Panic Disorder and Agoraphobia: What They Are, What They Look Like, and How Treatment Helps
READ TIME : 5 min
A panic attack can be terrifying.
Your heart races. You feel dizzy or lightheaded. Your chest feels tight. You can’t catch your breath. Things may suddenly feel unreal. And your brain very quickly arrives at:Something is seriously wrong.Having a panic attack doesn’t automatically mean you have panic disorder. But when you start becoming afraid of having another panic attack, your life can begin changing around that fear.That’s where panic disorder, and sometimes agoraphobia, can enter the picture.
What Is Panic Disorder?
Panic disorder involves recurrent, unexpected panic attacks followed by ongoing fear or behavioral changes related to having another one. CBT is a well-established treatment for panic disorder, including exposure to feared physical sensations. (National Institute of Mental Health)
And this is the part people sometimes miss:
The panic attacks themselves aren’t always the biggest problem. The fear of the next one can be.
You start monitoring your body.
Why is my heart beating faster?
Do I feel dizzy?
Was that shortness of breath?
You may avoid caffeine, exercise, getting overheated, being hungry, or anything else that creates sensations you’ve started associating with panic.
Eventually, you aren’t just afraid of panic.
You’re organizing your life around preventing it.
What Is Agoraphobia?
Agoraphobia is often misunderstood as simply being afraid to leave the house.
It’s much broader than that.
Agoraphobia involves fear or avoidance of situations where escaping might feel difficult or help might not be readily available if panic-like symptoms occur. That can include public transportation, open or enclosed spaces, crowds, lines, or being outside the home alone. (National Institute of Mental Health)
It might look like avoiding:
Highways or bridges.
Planes.
Concerts or movie theaters.
Long lines.
Restaurants where you’re seated far from the exit.
Being home alone.
Driving somewhere without a “safe person.”
You might still be doing plenty of things.
You’ve just gotten really good at arranging them so you feel safer.
How Panic Slowly Makes Your Life Smaller
Avoidance makes complete sense when something feels dangerous.
If driving on the highway caused a massive panic attack, taking back roads next time feels reasonable.
And immediately, you feel better.
Unfortunately, your brain can learn:
Thank God we avoided that. The highway must actually be dangerous.
So you avoid it again.
Then maybe another road feels unsafe.
Then driving alone.
Then driving somewhere unfamiliar.
Your world gets a little smaller at a time.
How Are Panic Disorder and Agoraphobia Treated?
One of the most effective psychological treatments for panic disorder is Cognitive Behavioral Therapy (CBT), particularly treatment that includes exposure. (National Institute of Mental Health)
And exposure therapy isn’t just “go do something scary.”
For panic disorder, treatment may include interoceptive exposure, which means intentionally practicing physical sensations associated with panic in a structured way. (National Institute of Mental Health)
We might intentionally create dizziness, a racing heart, breathlessness, or other sensations your brain has learned to fear.
For agoraphobia, exposure also means gradually returning to situations you’ve been avoiding.
The goal isn’t for me to calm you down while you do it.
We’re helping your brain learn that you can experience anxiety and keep going.
Treatment also involves identifying the sneaky safety behaviors that keep telling your brain you survived because you had your water bottle, checked your heart rate, sat near the exit, brought your safe person, or escaped before things got worse.
Begin Therapy With Michelle Stiles, LMHC
I specialize in evidence-based, compassionate treatment for panic disorder and agoraphobia. I offer:
In-person therapy in Syracuse, New York
Virtual therapy for adults throughout New York State
CBT and exposure-based treatment specifically targeting panic and avoidance
A warm, direct, collaborative approach that helps you start taking your life back from anxiety
If you’re ready to get started, visit my Panic Disorder Therapy page to learn more about my approach, or contact me to schedule a free 15-minute consultation.
This article is for educational purposes only and is not intended to diagnose or replace individualized mental health care.
Hi, I’m Michelle
I’ve been working in mental health since 2010 and struggling with anxiety for oh, idk, maybe my entire life.
And with my lived experience having anxiety, I know what works, what doesn’t, and what makes things feel worse. In here, you’re not alone, and I’ll work with you to shed the shame along with the anxiety. And by using evidence-based practices, I’ll help you recover, not just feel better.