Panic disorder + agoraphobia

Panic disorder

Presence of recurrent unexpected panic attacks w/ fear of future attacks and avoidance of situations.

Panic attack

Abrupt surge of intense fear or intense discomfort that reaches a peak within mins; during which 4 or more symptoms occur.

Panic attack symptoms

Palpitations or pounding heart; sweating; trembling; shortness of breath; feeling of choking; chest pain; nausea; feeling dizzy; chills or heat sensations; numbness or tingling; derealization; fear of losing control; fear of dying.

Expected panic attack

Fear response at inappropriate times in response to a trigger; often related to a feared stimulus in another disorder.

Unexpected panic attack

Out of the blue; comes on without an obvious trigger; usually occurs in Panic Disorder or agoraphobia.

Expected vs unexpected panic attacks

Expected attacks are often related to feared stimuli in other disorders; unexpected attacks are usually part of Panic Disorder or agoraphobia.

Interoceptive avoidance

Avoidance of internal physical sensations.

Role of interoceptive avoidance in Panic Disorder

People avoid things that may lead to sweating; heart racing; etc.; because the sensations are interpreted as dangerous.

Agoraphobia

Fear of being in situations where one might not be able to escape or get help if they become anxious or have other physical symptoms.

5 agoraphobic situations

Public transportation; open spaces; enclosed spaces; standing in line or being in a crowd; being outside of the home alone.

Biological factors of Panic Disorder

Genetic effect; family and twin studies suggest PD is about 45%; overactive limbic system; excessive PFC activation; dysregulation of norepinephrine; abnormalities in somatosensory cortex and thalamus.

Panic Disorder psychological cause

Anxiety sensitivity; belief that physical sensations of anxiety are dangerous.

Anxiety sensitivity

Belief that physical sensations of anxiety are dangerous.

Cognitive model of Panic Disorder

People with PD may have greater cognitive awareness and scan body for signs of anxiety; worry about anxiety; body starts showing signs of anxiety; become more anxious.

Behavioral factors of Panic Disorder

Interoceptive avoidance; avoidance of internal physical sensations; situational avoidance; avoiding situations where escape/help may be difficult.

Social factors of Panic Disorder

A major life stressor may occur around the time of the first panic attack; family/friends work around the symptoms; gender differences; PD is more common among women.

Panic Control Treatment (PCT)

Reduces interoceptive avoidance by exposing people to sensations that cause panic attacks; and reduces situational avoidance by exposing people to situations avoided.

Panic Disorder medication

Benzodiazepines increase GABA activity; calm; work fast; but can cause dependence. SSRIs allow more serotonin; work more slowly; symptoms return if stopped.