Panic & Agoraphobia

panic attacks

Panic Attack


Panic attacks are the central aspect of Panic Disorder. If you have experienced a panic attack, there is no mistaking the severity of the symptoms.  Panic attacks go beyond normal anxiety or fear sensations and cause a sudden rush of intense fear accompanied by a feeling of impending doom.  Panic attacks are accompanied by a wide variety of physical symptoms and psychological symptoms.  The symptoms occur along many systems of the body.  A person might think they are experiencing a heart attack because of the increased heart rate, shortness of breath, and thumping chest.  A person might think they are "going crazy" or "dying" due to dissociative symptoms and thoughts about "losing control."

Some panic attacks occur spontaneously, and others occur on cue due to anticipation or worry. 
A person experiencing a panic attack may think they are dying, having a heart attack, losing one’s sanity, losing control, or going to faint.  The person might also feel like they will be stuck in the state of panic forever.  This is a misconception.  Panic attacks only last for a certain amount of time and cannot go on forever.   Naturally, to be sure the symptoms are panic symptoms, a person should initially check with their physician.

Can you pass out from a panic attack?


A common worry for people new to panic attacks is the fear of passing out. Increased adrenaline and blood flow causes more sense of danger.  There might be intense feelings of terror, lightheadedness, chills on the back of the neck, overwhelming fear feelings in the facial, head, and neck area, dizziness, hyperventilation, etc. These feelings mistakenly cause the anxiety sufferer to believe that they are going to pass out. Usually, the opposite is true. The person is actually more alert and on-guard from the impending doom and there is a raise in blood pressure rather than a drop in blood pressure (which happens with fainting). With the exception of blood-injection phobia, people suffering with a genuine panic attacks are not likely to faint. Alertness, higher blood pressure, and heightened sensitivity usually causes us to be more awake than before.


For hyperventilation, breathing into a paper bag or into a cupped hand has been recommended to help increase carbon dioxide intake.


Can you go insane from a panic attack?


Panic attacks can feel like you are losing control. This can generate heightened alertness and compound the scary anxiety feelings such as lightheadedness, confusion, tension, lack of control, dazed feelings, and strange sensations throughout the body. As a result of the anxiety, the sufferer may become more afraid of the anxiety than other Lite-stressors. There are very common 'loss of control' worries such as the fear of going 'crazy,' hallucinating, being committed, or having a psychotic break. Many people fear that the panic will cause them to become schizophrenic.


However, the good news is that panic attacks do not cause a person to go 'crazy.' Just the fact that you are having worries about panic and insanity, indicates you are very much in connection with the moment (reality). You are not suffering with psychosis. A person 'going crazy' is not in contact with reality and is not having those worries.


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Common Somatic & Cognitive Symptoms

  • Symptoms vary from person to person, but here are some notable symptoms:
  • Dizziness / lightheadedness
  • Chest pain or discomfort
  • Accelerated heart rate / heart palpitations / heart pounding
  • Chills or hot flushes
  • Shortness of breath
  • Choking / smothering sensation
  • Fear of ‘losing control’ or ‘going crazy’
  • Trembling
  • Abdominal discomfort / Nausea
  • Depersonalization / derealization
  • Shaking
  • Feeling smothered
  • Numbness
  • Feeling unreal - Another common symptom that is not as well known to psychiatrists or psychologists - but nonetheless causes great distress - is the feeing of being unreal or that the world is unreal.  This is called of depersonalization or derealization.  During an episode of depersonalization, the perception of reality feels distorted and we feel detached from the self.  During the experience of derealization, there is a sense of being detached from the outside world, as if living in a dream.   To learn more about this experience, visit our depersonalization page here.



Three Types of Panic Attacks


1. Situationally bound

There is an awareness of the panic attack triggers.  They are tied to something specific, such as petting a dog. 


2.  Unexpected / unforeseen

The person is unaware of the source of panic.  The source could be physical or internal (subconscious).  The person is unaware of when the next attack will occur.

3. Situationally predisposed

The panic is triggered in a specific place that has already set off a former panic attack. The place is now associated with panic. 


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Panic Disorder Without Agoraphobia


Panic Disorder is one of the most researched anxiety disorders.  Panic Disorder can occur with or without Agoraphobia.  The defining characteristic of Panic Disorder without Agoraphobia is the experience of panic attacks.  In Panic Disorder, the panic attacks are recurrent and intrusive to daily functioning.  The panic is not related to a physiological condition or a substance (like a medication or narcotic). The sufferer has a concern about having additional attacks, and usually worries about the implications of the attack (or its consequences).  Accompanying fears may include: fear of getting a heart attack, not being able to breathe, choking fears, losing control of one’s actions, losing one’s “sanity,” etc. 


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Agoraphobia can be described as a fear of the fear itself.  The person with Agoraphobia seeks to avoid situations, places, or events from which escape is difficult or from which help is unavailable, and this is due to the fear of getting an anxiety attack.  The sufferer may also have a fear being embarrassed as a result of panicking.   Agoraphobic people tend to engage in a lot of avoidance.  A sufferer may avoid certain restaurants, cafes, stores, super markets, movie theaters, parks, and even the workplace.  As the world increasingly becomes more and more off-limits, Agoraphobia becomes an impairment to daily living.



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Panic Disorder With Agoraphobia


Panic Disorder With Agoraphobia is the term used to describe the symptoms of people who are actually suffering with panic attack episodes (Panic Disorder) with excessive and persistent fears of getting future attacks (Agoraphobia).  There is a significant change in behavior of the person with panic disorder.  This is due to new fears of experiencing anxiety episodes in specific places/situations. 



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Agoraphobia without a History of Panic Disorder


Agoraphobia without a History of Panic Disorder is a term used to describe the symptoms of sufferers with Agoraphobia / panic-like symptoms who do not have a history of unexpected Panic Attacks. 



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Page Disclaimer

The information on this site has not been evaluated nor has it been written by a physician or medical doctor. The information contained on this site is for entertainment purposes only and should not be used to diagnose, treat or prevent a medical or psychological disorder.


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