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Panic Disorder (with or without Agoraphobia)

Panic Disorder.

Panic Disorder is characterised by recurrent unexpected panic attacks.  A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and during which time four (or more) of the following symptoms occur.

  1. Palpitations, pounding heart or accelerated heart rate.
  2. Sweating (even though the environment around the individual is not hot).
  3. Trembling or shaking.
  4. Sensations of shortness of breath or smothering.
  5. Feelings of choking.
  6. Chest pain or discomfort.
  7. Nausea or abdominal distress.
  8. Feeling dizzy, unsteady, light-headed, or faint.
  9. Chills or heat sensations.
  10. Numbness or tingling sensations (paresthesias).
  11. Feelings of ‘unreality’, also known as Derealisation which is the experience of the world around the individual as dreamlike, distant or distorted. Depersonalisation may also be experienced, which is feeling detached from one’s mental processes or body, as if one were an outside observer.  For example, feeling as though one were in a dream; feeling a sense of unreality of self or body or of time moving slowly.
  12. Fear of losing control or “going crazy”.
  13. Fear of dying.

Panic Disorder includes panic attacks and a persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, “going crazy”) for at least a month or longer.  A key aspect of Panic Disorder is a person’s fear of panic itself.  People who experience Panic Disorder may also change their behaviour to avoid having panic attacks.  Such changes might include avoiding exercise or unfamiliar situations if the person suspects those situations may trigger their panic.

Panic Disorder is only diagnosed if the above symptoms result in significant emotional distress or impairment in the persons ability to work and maintain social or occupational relationships.

Panic Disorder is diagnosed only if it’s clear that another medical issue or legal or illegal drug use is not causing the excessive fear and other symptoms of anxiety.

Agoraphobia.

Agoraphobia involves a marked fear or anxiety about two or more of the following situations.  It should be noted however that the following situations are not exhaustive and other situations may exist that are not listed.

  1. Using public transportation (e.g., automobiles, buses, trains, ships, planes).
  2. Being in open spaces (e.g., parking lots, marketplaces, bridges).
  3. Being in enclosed places (e.g., shops, theatres, cinemas).
  4. Standing in line or being in a crowd.
  5. Being outside of the home alone.

The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms (see above) OR other incapacitating/embarrassing symptoms.  E.g., fear of falling in the elderly or a fear of incontinence.

For Agoraphobia to be diagnosed the feared situations must almost always provoke fear or anxiety and are actively avoided.  If the situations can’t be avoided, they are endured with intense fear or anxiety or may be only endured with the reassuring company of another person.  It is also assumed that the fear of the given situation is out of proportion to any actual danger posed and the fear and avoidance of the situations persists for six months or more.

Like all other disorders, Agoraphobia is only diagnosed if the above symptoms result in significant emotional distress or impairment in the person’s ability to work and maintain social or occupational relationships.

Agoraphobia is also diagnosed only if it’s clear that another medical issue or legal or illegal drug use is not causing the excessive fear and other symptoms of anxiety.

Disclaimer:  The information covered on this website is for educational purposes only.  Other anxiety disorders including Generalised Anxiety Disorder and Social Anxiety can share symptoms in common with Panic Disorder and Agoraphobia, so it’s important to speak with your GP or a psychologist about your concerns to clarify what you’re experiencing and to receive appropriate treatment.  A diagnosis of any psychiatric or medical condition must only be made by a medical or mental health specialist.  Diagnosing a psychiatric concern is a complex process that involves formal training, do not ‘diagnose’ yourself.

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