Some agoraphobics experience no symptoms of panic. Fearful thoughts continue to control these individuals, but they have restricted their lifestyle, through avoidance, to such a degree that they no longer become uncomfortable.

When agoraphobics retreat to protect themselves, they often have to sacrifice friendships, family responsibilities, and/or career. Their loss of relationships, affections, and accomplishments compounds the problem. It leads to low self-esteem, isolation, loneliness, and depression. In addition, the agoraphobic may become dependent on alcohol or drugs in an unsuccessful attempt to cope.

Professional Help

Panic disorder is the only psychological problem whose predominant feature is recurring panic (or anxiety) attacks. The following is a brief summary of professional treatment of this problem.

One of the most difficult problems for individuals with panic disorder is getting the right diagnosis. Panic disorder is regarded as one of the great impostors of medicine because its symptoms are similar to those found in a number of physical ailments (see Physical Causes of Panic-like Symptoms), including heart attacks, some respiratory illnesses and thyroid diseases. Once diagnosed and proper treatment begun, recovery may occur in a matter of months, but can take longer depending on individual circumstances.

The most successful treatment regimens include a combination of behavior therapy and cognitive therapy, sometimes with medication. Support groups may also be extremely useful, because many individuals need the reassurance that they are not alone. A successful treatment program must address all the individual's problems, including depression or substance abuse, that might accompany the underlying emotional disorder.

Cognitive-behavior therapy attempts to alter the way a person thinks and acts in certain circumstances. Specifically, the therapist helps the patient develop anxiety reduction skills and new ways to express emotions. Relaxation techniques, such as controlled breathing, are a typical feature. The patient also may be taught to re-examine the thoughts and feelings that trigger his fears and maintain his anxiety. The patient often is gradually exposed to the feared situation, and taught that he can cope.

There are a number of anti-anxiety and antidepressant medications that can be effective in controlling panic disorder. The medication regimen may last just a few weeks, but in many cases this therapy may be required for a year or longer. Medication should be accompanied by other therapy, however, because the majority of patients treated only with drugs relapse once the medication is discontinued.

next: STEP 1: Check Out All the Physical Symptoms