Phobias, Panic, and Agoraphobia
INTRODUCTION
Every human feels anxiety on occasion; it is a part of life. We all know what it is like to feel worry, nervousness, fear, and concern. But millions of people (an estimated 15 percent of the population) suffer from devastating and constant anxiety that severely affects, and sometimes highly restricts, their lives. They experience panic attacks, phobias, extreme shyness, and obsessive thoughts and compulsive behaviors. The feeling of anxiety is a constant dominating force that disrupts their lives. Some become prisoners in their own homes, unable to leave to work, drive, or visit the grocery store. For people with panic attacks, phobias, and agoraphobia, anxiety is much more than just an occasional wave of apprehension.
WHAT IS PANIC DISORDER?
Panic disorder is a condition in which a person has panic attacks without warning. According to the National Institutes of Mental Health, about 5 percent of the adult population in the United States suffers from panic attacks. Some experts say that this number is actually higher, since many people experience panic attacks but never receive treatment.
A panic attack is extremely upsetting and frightening. It typically lasts several minutes, but in some cases, it lasts longer or strikes several times in a short time period. Often, a panic attack is followed by feelings of depression and helplessness. Most people who have experienced a panic attack say that their greatest fear is that the attack will happen again.
Many times, a person who has experienced a panic attack doesn’t know its cause. Other times, a person reports having felt extreme stress or having encountered difficult times and isn’t surprised that a panic attack occurred.
When a person has two or more sudden panic attacks and during the following month becomes fearful of having another attack, he/she may be diagnosed with panic disorder. People who experience a series of panic attacks may begin to worry that they have a physical illness. They may go to the doctor for medical testing and continue to worry even when tests show no physical problem.
COMMON PANIC SYMPTOMS
- Racing or pounding heart
- Trembling
- Sweaty palms
- Feeling of terror
- Pains or heaviness in chest
- Dizziness and light-headedness
- Fear of dying
- Fear of going crazy
- Fear of losing control
- Feeling unable to catch one’s breath
- Tingling in the hands, feet, legs, and arms
WHAT IS A PHOBIA?
A person with a phobia has extreme fear of a specific situation (e.g., flying in a plane) or thing (e.g., dogs). People exposed to their feared situation or thing feel extreme anxiety and perhaps panic. While most adults with phobias know that these fears are extreme and irrational, they are unable to control them. As a result, they dread and attempt to avoid the thing or situation that they fear.
Sometimes, a person’s fear is so strong that it interferes with his/her daily life, job, social relationships, and so forth. The person’s life may be affected in a variety of ways, such as missing out on a promotion because of a fear of flying or being unable to go to crowded places. The fear may also cause extreme distress. Such fears are considered phobias if they are not reasonable.
Phobias often begin in childhood and may coincide with a traumatic event. A fear of birds, for example, may begin when a child is frightened by a bird flying into his/her house. Many phobias that begin in childhood fade by adulthood.
WHAT IS AGORAPHOBIA?
Agoraphobia is the disabling fear that prevents one from leaving home or other safe place. This disorder usually stems from the fear of having a panic attack in a specific situation. When in that situation, a person with agoraphobia may experience a panic attack if getting away or getting help seems difficult or embarrassing.
The literal meaning of agoraphobia is fear of open spaces or the marketplace. People with agoraphobia fear and avoid settings where there are crowds of people, such as stores and bus, train, or auto travel. They may also avoid tall places, such as buildings and bridges.
People who suffer from agoraphobia often become extremely anxious, avoiding all but a few situations that seem safe. Some are unable to leave their homes for years at a time.
WHAT IS THE TREATMENT FOR THESE DISORDERS?
Most people who suffer from anxiety disorders begin to feel better when they receive the proper treatment. It can be difficult to identify the proper treatment, however, because each person’s anxiety is caused by a unique set of factors. It can be frustrating for the client when treatment is not immediately successful or takes longer than hoped for. Some clients feel better after a few weeks or months of treatment, while others may need a year or more. If a person has an anxiety disorder in combination with another disorder (e.g., alcoholism or depression), treatment will be more complicated and will take longer.
Although a treatment plan must be specifically designed for each individual, a number of standard approaches exist. Mental health professionals who specialize in treating anxiety most often use a combination of the following treatments. There is no single correct approach.
Cognitive therapy.
The client learns how to identify and change unproductive thought patterns by observing his/her feelings and learning to separate realistic from unrealistic thoughts.
Behavior therapy.
This treatment helps the client alter and control unwanted behavior. Systematic desensitization is a type of behavior therapy often used to help people with phobias, obsessive-compulsive disorder (OCD), and agoraphobia. The client is exposed to anxiety-producing stimuli one small step at a time, which gradually increases his/her tolerance to situations that have produced disabling anxiety.
Relaxation Training.
Many people with anxiety disorders benefit from self-hypnosis, guided visualization, and biofeedback. Relaxation training is often part of psychotherapy.
Medication.
Antidepressant and anti-anxiety medications can help restore chemical imbalances that cause symptoms of anxiety. Using medication, especially in combination with psychotherapy, is an effective treatment for many people.
Treatment for an anxiety disorder depends on the severity and length of the disorder. The client’s willingness to actively participate in treatment is also an important factor. When a person with panic disorder is motivated to try new behaviors and practice new skills and techniques, he/she can learn to change the way the brain responds to familiar thoughts and feelings that previously caused anxiety.
WHERE CAN I GO FOR MORE INFORMATION?
Anxiety Disorders Association of America (adaa.org).
Anxiety Panic Internet Resource (algy.com/anxiety).
Internet Mental Health (mentalhealth.com).
Bassett, Lucinda. From Panic to Power: Proven Techniques to Calm Your Anxieties, Conquer Your Fears, and Put You in Control of Your Life. New York: Quill, 1997.
Bourne, Edmund J. The Anxiety and Phobia Workbook. Oakland, CA: New Harbinger, 2000.
Ross, Jerilyn. Triumph over Fear: A Book of Help and Hope for People with Anxiety Disorders. New York: Bantam Books, 1995.