybe a whole-body condition.
Once you are under enough stress, almost anything can set off a panic attack. Suppose you are under a lot of stress, but still managing. If you add even more stress, your brain will begin to feel under siege. Your body will respond by releasing adrenaline as part of the fight or flight response. That will cause more anxiety, which will create a vicious feedback that will turn into a panic disorder.
Obsessive-compulsive Disorder (OCD): In OCD, a person becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing but extremely difficult to overcome. Such rituals as counting, prolonged handwashing, and repeatedly checking for danger may occupy much of the person’s time and interfere with other activities. Like panic disorder, OCD can be treated effectively with medication and/or psychotherapy.
The typical course of panic disorder begins in adolescence and peaks in early to mid-twenties, with symptoms rarely present in children under the age of 14 or in older adults over the age of 64 (Kessler et al., 2012). Caregivers can look for symptoms of panic attacks in adolescents, followed by notable changes in their behavior (e.g., avoiding experiencing strong physical sensations), to help potentially identify the onset of panic disorder. Panic disorder is most likely to develop between the ages of 20-24 years and although females are more likely to have panic disorder, there are no significant sex differences in how the disorder presents (McLean et al., 2011).
Panic attacks and panic disorder are treatable once the underlying cause of is identified. “Usually medical conditions and other factors (substance use or withdrawal from substances) are ruled out before making the diagnosis,” says Flo Leighton, psychiatric nurse practitioner, and therapist with Union Square Practice in Manhattan. Getting to the root cause typically takes a couple of sessions, says Leighton. Here are some options that may be recommended to you :
W hen you’re in danger, your body’s natural reaction is to rapidly initiate the fight-or-flight response. This brain response occurs immediately when someone senses danger and it activates many brain areas that are designed to protect you from that danger by preparing you to “fight” the danger or to escape from it (i.e., “flight”). As part of this response, the brain triggers the release of adrenaline and other hormones throughout your body, so you can respond to the threat. This protective mechanism is called the fight-or-flight response and it helps us to survive. Your emotional and physical responses during fight-or-flight can be described as panic.
Everyone has probably experienced panic, or something like it, at least once in their lifetime: on a disturbingly turbulent plane, or before giving an important presentation, or after realizing you hit reply all when you really, really should not have. We all know the paralyzed feeling and the heightened physical sensations. But panic attacks and panic disorder take a different shape. Panic attacks have many physical symptoms and tend to peak around 10 minutes, and may last for 30. Panic disorder is diagnosed by the frequency of these attacks, and the presence of a fear of having them.
People with panic disorder may also experience comorbid bipolar disorder, alcohol or substance use disorder, or medical problems that accompany their panic. It is common for individuals with panic disorder to have thyroid problems, respiratory issues, heart problems, or feelings of dizziness (APA, 2013). In general, it has been reported that 93.7% of people with panic disorder meet criteria for at least one other medical or mental disorder (Arch, Kirk, & Craske, 2017). That being said, comorbidity is not inevitable with panic disorder and it is important to discuss your symptoms thoroughly with a medical professional. Additionally, the causality of the link between panic disorders and medical problems remains unclear.
Because there are many medical conditions that can cause anxiety attack signs and symptoms, such as the strong sensations and feelings associated with anxiety attacks, it’s wise to discuss them with your doctor. If your doctor has attributed your anxiety attacks to stress and anxiety, you can feel confident that your doctor’s diagnosis is correct. Anxiety attacks and their signs and symptoms are relatively easy to diagnose and aren’t easily confused with other medical conditions.