Panic disorder and Agoraphobia

May 2014

Panic disorder affects thousands of people and can be very debilitating. People with panic disorder have sudden and repeated attacks of intense fear that last for several minutes or much longer.

If you think that sounds like small beer, imagine the feeling of stepping out into the road without looking and discovering a bus is about to hit you at speed. That’s how it is, not for a merciful split second, but for minutes or longer.

The subconscious mind cannot distinguish between ‘real’ and ‘theoretical’ danger which is why the symptoms are so intense. What’s more, the conscious, rational mind has no hold over the subconscious, which is why knowing that a (spider, hairbrush, button, trip to the corner shop....) cannot actually inflict physical harm on you doesn’t actually help.

Panic attacks are characterized by a fear of catastrophe, death or of losing control even when there is no ‘real’ danger. A person may believe they are having a heart attack and may dread the possibility of having another attack. This in turn may lead to the person’s life becoming affected by the fear. This fear of fear itself can mean that a person begins to avoid the trigger places or situations where they had the attack. They may also feel ashamed of themselves and cover the reasons for the avoidance behaviour with a ‘more acceptable’ excuse.

No-one knows why people suffer from panic disorder. Stress and environmental factors may play a role; some people may just be ‘hard-wired’ for panic disorder.

People with panic disorder may have sudden and repeated panic attacks, a feeling of catastrophe or being out of control, worry about the next attack, avoidance behaviour. The fear may manifest as sweating, a pounding heart, chest pain, tingling extremities, faintness or headache, or digestive disturbance.

Panic disorder affects around 590,000 people in the UK and is twice as common in women as men. Panic attacks often begin in late adolescence or early adulthood, but not everyone who has panic attacks will develop panic disorder. Many people have just one attack and never have another.

Diagnosis Panic attacks can occur at any time, even during sleep. It usually peaks within a few minutes, but some symptoms can last much longer. People who have full-blown, repeated panic attacks can become very disabled by their condition and should seek help before they start to avoid places or situations where panic attacks have happened. Some people’s lives become so restricted that they avoid normal activities, such as shopping or driving. Some become housebound or need to be accompanied by a partner or friend to face the situation.  When the condition gets to this stage, it’s known as agoraphobia, which literally translated, means a fear of open spaces.

Early treatment can prevent people moving from panic attack to panic disorder and from panic disorder to agoraphobia. People can sometimes visit the doctor repeatedly for years before their condition is correctly diagnosed.

But sufferers should take heart, because panic disorder is a very treatable kind of anxiety disorder, responding in many cases to cognitive and hypnotherapy which together help change thinking patterns that lead to anxiety and provide strategies for combatting the onset of panic attacks. Panic disorder can be accompanied by other problems, such as depression, drug abuse, or alcoholism and these need to be treated separately.

Panic disorder and agoraphobia can be treated with medication, which usually comes with side effects, or with therapies which don’t.

Cognitive behavioural therapy (which teaches people to think differently about situations) and hypnotherapy, which provides a way of ‘tuning in’ to people’s natural ability to relax and helping them develop and use it on occasions previously perceived as difficult. Hypnotherapy also relaxes the conscious mind to the point where the individual can take on positive suggestions which can be recreated in trigger situations, breaking down the fear of fear cycle and returning sufferers to a happier, calmer state of mind.