Panic disorders & Agoraphobia

Spontaneous and unexpected occurrence of panic attacks are what characterize Panic Disorder. This can vary from several attacks per day to only a few attacks per year. Panic attacks are defined as a period of intense fear from which 4 of 13 defined symptoms develop in a sudden manner and peak in about 10 minutes from the moment they started. Although panic attacks can occur in other anxiety disorders, in panic disorder, the attacks often occur for no apparent reason.


The DSM-5 criteria for Panic Disorder are:

4 or more panic attacks in a 4-week period, and one panic attack followed by at least 1 month of fear of having another panic attack and one or more of the following:

  • Persistent concern about the implications of the attack, such as its consequences (e.g., losing control, having a heart attack, “going crazy”) or fears of having additional attacks.

  • A significant change in behavior related to the attacks (e.g., avoid exercise or unfamiliar situations).

  • The Panic Attacks may not be due to the direct physiological effects of use or abuse of a substance (alcohol, drugs, medications) or a general medical condition (e.g., hyperthyroidism).

Here are the possible panic attack symptoms

  • Palpitations, pounding heart, or accelerated heart rate

  • Sweating

  • Trembling or shaking

  • Sense of shortness of breath or smothering

  • Feeling of choking

  • Chest pain or discomfort

  • Nausea or abdominal distress

  • Feeling dizzy, unsteady, lightheaded, or faint

  • Derealization or depersonalization (feeling detached from oneself)

  • Fear of losing control or going crazy

  • Fear of dying

  • Numbness or tingling sensations

  • Chills or hot flashes

Types of panic attacks:

  1. Unexpected panic attacks, which are the trademark of panic disorder, occur spontaneously or “out of the blue.” No situational or environmental triggers are associated with the attack. These types of panic attacks may even occur during one’s sleep.

  1. Expected panic attacks occur upon actual or anticipated exposure to certain situations. These situations become cues or triggers for a panic episode. For example, an individual who fears enclosed spaces experiences a panic attack when entering, or thinking about entering, a movie theater.

Do you think that you or someone you know are suffering from Panic disorder?

Complete the following quiz: Free Panic Disorder test (upcoming)


Almost one-third of people suffering with panic disorder will develop another distressing condition known as agoraphobia.

Agoraphobia is essentially the fear of having a panic attack in places or situations in which it would be humiliating and/or extremely difficult to escape (Such as a movie theater). Individuals suffering from agoraphobia may experience the fear of being in situations where they believe that people would not be able to help them in case they were to have a panic attack.

The DSM-5 criteria for Agoraphobia are:

The experience of intense fear or anxiety in at least two agoraphobic situations, such as being outside the home alone, public transportation (i.e. airplanes, buses, subways, etc.), open spaces, public places (i.e. stores, theaters, or cinemas), or a combination of two or more of these scenarios. To be diagnosed with agoraphobia, the person will also need to be exhibiting avoidance behaviors.

Avoidance Behaviors and Safe Zones

People who struggle with the symptoms of agoraphobia often develop avoidance behaviors. This occurs when the person begins to stay away from places, situations, and events that they believe may cause intense anxiety and possibly trigger a full-blown panic attack. The avoidance behaviors associated with agoraphobia can become so severe that the person’s overall quality of life begins to suffer. It is not uncommon for people with agoraphobia to begin to limit their exposure to only a few areas that they believe are safe. Known as “safe zones,” creating such restrictive boundaries can negatively impact a person’s quality of life. Many people with agoraphobia find it extremely challenging, if not unbearable, to go outside of their safe zone. This anxiety can greatly affect their ability to maintain friendships and employment, leading to feelings of loneliness and isolation.

Symptoms of agoraphobia may include:

  • Panicked Feelings: Agoraphobia can become a self-replicating cycle. The sufferer is anxious about having a panic attack which can, in turn, lead to a panic attack.

  • Avoidant Behavior: Limiting life activities in an effort to avoid situations where help for a panic attack may not be available.

  • Clustering: A pattern of avoided situations is generally present. Common clusters include public transportation; shopping; driving; and leaving home. For example, a person may become fearful about various forms of travel, such as buses, trains, and cars.

Do you think that you or someone you know are suffering from Panic disorder? Complete the following quiz: Free Panic Disorder test (upcoming)