Panic/Agoraphobia

SNOMED Terms

• Agoraphobia without history of panic disorder

• Panic disorder with agoraphobia

• Panic disorder without agoraphobia

Goals

• Reduce the frequency, intensity, and duration of panic attacks.

• Reduce the fear that panic symptoms will recur without the ability to manage them.

• Reduce the fear of triggering panic and eliminate avoidance of activities and environments thought to trigger panic.

• Increase comfort in freely leaving home and being in a public environment.

Behavioral Definitions

• Complains of unexpected, sudden, debilitating panic symptoms (e.g., shallow breathing, sweating, heart racing or pounding, dizziness, depersonalization or derealization, trembling, chest tightness, fear of dying or losing control, nausea) that have occurred repeatedly, resulting in persisting concern about having additional attacks.

• Demonstrates marked avoidance of activities or environments due to fear of triggering intense panic symptoms, resulting in interference with normal routine.

• Acknowledges a persistence of fear in spite of the recognition that the fear is unreasonable.

• Increasingly isolates self due to fear of traveling or leaving a "safe environment," such as home.

• Avoids public places or environments with large groups of people, such as malls or big stores.

• Displays no evidence of agoraphobia.

Diagnoses

• Panic Disorder Without Agoraphobia

• Panic Disorder With Agoraphobia

• Agoraphobia Without Panic Disorder

What is Panic/Agoraphobia?

Panic Disorder: Characterized by sudden and unexpected panic attacks that cause intense fear and physical symptoms. Panic attacks can strike anywhere, at any time, and often come on without any warning.

Physical symptoms of panic attacks can include:

• Heart palpitations

• Shortness of breath

• Chest pain

• Dizziness or lightheadedness

• Sweating

• Nausea or upset stomach

• Feeling detached from reality (derealization)

• Fear of losing control or going crazy (depersonalization)

Agoraphobia: Develops from the fear and anxiety associated with panic attacks. People with agoraphobia develop a fear of situations where they believe escape might be difficult, or help wouldn't be available in case of a panic attack.

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Common fears associated with agoraphobia include:

• Crowded places (e.g., public transportation, malls)

• Open spaces (e.g., parking lots, bridges)

• Enclosed spaces (e.g., airplanes, elevators)

• Being outside the home alone​

The Connection:

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Not everyone who experiences panic attacks develops agoraphobia. However, the fear of having another panic attack can lead people to avoid situations where they fear a panic attack might occur, which is agoraphobia.

Effects of Chronic Pain

Panic disorder and agoraphobia can significantly impact a person's life, leading to:

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Social Isolation: Avoiding places and situations can lead to social isolation and withdrawal from activities you once enjoyed.

Limited Work or School: The fear of panic attacks can make it difficult to hold a job or attend school regularly.

Strained Relationships: Avoiding social situations can strain relationships with family and friends.

Anxiety and Depression: The constant fear of panic attacks can lead to anxiety and depression.

Reduced Quality of Life: Overall, panic disorder and agoraphobia can significantly reduce a person's quality of life.

How does Chronic Pain affect your life?

Physical: Chronic pain is a persistent pain that lasts longer than three months. It can range from mild to severe and can interfere with daily activities such as walking, sleeping, and working.

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Mental and Emotional: Living with chronic pain can be emotionally draining. It can lead to anxiety, depression, frustration, and anger. The constant discomfort and limitations imposed by pain can be very discouraging.

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Social Life: Chronic pain can make it difficult to participate in social activities and outings. People with chronic pain may avoid social gatherings or hobbies due to fear of pain flare-ups or limitations in mobility.

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Work and Finances: Chronic pain can affect a person's ability to work, potentially leading to job loss or reduced income.  Managing medical bills and treatment costs can also be a significant financial burden.

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Relationships: Chronic pain can strain relationships with family and friends. Loved ones may not understand the condition or the limitations it imposes. Communication and empathy are crucial for maintaining strong relationships.