A panic attack is not a mental disorder. In fact, more than one in five people experience one or more panic attacks in their lifetime (Kessler, 2006) but few go on to develop panic disorder or agoraphobia (anxiety disorders related to panic attacks).
If a person does not interpret the sensations present in the panic attacks as signs of imminent danger e.g. having a heart attack,/stroke fainting, choking, losing control, going mad, suffocating or dying, then it is not likely that those panic attacks will develop into panic disorder.
In order to diagnose panic disorder (PD), according to the DSM-IV, someone has to experience recurrent panic attacks (at least 2 of which appeared unexpectedly including 4 or more symptoms of the above mentioned ones) followed by at least 1 month of ONE or MORE of the following:
1- Persistent concern about having more panic attacks
2- Anxiety surrounding the implications or consequences of the attack (e.g. Losing control of oneself, having a heart attack, going crazy, fainting, choking, suffocating, etc.)
3 – Finally, the individual significantly changed their behaviour in order to avoid having another panic attack, for example by adopting safety behaviours (e.g. sitting next to an escape exit, being accompanied by someone when going out, avoid queues, drive with windows open, drinking sips of water frequently, etc.). A safety behaviour is anything a person does during a panic attack to minimise their distressing sensations. These are maladaptive and perpetuate the anxiety in the long term.
These unexpected panic attacks can interfere with a person's emotional life, relationships and ability to work.
John and Sylvia are both specialists in treating panic disorder with or without agoraphobia and they will be able to determine, after a thorough online assessment, whether or not you are suffering from panic disorder.
5. Agoraphobia with or without panic disorder
A. Agoraphobia with panic disorder
Approximately 33% to 50% of patients with panic disorder will also be diagnosed with agoraphobia. The fear of embarrassment plays a pivotal role, as most agoraphobics fear not only panic attacks, but also what other people may think if they see them having a panic attack (Bourne, 1990).
Panic disorder may progress to a more advanced state in which the person becomes afraid of being in any place or situation where escape might be difficult or help unavailable in the event of a panic attack. This condition is called agoraphobia. It affects at least a third of all people with panic disorder. Typically, people with agoraphobia fear being in crowds, waiting in a queue, crossing a bridge, entering shopping centres, malls, and using public transportation (or even their own car). Often, these people restrict themselves to a "zone of safety" that may include only the home or immediate neighbourhood.
Agoraphobia is a coping strategy involving avoidance, where the individual is heavily reliant on avoidance of the types of situations just mentioned. It is not just being afraid of being in open spaces or crowds. Agoraphobia is also diagnosed when the sufferer of panic attacks needs a companion to function. A person with agoraphobia typically leads a life of extreme dependency as well as great discomfort although there are different degrees in agoraphobia. Normally, the greater the avoidance of situations (agoraphobia), the longer the treatment will be.
B. Agoraphobia without panic disorder
While agoraphobia is likely to present in panic disorder, sometimes people may experience agoraphobia without having experienced panic attacks. In this particular case, the fear is limited to just ONE SYMPTOM with catastrophic perceived consequences, such as fear of losing control of the bladder, or bowels , vomiting, headaches (including pressure headaches) or fainting.