Panic Disorder & Agoraphobia

Suffolk Cogntive-Behavioral PLLC
Director: Mark Sisti, PhD
Offices: Huntington, Setauket & Brooklyn 631-696-2896
How common is it? 
It is estimated that somewhere between 1% to 4% of the people in the U.S. suffer from panic disorder, that’s 2 to 6 million people. It seems to occur more often in women (almost twice as often) , though it is also a common condition among men. Approximately 33% to 50% of those suffering from Panic attacks also suffer from agoraphobia. Panic occurs equally among all racial, economic, and geographic groups. Often the symptoms start in late adolescence or early twenties. The severity of symptoms tend to wax and wane over the course of time.
Physical and emotional symptoms 
We have all experienced panic, that sudden rush of terror that occurs when something life threatening is about to happen. Panic disorder is having that same sudden sense of something horrible about to happen only, nothing dangerous is happening, the attacks come out of the blue – for no apparent reason. Along with this sudden unprovoked attack of terror, there are a variety of physical symptoms that accompany the attack: trembling/shaking, sweating, hot/cold flashes, faintness, unsteadiness, dizziness, difficulty concentrating, disorientation, a sense of unreality, racing heart, chest discomfort, difficulty breathing, dry mouth, numb body parts, etc.
Behavioral Characteristics 
The behavioral symptoms of panic disorder are really just different forms of escape and avoidance. Avoidance can take many forms, often it’s as simple as giving in to the urge not to go to a certain place, or to quickly escape if the discomfort get too powerful. After several panic attacks sufferers begin to avoid places from which immediate escape is difficult (e.g. crowds, malls, restaurants, highways, public transportation, long lines, etc). Being alone is often avoided. Sufferers may become increasingly reluctant to leave the house without a safe-person (“someone who understands”). This avoidance is a natural, almost automatic way that people try to reduce anxiety, physical distress and panic. Unfortunately avoidance never helps a person to learn how to cope. Instead avoidance weakens coping skills, worsening the problem. If avoidance goes uncorrected the loss of the ability to function independently gets worse and the situations in which a person feels comfortable become fewer and fewer.
Cognitive Characteristics 
Thoughts (cognitions) include the ideas or images that come to mind just before or during and after a panic attack. People who suffer from panic disorder usually believe that they are either dying (e.g. heart attack, or stroke) , or that they are loosing their minds (going crazy) or loosing control. After the first several attacks panic disorder can begin to grow into an additional problem – agoraphobia. Agoraphobia is a fear of being unable to get away to a safe place, or to a safe person and having another panic attack. People with agoraphobia often start to think; “if I’m alone or away from a familiar place it will cause an attack” or “I cannot get through an attack alone”. Often during the first several attacks a Person may end up in the emergency room, taking multiple test in order to try and figure out what is physically wrong. While getting a good physical and ruling out other medical conditions is a good idea, often a person with panic disorder continues to believe that something physically wrong is being missed. Very often continuing to believe incorrectly that they are still in some kind of danger. Anticipating having the next attack starts a vicious cycle known as fear of fear. Without treatment, panic disorder sufferers usually begin to develop agoraphobic avoidance habits (avoiding traveling alone) and that is why panic disorder and agoraphobia are often terms used interchangeably.

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