Agoraphobia is an anxiety disorder which primarily consists of the fear of experiencing a difficult or embarrassing situation from which the sufferer cannot escape. Panic attacks are commonly linked to agoraphobia and the fear of not being able to escape a bad situation.[20] As the result, severe sufferers of agoraphobia may become confined to their homes, experiencing difficulty traveling from this "safe place".[21] The word "agoraphobia" is an English adoption of the Greek words agora (αγορά) and phobos (φόβος). The term "agora" refers to the place where ancient Greeks used to gather and talk about issues of the city, so it basically applies to any or all public places; however the essence of agoraphobia is a fear of panic attacks especially if they occur in public as the victim may feel like he or she has no escape. In the case of agoraphobia caused by social phobia or social anxiety, sufferers may be very embarrassed by having a panic attack publicly in the first place. This translation is the reason for the common misconception that agoraphobia is a fear of open spaces, and is not clinically accurate. Agoraphobia, as described in this manner, is actually a symptom professionals check for when making a diagnosis of panic disorder.
Mindfulness involves spending time focusing on the present moment and using a nonjudgmental stance (things are not good or bad, they just are). This may sound straightforward but it can be tricky as our mind often wanders. Try to spend some time each day focusing on a single activity for 10 minutes. For example, focus on the experience of breathing: noticing the physical sensations that you have, the sound of your breath, the feeling of your chest rising and falling as you breathe, the feeling of air entering and leaving your lungs, etc. Try your best to keep your mind focused on these sensations. If you notice your mind wandering, gently redirect it back to the exercise. Engaging in these exercises on a regular basis can help you to feel emotionally centered. Check out websites, apps, and books for more information on mindfulness and guided mindfulness exercises.
There are also things that people with panic disorder can do to learn how to handle it and to make treatment more effective. Since substances like drinking alcohol or caffeinated beverages, or using illicit drugs can worsen panic attacks, those things should be avoided. Other tips to prevent or manage panic attacks include engaging in aerobic exercise and stress-management techniques like deep breathing, massage therapy, and yoga, since these self-help activities have also been found to help decrease the frequency and severity of panic attacks. Although many people use home remedies like breathing into a paper bag when afflicted by the hyperventilation that can be associated with panic, the benefit received may be the result of the individual believing it will remedy the symptoms (placebo effect). Also, breathing into a paper bag when one is already having trouble breathing can make matters worse when the hyperventilation is the result of conditions of oxygen deprivation, like an asthma attack or a heart attack.
There are two very important guidelines to think about, aside from symptoms. These are duration of symptoms and level of impairment. Anxiety is a normal reaction to stressful situations, and even high levels of anxiety can be healthy and beneficial at times. Disorders are only present when anxiety symptoms last for several weeks to months and significantly interfere with every day function or cause long-lasting distress.

Acupuncture is a treatment derived from traditional Chinese medicine. It consists of inserting very thin needles into the body in targeted areas. To date there is very little evidence that acupuncture can significantly treat generalized anxiety, although there are currently ongoing research trials for PTSD. One study did find that acupuncture can reduce pre-operative anxiety.

The signs and symptoms of a panic attack develop abruptly and usually reach their peak within 10 minutes. They rarely last more than an hour, with most ending within 20 to 30 minutes. Panic attacks can happen anywhere and at any time. You may have one while you’re in a store shopping, walking down the street, driving in your car, or even sitting on the couch at home.
The causes of anxiety attacks are not well understood. Some traumatic life events can set off anxiety attacks if the person is prone to depression or anxiety disorders. Also, medical conditions and some medications may trigger anxiety attacks. Many believe anxiety attacks run in families with a genetic predisposition. In other words, if your mom and her sister had anxiety attacks, it’s likely you will, too.

People with panic attacks often report a fear of dying or heart attack, flashing vision, faintness or nausea, numbness throughout the body, heavy breathing and hyperventilation, or loss of body control. Some people also suffer from tunnel vision, mostly due to blood flow leaving the head to more critical parts of the body in defense. These feelings may provoke a strong urge to escape or flee the place where the attack began (a consequence of the "fight-or-flight response", in which the hormone causing this response is released in significant amounts). This response floods the body with hormones, particularly epinephrine (adrenaline), which aid it in defending against harm.[9]
“Anxiety attack” is not a formal, clinical term, but one that is used by many people to describe all sorts of things, from feeling worried about an upcoming event to intense feelings of terror or fear that would meet the diagnostic criteria for a panic attack. In order to understand what someone means by “anxiety attack,” it is necessary to consider the context in which the symptoms occur.

^ Anxiety: management of anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care. National Institute for Health and Clinical Excellence. Clinical Guideline 22. Issue date: April 2007 "Archived copy" (PDF). Archived from the original (PDF) on 24 August 2009. Retrieved 2009-07-21. ISBN 1-84629-400-2
The person being treated will be closely monitored for the possibility of side effects that can range from minor to severe and can sometimes even be life-threatening. Because of the possible risks to the fetus of a mother being treated with medications for panic attacks, psychotherapy continues to be the treatment of first choice when treatment of this symptom is given during pregnancy.
Post-traumatic stress disorder -- or PTSD -- was considered to be a type of anxiety disorder in earlier versions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. But in 2013, PTSD was reclassified as its own condition. It describes a range of emotional reactions caused by exposure to either death or near-death circumstances (such as fires, floods, earthquakes, shootings, assault, automobile accidents, or wars) or to events that threaten one's own or another person's physical well-being. The traumatic event is re-experienced with fear of feelings of helplessness or horror and may appear in thoughts and dreams. Common behaviors include the following:
When we are mildly concerned (worried, afraid), the stress response produces a mild reaction in the body. When we are greatly concerned/worried/afraid, the stress response produces a dramatic reaction in the body. Since the stress response is directly proportional to the degree of worry, a panic attack and its symptoms are generally the result of serious worry, concern, and fear.
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What happens, exactly? "We all physically respond to stress," says Barbara O. Rothbaum, PhD, psychiatry professor and director, Trauma and Anxiety Recovery Program, at Atlanta's Emory University School of Medicine. "You might feel anxious about work-related problems, taking a big exam, or making an important decision. But someone who suffers from panic disorder may react to those same moderate pressures with an exaggerated physical reaction-as if he or she were about to be attacked by a wild tiger or fall from a great height. It's full-on, adrenaline-pumping, fight-or-flight response."
Furthermore, certain organic diseases may present with anxiety or symptoms that mimic anxiety.[6][7] These disorders include certain endocrine diseases (hypo- and hyperthyroidism, hyperprolactinemia),[7][73] metabolic disorders (diabetes),[7][74][75] deficiency states (low levels of vitamin D, B2, B12, folic acid),[7] gastrointestinal diseases (celiac disease, non-celiac gluten sensitivity, inflammatory bowel disease),[76][77][78] heart diseases, blood diseases (anemia),[7] cerebral vascular accidents (transient ischemic attack, stroke),[7] and brain degenerative diseases (Parkinson's disease, dementia, multiple sclerosis, Huntington's disease), among others.[7][79][80][81]
An evolutionary psychology explanation is that increased anxiety serves the purpose of increased vigilance regarding potential threats in the environment as well as increased tendency to take proactive actions regarding such possible threats. This may cause false positive reactions but an individual suffering from anxiety may also avoid real threats. This may explain why anxious people are less likely to die due to accidents.[86]
Additionally, there is some evidence that Acceptance and Commitment Therapy (ACT), Mindfulness-based Stress Reduction treatment (MBSR), as well as online and computerized treatments are effective in treating panic disorder (Arch et al., 2017). However, the overwhelming majority of research supports the long-term success of CBT for treating panic disorder. More research is needed to explore the extent to which MBSR and ACT work when compared to CBT and other treatments, but preliminary results are positive. In general, empirically-supported treatments that are founded on the basis of research within the psychological and medical fields are recommended for treating panic disorder.
The symptoms of a panic attack may cause the person to feel that their body is failing. The symptoms can be understood as follows. First, there is frequently the sudden onset of fear with little provoking stimulus. This leads to a release of adrenaline (epinephrine) which brings about the fight-or-flight response when the body prepares for strenuous physical activity. This leads to an increased heart rate (tachycardia), rapid breathing (hyperventilation) which may be perceived as shortness of breath (dyspnea), and sweating. Because strenuous activity rarely ensues, the hyperventilation leads to a drop in carbon dioxide levels in the lungs and then in the blood. This leads to shifts in blood pH (respiratory alkalosis or hypocapnia), causing compensatory metabolic acidosis activating chemosensing mechanisms which translate this pH shift into autonomic and respiratory responses.[25][26] The person him/herself may overlook the hyperventilation, having become preoccupied with the associated somatic symptoms.[27]

If you are greatly afraid, however, such as being terrified that there is a burglar in your home that is about to harm you, the body produces a high degree stress response. We generally experience high degree stress responses as being anxiety attacks: where the changes are so profound they get our full attention. The greater the degree of anxiety and stress response, the more changes the body experiences.


People with panic attacks often report a fear of dying or heart attack, flashing vision, faintness or nausea, numbness throughout the body, heavy breathing and hyperventilation, or loss of body control. Some people also suffer from tunnel vision, mostly due to blood flow leaving the head to more critical parts of the body in defense. These feelings may provoke a strong urge to escape or flee the place where the attack began (a consequence of the "fight-or-flight response", in which the hormone causing this response is released in significant amounts). This response floods the body with hormones, particularly epinephrine (adrenaline), which aid it in defending against harm.[9]
In the central nervous system (CNS), the major mediators of the symptoms of anxiety disorders appear to be norepinephrine, serotonin, dopamine, and gamma-aminobutyric acid (GABA). Other neurotransmitters and peptides, such as corticotropin-releasing factor, may be involved. Peripherally, the autonomic nervous system, especially the sympathetic nervous system, mediates many of the symptoms. Increased flow in the right parahippocampal region and reduced serotonin type 1A receptor binding in the anterior and posterior cingulate and raphe of patients are the diagnostic factors for prevalence of anxiety disorder.

For more information, please visit Mental Health Medications Health Topic webpage. Please note that any information on this website regarding medications is provided for educational purposes only and may be outdated. Diagnosis and treatment decisions should be made in consultation with your doctor. Information about medications changes frequently. Please visit the U.S. Food and Drug Administration website for the latest information on warnings, patient medication guides, or newly approved medications.
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