Some people's lives become greatly restricted--they
avoid normal, everyday activities such as grocery
shopping, driving, or in some cases even leaving the
house. Or, they may be able to confront a feared
situation only if accompanied by a spouse or other
trusted person. Basically, they avoid any situation
they fear would make them feel helpless if a panic
attack occurs. When people's lives become so
restricted by the disorder, as happens in about
one-third of all people with panic disorder, the
condition is called agoraphobia. A tendency toward
panic disorder and agoraphobia runs in families.
Nevertheless, early treatment of panic disorder can
often stop the progression to agoraphobia.
Studies have shown that proper treatment--a type of
psychotherapy called cognitive-behavioral therapy,
medications, or possibly a combination of the
two--helps 70 to 90 percent of people with panic
disorder. Significant improvement is usually seen
within 6 to 8 weeks.
Cognitive-behavioral approaches teach patients how
to view the panic situations differently and
demonstrate ways to reduce anxiety, using breathing
exercises or techniques to refocus attention, for
example. Another technique used in
cognitive-behavioral therapy, called exposure
therapy, can often help alleviate the phobias that
may result from panic disorder. In exposure therapy,
people are very slowly exposed to the fearful
situation until they become desensitized to it.
Some people find the greatest relief from panic
disorder symptoms when they take certain
prescription medications. Such medications, like
cognitive-behavioral therapy, can help to prevent
panic attacks or reduce their frequency and
severity. Two types of medications that have been
shown to be safe and effective in the treatment of
panic disorder are antidepressants and
benzodiazepines.
Phobias
Phobias occur in several forms. A specific phobia is
a fear of a particular object or situation. Social
phobia is a fear of being painfully embarrassed in a
social setting. And agoraphobia, which often
accompanies panic disorder, is a fear of being in
any situation that might provoke a panic attack, or
from which escape might be difficult if one
occurred.
Specific Phobias
-
"I'm scared to death of flying, and I never do it
anymore. It's an awful feeling when that airplane
door closes and I feel trapped. My heart pounds and
I sweat bullets. If somebody starts talking to me, I
get very stiff and preoccupied. When the airplane
starts to ascend, it just reinforces that feeling
that I can't get out. I picture myself losing
control, freaking out, climbing the walls, but of
course I never do. I'm not afraid of crashing or
hitting turbulence. It's just that feeling of being
trapped. Whenever I've thought about changing jobs,
I've had to think, "Would I be under pressure to
fly?" These days I only go places where I can drive
or take a train. My friends always point out that I
couldn't get off a train traveling at high speeds
either, so why don't trains bother me? I just tell
them it isn't a rational fear."
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Phobias aren't just extreme fear;
they are irrational fear. You may be
able to ski the world's tallest
mountains with ease but feel panic
going above the 10th floor of an
office building
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