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WHAT IS A PANIC ATTACK?

A panic attack is a sudden rush of uncomfortable physical symptoms coupled with thoughts of impending doom (making a scene, heart attack, not being able to breathe). Although the first panic attack may take place in a distinct situation, further episodes are unpredictable as to time or place. One or more uncomfortable physical symptoms will be present in a severe form during an actual panic attack, such as increased heart rate, dizziness or lightheadedness, shortness of breath, inability to concentrate, and confusion.

After a number of panic episodes, the individual can become afraid of being a helpless victim of panic. He or she may hesitate to be alone, to venture far from home, or to be in public places. Even when not experiencing an anxiety attack, the person with panic attacks often becomes increasingly nervous and apprehensive. He or she attempts to remain physically and psychologically tense in preparation for the next attack.

THE BASICS ABOUT PANIC ATTACKS

Although the first panic attack may seem to appear "out of the blue," it typically comes during an extended period of stress. This stress is not caused by a few days of tension, but extends over several months. Life transitions, such as moving, job change, marriage, or the birth of a child, often account for much of the psychological pressure. For some individuals, learning to manage this stressful period or to reduce the pressures will eliminate the panic episodes. For others, it is as though the stress of the life transition or problem situation uncovered a psychological vulnerability.

If the panic-prone individual accepts increased responsibilities -- for instance, through a job promotion or through the birth of a first child -- he may begin to doubt his ability to meet the new demands, the expectation of others, and the increased energy required for these responsibilities. Instead of focusing on mastering the task, he becomes more concerned with the possibility of failure. This attention to the threat of failure continually undermines his confidence. Either gradually or quickly, he translates these fears into panic.

WHAT IS AGORAPHOBIA?

Each person diagnosed with agoraphobia (meaning "fear of the marketplace") has a unique combination of symptoms. But common to all agoraphobics is a marked fear or avoidance either of being alone or of being in certain public places. It is a response strong enough to significantly limit the individual's normal activities.

For the person who experiences panic attacks, the distinction between agoraphobia and panic disorder is based on how many activities he avoids. In panic disorder, the person remains relatively active, although he may avoid a few uncomfortable situations. If the panic-prone person begins to significantly restrict his normal activities because of his fearful thoughts, agoraphobia is the more appropriate diagnosis. For some, agoraphobia develops from panic disorder.

Repeated panic attacks produce "anticipatory anxiety," a state of physical and emotional tension in anticipation of the next attack. The person then begins to avoid any circumstances that seem associated with past panic attacks, becoming more and more limited in his range of activities.

The fearful thoughts that plague the agoraphobic often revolve around loss of control. The person may fear the development of uncomfortable physical symptoms familiar from past experiences (such as dizziness or rapid heartbeat). He may then worry that these symptoms could become even worse than they were in the past (fainting or heart attack), and/or that he will become trapped or confined in some physical location or social situation (such as a restaurant or party).

In the first two situations, the person senses that his body is out of control. In the third, he feels unable to readily control his surroundings. The following list shows the types of surroundings that can provoke these fears.

FEAR OF THE SURROUNDINGS

Public places or enclosed spaces
Confinement or restriction of movement
Barber's, hairdresser's, or dentist's chair
Stores, lines in a store, streets
Restaurants, theaters
Waiting for appointments
Prolonged conversations in person
Churches, crowds
Talking on the phone

TRAVEL:

On trains, buses, planes, subways, cars
Over bridges, through tunnels
Being far away from home
Remaining at home alone
Open spaces, traffic, parks
Fields, wide streets

The agoraphobic may avoid one or many of these situations as a way to feel safe. The need to avoid is so strong that some agoraphobics will quit their jobs, stop driving or taking public transportation, stop shopping or eating in restaurants, or, in the worst cases, never venture outside their home for years.

Learn how to conquer your fears, and recover from this condition! Read the information regarding therapy on the following page(s) and take control of your life, once and for all!





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