We have already looked into what a panic attack is. If you haven’t already, read the articles on this page if you would like some more information as to what constitutes a panic attack. This article will look into the relationship between panic attacks and agoraphobia. While they are two separate conditions, the relationship between them is important.
Agoraphobia has always been defined as a fear of open spaces. It is now increasingly being defined as a fear of panic attacks. Agoraphobia is one of the results if treatment for panic attacks is not sought and the panic disorder worsens. While not all agoraphobics have panic disorder, over two thirds of them do. In the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, the two conditions that concern us here are listed as three separate disorders – panic disorder with agoraphobia, panic disorder without agoraphobia and agoraphobia without a history of panic disorder.
Panic attacks are embarrassing. Dealing with the symptoms is a nightmare, but having an audience is worse. It’s not something that goes through your mind at the time but afterwards when you think about it, you wonder what people thought or think of you; you think about how awful you must have looked. It is the fear of having another panic attack that leads to changes in behavior. The fear of having another panic attack in public gradually leads to agoraphobia. While it may develop at any time, it is usually within the first year of recurring panic attacks that agoraphobia occurs.
Many agoraphobics feel safe only when following a specific routine or going to set places. Anything different will trigger an attack. These are panic attacks with the intense feeling of fear, heart palpitations, sweating and/or getting the chills, feeling faint and dizzy. Agoraphobics also experience the depersonalization that some panic attack sufferers feel; as if they are floating above their bodies and witness what is happening as if it is to someone else. Another symptom they have in common is the feeling they are going crazy or the fear that they are going to die. In severe cases, agoraphobia results in the person becoming completely housebound, sometimes for years.
It is no simple thing to allow your fear to control your behavior to such an extent as to severely limit the choices you feel able to make. Treatment may take some time, months or even more. The condition has taken years to develop; and so, it will take time to cure. Agoraphobia is treatable, however, and does respond well to treatment.
Usually, a combination of therapies is the best approach with a limited use of medication (if necessary) and a therapy such as cognitive behavior therapy or interoceptive exposure.
The first step in treating agoraphobia is an examination of the conditions in which it developed in the first place. Family background, upbringing, genetics, stress factors, diet and lifestyle all contain clues of the cause or causes of panic disorders and phobias.