A fear of being in places or situations from which escape may be difficult or impossible

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Panic disorder is a type of anxiety disorder characterized by recurrent and unpredictable bursts of terror known as panic attacks. A panic attack is accompanied by physical symptoms that may feel similar to a heart attack or other life-threatening condition.

Intense anxiety often develops between episodes of panic. As panic attacks become more frequent, you may begin to avoid situations that could trigger them. Panic attacks can lead to agoraphobia, the fear of being trapped in places or situations where escape could be difficult or impossible.

Panic disorder is likely to be an interaction of:

  • Genetics
  • Changes in brain function or metabolism
  • Psychosocial stressors that combine to influence the brain's fear networks

Risk Factors

Panic disorder is more common in women and young adults. Other factors that may increase your risk of developing panic disorder include:

  • Family history
  • Stressful life events
  • Increased sensitivity to physical sensations
  • History of another anxiety disorder or anxious temperament
  • Cigarette smoking during adolescence and young adulthood

Symptoms

Panic attacks usually occur unexpectedly and repeatedly. Panic attack symptoms may include:

  • Sudden and intense episodes of fear
  • Racing, pounding, or skipping heartbeat
  • Chest pain, pressure, or discomfort
  • Difficulty breathing
  • Choking sensation or lump in the throat
  • Excessive sweating
  • Lightheadedness
  • Nausea
  • Tingling or numbness in parts of the body
  • Chills or hot flashes
  • Shaking or trembling
  • Feelings of unreality or being detached from the body
  • An urge to flee
  • Fear of impending doom, such as death, a heart attack, suffocation, loss of control or embarrassment
  • Stomach pain

Diagnosis & Treatment

Your doctor can diagnose you with panic disorder if you have had a panic attack with at least four symptoms and persistent worries about the attack for more than one month. Since some panic disorder symptoms are similar to heart, digestive, and/or thyroid problems, your doctor may recommend tests to rule out an underlying condition.

Treatment aims to decrease the frequency and intensity of panic attacks.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy can prepare you for situations that may trigger panic attacks. Therapy focuses on:

  • Learning how to recognize what causes your fears
  • Gradually forming healthier thinking patterns
  • Doing breathing exercises to increase relaxation
  • Reducing fear and feelings of terror

Medications

Your doctor may recommend antidepressants or anti-anxiety medications.

 

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.

Michael T, Zetsche U, and Margraf J. Epidemiology of Anxiety Disorders. Epidemiology and Psychopharmacology 136:142, 2007.

  • Goodwin RD, Stein DJ. Anxiety disorders and drug dependence: evidence on sequence and specificity among adults. Psychiatry Clin Neurosci. 2013;67(3):167-73.  [PMID:23581868]
  • Wittchen HU, Gloster AT, Beesdo-Baum K, et al. Agoraphobia: a review of the diagnostic classificatory position and criteria. Depress Anxiety. 2010;27(2):113-33.  [PMID:20143426]
  • Perugi G, Frare F, Toni C. Diagnosis and treatment of agoraphobia with panic disorder. CNS Drugs. 2007;21(9):741-64.  [PMID:17696574]
  • Perna G, Daccò S, Menotti R, et al. Antianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition. Neuropsychiatr Dis Treat. 2011;7:621-37.  [PMID:22090798]
  • Hofmeijer-Sevink MK, Duits P, Rijkeboer MM, et al. No Effects of D-Cycloserine Enhancement in Exposure With Response Prevention Therapy in Panic Disorder With Agoraphobia: A Double-Blind, Randomized Controlled Trial. J Clin Psychopharmacol. 2017.  [PMID:28820746]
  • Gloster AT, Hauke C, Höfler M, et al. Long-term stability of cognitive behavioral therapy effects for panic disorder with agoraphobia: A two-year follow-up study. Behav Res Ther. 2013;51(12):830-839.  [PMID:24184430]
  • James JE, Hampton BA, Larsen SA. The relative efficacy of imaginal and in vivo desensitization in the treatment of agoraphobia. J Behav Ther Exp Psychiatry. 1983;14(3):203-7.  [PMID:6139389]
  • Bouchard S, Gauthier J, Laberge B, et al. Exposure versus cognitive restructuring in the treatment of panic disorder with agoraphobia. Behav Res Ther. 1996;34(3):213-24.  [PMID:8881091]
  • Zalaznik D, Weiss M, Huppert JD. Improvement in adult anxious and avoidant attachment during cognitive behavioral therapy for panic disorder. Psychother Res. 2017.  [PMID:28826378]
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing
  • Meyerbroeker K, Morina N, Kerkhof GA, et al. Virtual reality exposure therapy does not provide any additional value in agoraphobic patients: a randomized controlled trial. Psychother Psychosom. 2013;82(3):170-6.  [PMID:23548832]
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    Last updated: November 1, 2017

    Citation

    Winter, Elizabeth. "Agoraphobia." Johns Hopkins Psychiatry Guide, 2017. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787057/all/Agoraphobia.

    Winter E. Agoraphobia. Johns Hopkins Psychiatry Guide. 2017. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787057/all/Agoraphobia. Accessed January 3, 2023.

    Winter, E. (2017). Agoraphobia. In Johns Hopkins Psychiatry Guide https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787057/all/Agoraphobia

    Winter E. Agoraphobia [Internet]. In: Johns Hopkins Psychiatry Guide. ; 2017. [cited 2023 January 03]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787057/all/Agoraphobia.

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    TY - ELEC T1 - Agoraphobia ID - 787057 A1 - Winter,Elizabeth,M.D. Y1 - 2017/11/01/ BT - Johns Hopkins Psychiatry Guide UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787057/all/Agoraphobia DB - Johns Hopkins Guide DP - Unbound Medicine ER -

    What is the fear of being in places or situations where escape may be difficult or impossible?

    Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.

    What is an enochlophobia?

    Noun. enochlophobia (uncountable) (rare) Fear of crowds.

    Why is agoraphobia called agoraphobia?

    In severe cases people may become completely unable to leave their homes. An ancient agora in Delos, Greece—one of the public spaces after which the condition is named. Agoraphobia is believed to be due to a combination of genetic and environmental factors.

    What is Apeirophobia?

    apeirophobia (uncountable) The fear of infinity and/or eternity. quotations ▼