Panic disorder and agoraphobia are two anxiety disorders that have a chronic. They can occur alone, but also together. Learn about the symptoms of anxiety disorders, how they progress and how widespread they are in Germany.
Last updated on 30.04.2021
Scientific advice Prof. Dr. Anke Steckelberg
Created 07.10.2019
Next planned revision: November 2022
Prof. Dr. Anke Steckelberg
Prof. Dr. phil. Anke Steckelberg studied teaching at vocational schools with a specialization in health; earned her doctorate in health sciences on the topic of evidence-based health information and then worked at the universities of Hamburg and Bremen. The scientist conducts research and teaches on the topics of evidence-based health information and critical health literacy. She has been a professor at Martin Luther University Halle-Wittenberg since 2016.
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Table of Contents
What is panic disorder? Put in the info basket
Panic disorder is an anxiety disorder in which sufferers experience sudden panic attacks. Panic attacks occur out of the blue without a particular trigger. They are accompanied by increasing physical anxiety reactions, such as:
- palpitations or racing heart
- Shortness of breath or shortness of breath
- feelings of suffocation
- chest pain
- dizziness
- sweating
- Tremor
Anxiety can be associated with feelings of alienation. For example, one has the feeling of being a stranger to oneself. Or the environment seems strangely foreign, unreal or artificial, although one knows it. A panic attack can get to the point where people feel the fear of going crazy, having a physical breakdown, or losing control. The fear can even increase to the point of death anxiety.
People with panic disorder therefore often avoid the places or situations where they had a panic attack. Because they are afraid of being seized by panic again there. Avoidance behavior increasingly restricts everyday life and quality of life.
What is panic disorder?
Panic disorder belongs to the anxiety disorders. It is characterized by recurring panic attacks that are unexpected and unexplainable to the sufferer. And without a recognizable trigger.
A panic attack is a sudden and very strong fear reaction, which also manifests itself physically. The fear of losing control or dying, for example, becomes stronger and stronger, reaches its peak after a few minutes, and then usually subsides again of its own accord. Severe physical symptoms occur, such as dizziness, palpitations or racing heart, shortness of breath or the feeling of suffocating.
This is why those affected often live in fear of the next panic attack. This is called anticipatory anxiety and can lead to avoiding situations where panic attacks have occurred before.
Panic disorder often first appears in young adulthood. Ca. 2% of people in Germany are affected. Women more often than men.
A panic disorder with strong avoidance behavior can develop into another anxiety disorder. Agoraphobia, or fear of z.B. Public places or certain situations.
Together with medical professionals, however, a treatment can be found that alleviates the symptoms.
Still questions?
See in another film, what is agoraphobia?. This and more information about anxiety disorders can be found on the health portal of the Health Knowledge Foundation.
Knowledge is healthy.
What is agoraphobia? Put in the info basket
Agoraphobia is an anxiety disorder in which sufferers are afraid of public places and crowds of people. Typical are also fears of leaving the house or traveling unaccompanied by train, bus or plane. People with agoraphobia live in fear of developing panic symptoms such as dizziness or palpitations in public spaces. They fear that they will not be able to leave these places in the event of panic-like symptoms or that no one will come to their aid there in these situations. In doing so, they may well recognize that their fear is exaggerated and disproportionate.
In order not to get into fear-inducing situations, people with agoraphobia develop a pronounced avoidance behavior. This "fear of fear" can lead to restrictions in daily life.
What is agoraphobia?
Agoraphobia is one of the anxiety disorders with an identifiable trigger. The word comes from ancient Greek, where agora stands for a central
Gathering place and phobia stands for fear. It means "fear of public places". However, agoraphobia also describes the fear of crowds or long unaccompanied journeys.
In these situations, sufferers fear panicking and not getting help. Or not being able to leave the situation because of distance. The fear is recognized as completely exaggerated. But it cannot be suppressed.
For this reason, every effort is made to avoid the anxiety-provoking situations. This can severely limit life, as some sufferers no longer even leave the house out of sheer fear.
Agoraphobia usually occurs in young adulthood. Approximately 4% of people in Germany are affected by it. Women more often than men.
Agoraphobia can often be accompanied by another anxiety disorder, panic disorder.
There are several options for the treatment of agoraphobia. With therapeutic help an improvement can be achieved.
See in another film, what a panic disorder is. This film and more information about anxiety disorders can be found on the health portal of the Health Knowledge Foundation.
Knowledge is healthy.
Fear of flying, spiders or places with lots of people
In addition to agoraphobia and panic disorder, there are other forms of anxiety disorders. Learn about the different anxiety disorders and how they are classified.
How common is panic disorder and agoraphobia? Put in the info basket
In Germany, about 2 out of 100 adults are affected in the course of a year by an Panic Disorder Affected. The disorder occurs more frequently in women than in men. About 3 in 100 women and 1 in 100 men have panic disorder each year.
A Agoraphobia have in the course of a year about 4 out of 100 people. Separated by gender, this affects 6 out of 100 women and 2 out of 100 men.
Agoraphobia and panic disorder first appear on average at age 30.
What concomitant disorders may occur? Put in the info basket
Agoraphobia and panic disorder often co-occur with other mental illnesses. These disorders are therefore also called concomitant disorders of agoraphobia or panic disorder.
How often do concomitant mental illnesses occur in people with agoraphobia?
About 80 out of 100 people aged 18 to 65 with agoraphobia also had at least one other mental illness in the course of a year.
About 43 out of 100 people with agoraphobia aged 18 to 65 also had a depressive disorder in the course of a year.
How often do concomitant mental illnesses occur in people with panic disorder??
About 88 out of 100 people aged 18 to 65 with panic disorder (with or without agoraphobia) also had at least one other mental illness in the course of a year.
About 57 out of 100 people with panic disorder (with or without agoraphobia) aged 18 to 65 also had a depressive disorder in the course of a year.
Download graphic: Frequency of concomitant mental illnesses in agoraphobia
Graphic for download: Frequency of concomitant mental illnesses in panic disorders
Causes and development
How panic attacks and agoraphobias develop?
Anxiety disorders, such as panic disorder and agoraphobia, are currently thought to be caused by an interaction of various factors. These include a possible hereditary predisposition to develop such a disorder, or physical factors such as an altered balance of certain neurotransmitters in the brain.
Vicious circle of fear: How does a panic attack develop?? Put in the info basket
People with panic disorder are thought to be more sensitive to and more likely to misperceive physical and psychological changes, such as heart rate or concentration problems. They see actually harmless changes of the body as signs of a physical danger. If, for example, the heartbeat speeds up when climbing stairs, thoughts such as: "I’m going to have a heart attack" may arise!"This can lead to anxiety and panic, driving what is known as the "vicious cycle of anxiety".
The misinterpretation: "Oh horror, I’m going to have a heart attack!", leads to even more anxiety. As a result, stress hormones are released, which cause physical changes such as a faster heartbeat. This reaction of the body was originally for survival through fight or flight. In panic disorder, however, physical changes such as palpitations or tremors can reinforce the sufferer’s belief that they have a threatening illness. They become even more anxious and the physical symptoms intensify: palpitations then become heart palpitations. This is how a panic attack can develop. It subsides on its own after some time. Because panic attacks occur suddenly and unpredictably and the situation seems uncontrollable, sufferers develop a fear of renewed panic attacks.
What is the course of panic disorders and agoraphobias?? Put in the info basket
Studies show that both agoraphobia and panic disorders usually persist over a long period of time and occur repeatedly. Variations may occur. That is, they can also be absent for a period of time and then recur. As a rule they do not disappear by themselves.
People with agoraphobia sometimes remain without a major fear experience for a relatively long time if they avoid the triggers of their phobia – for example, places and situations with crowds of people. Avoidance behaviors can increase over time and, in extreme cases, lead to an inability to leave home.
Agoraphobia and panic disorder: how to treat them?
There are different ways in which anxiety disorders can be treated. In certain cases, for example, exposure therapy may be an option – a behavioral therapy in which sufferers consciously put themselves in fear-inducing situations with the support of the therapist in order to overcome the fear.
Testing knowledge: which anxiety disorder is present? Put in the info basket
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Bandelow B, Wiltink J, Alpers GW, Benecke C, Deckert J, Eckhardt-Henn A et al. German S3 guideline treatment of anxiety disorders; 2014.
Jacobi F, Hofler M, Strehle J, Mack S, Gerschler A, Scholl L et al. [Mental disorders in the general population: Study on the health of adults in Germany and the additional module mental health (DEGS1-MH)]. Nervenarzt 2014;85(1):77-87.
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Lijster JM, Dierckx B, Utens EM, Verhulst FC, Zieldorff C, Dieleman GC et al. The age of onset of anxiety disorders. Can J Psychiatry 2017;62(4):237-46.
Dilling H, Mombour W, Schmidt MH, Schulte-Markwort E, Remschmidt H. International Classification of Mental Disorders. ICD-10 Chapter V (F) clinical diagnostic guidelines. 10. 1st edition, incorporating changes according to ICD-10-GM 2015 ed. World Health Organization, editor. Bern: Hogrefe Verlag; 2015.
Bruce SE, Yonkers KA, Otto MW, Eisen JL, Weisberg RB, Pagano M et al. Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: A 12-year prospective study. The American journal of psychiatry 162 (6), p. 1179-1187. DOI: 10.1176/appi.ajp.162.6.1179.
Wittchen HU, Essau CA, Krieg JC. Anxiety disorders: Similarities and differences of comorbidity in treated and untreated groups. The British journal of psychiatry 1991; Supplement (12), p. 23-33.
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