Panic & Agoraphobia

The clinicians at Mindcare Centre are highly experienced at dealing with panic attacks. If you are experiencing panic attacks and you are worried about them our clinical psychologists and psychiatrists can help you understand why the panic attacks are happening and what to do about them. Contact us during business hours on (02) 9212 4445 or email us an enquiry.

So what are panic attacks?

Panic attacks are common experiences and can be terrifying.  Approximately 35% of the population will experience a panic attack in their lifetime.  A panic attacks is an abrupt surge of intense fear or discomfort that peaks within minutes and is associated with four or more of a range of symptoms such as:

  • Racing heart or heart palpitations
  • Dizziness
  • Nausea or abdominal distress
  • Sweating
  • Shaking, trembling
  • Shortness of breath
  • Muscle tension
  • Constricted chest
  • Hot flushes
  • Anxiety and irrational thinking
  • Fear of losing control, passing out, going crazy, or fainting
  • Sense of dread and danger
  • Tingling, especially in arms and hands
  • Dry mouth
  • Feeling of unreality and detachment from the present environment

A panic attack occurs when the body’s natural ‘fight or flight’ response it triggered but there is no immediate danger.  A panic attack can last anywhere from a few minutes to half an hour.  However the physical and emotional effects of the attack can last for a few hours. Panic attacks do not kill people they are just an uncomfortable nuisance.

A panic attack in itself is not a diagnosis or a disorder. Panic attacks can occur on their own without any long lasting mental health effects. However they may also be a symptom of a disorder such as an anxiety disorder or depression.

Panic Disorder

Panic Disorder is an anxiety disorder.  Panic Disorder is typically diagnosed if there are recurrent and unexpected panic attacks along with at least one month or more of persistent concern or worry about having further panic attacks or significant unhelpful behaviour change related to the panic attacks. People typically worry excessively about the possible consequences of having a panic attack (i.e. I might lose control, have a heart attack, go crazy).  As a result of this worry some people engage in avoidance behaviours such as not exercising or not going to certain places where a panic might occur.

Panic disorder responds extremely well to Cognitive Behaviour Therapy. All the clinical psychologists at Mindcare Centre and some of the psychiatrists have expertise in the use of CBT for Panic Disorder. Treatment for panic disorder is usually not a lengthy process unless there are other complicating factors. Significant improvements can often be made in only a handful of sessions.  Medication can sometimes be helpful for this problem in more severe cases however lasting improvements and relapse prevention is grounded in good psychological treatment.

Agoraphobia

Agoraphobia is a term used to describe a fear or anxiety about being in two or more of the following situations:

  • Using public transport (cars, buses, trains, ships, planes)
  • Being in open spaces (parking lots, bridges, sporting events)
  • Being in enclosed places (shops, theatres, cinemas)
  • Standing in line or being in a crowd
  • Being outside of the home alone

The person fears or avoids these situations because escape might be difficult or help might not be available. For example, the person might worry that they will not be able to get to a place of safety in the event of a panic attack, that they will be dying and no-one will save them, that they will become incapacitated in some way (e.g. fall over) or there will be no-one to help them if they suffer an embarrassing experience (e.g. become incontinent, vomit, etc.)

It is common to experience both Panic Disorder and Agoraphobia together.  Often panic attacks can lead to Agoraphobia.  It is also possible to have Agoraphobia without any experience or history of panic attacks.

Agoraphobia affects almost one person in 50 each year with two out of three cases developing before the age of 35 years. Females are twice as likely as males to have Agoraphobia. The disorder is often inherited. People who develop Agoraphobia often have a high sensitivity to anxiety (they tend to believe that anxiety symptoms are harmful) and may have experienced stressful or frightening events (e.g., being mugged) or experimented with illegal drugs before the onset of the disorder. In many cases the person may have grown up in an overprotective household.

In the absence of treatment Agoraphobia does not usually resolve on its own. Treatment of Agoraphobia can produce significant benefits including greatly improved quality of life and freedom of activities although for many people the symptoms wax and wane across the lifespan. People with Agoraphobia are at greater risk of developing depression or substance use disorders so it is very important to get help for Agoraphobia rather than hope it will resolve on its own.

The treatment of choice for Agoraphobia is psychological therapy with or without medication. The most effective forms of psychological therapy are Cognitive Behaviour Therapy (CBT) and Acceptance and Commitment Therapy (ACT). Cognitive Behaviour Therapy has been used for the treatment of Agoraphobia for a lot longer than ACT and probably remains the most widely used form of therapy for Agoraphobia with or without Panic Disorder.

How to get help for Panic Attacks, Panic Disorder, or Agoraphobia

The clinical psychologists and some of the psychiatrists at Mindcare Centre are skilled in the use of CBT for the treatment of panic attacks, Panic Disorder and Agoraphobia. Some of our clinical psychologists also have skills in ACT and our psychiatrists are able to manage any medication needs that may arise. Contact Mindcare Centre during business hours on (02) 9212 4445 to make an appointment with one of our experts or email us with your enquiries. Also talk to your GP for further support and advice and for a referral if you wish to claim a Medicare rebate.

If your Agoraphobia prevents you from travelling to see us we can organise a telephone or Skype consultation although be advised that Medicare rebates cannot be claimed for such consultations unless you live more than 100km away and the consultation is with a psychiatrist. Home visits can also be arranged but will incur costs to cover travelling time to and from your house.

Useful links

Beyond Blue
Centre for Clinical Interventions: Panic Stations

Useful books

Overcoming Panic and Agoraphobia by Derrick Silove & Vijaya Manicavasagar
Mastery of your Anxiety and Panic by David Barlow and Michelle Craske

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