Agoraphobia is a disabling complication of panic disorder characterized by fearful avoidance of situations that might cause a panic attack. Although in the public imagination it is thought of as a condition that prevents people from entering public places-and this is true for many agoraphobics, at its core, agoraphobia is really about being away from one's source of security. For example , if an agoraphobic patient had a panic attack in an elevator, he might avoid buildings or places with an elevator. Furthermore, he may even have anxiety about thinking about his taxes, since he knows that his accountant's office is on the 15th floor.
Many panic attacks ae due to crowds, feeling pinned down or trapped or before an appointment. I once treated a patient who experienced panic attacks if he couldn't fall asleep. Unable to fall asleep, he would ruminate about the effects it would have on his ability to function the next day. Often this led to a full blown panic attack, complete with palpitations, shortness of breath, chest pain, diziness and more. On several occasions, he felt compelled to go to the emergency room to ensure that he was not having a heart attack. (this, of course, all but ended the possibility of getting a restful night of sleep. Interestingly, his panic disorder was eventually accompanied by agoraphobia. He would not travel for fear that being in another bed might delay his ability to fall asleep. This prevented him from attending conferences and even visiting his girlfriend who was a student in another state!
It is important to remember that Panic Disorder, especially when accompanied by Agoraphobia can be debilitating and impact the quality of your life. There are several methods for treating panic disorder that are very effective. These will be discussed in my next blog. In the meantime, if you feel you experience some of these symptoms you should seek consultation with your health-care professional. If you feel you are having a panic attack, you may even want to report to the nearest emergency room.
