Panic Disorder & Agoraphobia

Panic disorder is diagnosed in people who experience spontaneous seemingly out-of-the-blue panic attacks and are preoccupied with the fear of a recurring attack. Panic attacks occur unexpectedly, sometimes even during sleep.

Many people don’t know that their disorder is real and highly responsive to treatment. Some are afraid or embarrassed to tell anyone, including their doctors and loved ones, about what they experience for fear of being considered a hypochondriac. Instead they suffer in silence, distancing themselves from friends, family, and others who could be helpful or supportive.

The disorder often occurs with other mental and physical disorders, including other anxiety disorders, depression, irritable bowel syndrome, asthma, or substance abuse. This may complicate of getting a correct diagnosis.


Some people stop going into situations or places in which they’ve previously had a panic attack in anticipation of it happening again.

These people have agoraphobia, and they typically avoid public places where they feel immediate escape might be difficult, such as shopping malls, public transportation, or large sports arenas. About one in three people with panic disorder develops agoraphobia. Their world may become smaller as they are constantly on guard, waiting for the next panic attack. Some people develop a fixed route or territory, and it may become impossible for them to travel beyond their safety zones without suffering severe anxiety.


A panic attack is the abrupt onset of intense fear or discomfort that reaches a peak within minutes and includes at least four of the following symptoms:

  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • Feelings of choking
  • Chest pain or discomfort 
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, light-headed, or faint
  • Chills or heat sensations
  • Paresthesia (numbness or tingling sensations)
  • Derealization (feelings of unreality) or depersonalization (being detached from oneself)
  • Fear of losing control or “going crazy”
  • Fear of dying

Since many of the symptoms of panic disorder mimic those of heart disease, thyroid problems, breathing disorders, and other illnesses, people with panic disorder often make many visits to emergency rooms or doctors’ surgeries, convinced they have a life-threatening issue.

In the past it might have taken months or years and lots of frustration before getting a proper diagnosis. Some people are afraid or embarrassed to tell anyone, including their doctors or loved ones about what they are experiencing for fear of being seen as a hypochondriac. Instead they suffer in silence, distancing themselves from friends, family, and others who could be helpful. We hope this pattern is changing.

Many people suffering from panic attacks don’t know they have a real and highly treatable disorder.

Speak to your Doctor today for advice about the different medications and therapies that are available in order to overcome your mental illnesses. You don’t have to be embarrassed about your condition, its more common than you actually think, and GPs deal with all sorts of mental health issues on a daily basis. Take it from me, i avoided it and suffered for years because i was afraid what people might think. But knowing what i know now, Its not something to be embarrassed about and more people than you actually think also suffer from the same illness your going through.




I think in the light of it all, and I truly believe that this is just silly, but is it ? Is it not irritating, tiresome and demoralising ? That mithering voice that only brings us bad news if we don’t do as directed. The waves of frustration that you feel as you return to a light switch to make sure that you have turned it off, but not just once or twice or even ten times, but constantly until the voice is satisfied that the light is truly switched off. You see the insanity of it is that you know when a light is off because the room goes darker, But oh no the voice isn’t convinced yet. But what would happen though if you don’t do as requested and switch the light on and off again ? Nothing would happen apparently as some people would say. But the voice would have you believe that something terrible will happen to you or a loved one and boy we would hate it if that happened, so we obey the voice to prevent anything bad from happening, you see ive been doing it for that long now habitually to safeguard myself and my loved ones from danger that it has now become a ritual that I undertake even on auto pilot because I’ve sat in the voices classroom for far too long and become conditioned to obey it to protect what matters. Sound familiar ?? BUT and I emphasise this that if you was to truly ask yourself this question and answer honestly. What would the voice have you believe that would actualy happen if you decided to disagree with it and ignore it’s repetitive requests to switch the light on and off again ?? When you’ve got your answer that you have answered as honestly as possible, write it down and read it back to yourself logically 50 times or more. Now ask yourself would this really actualy happen if I didn’t obey. What evidence have I got that something will happen ? I’m no genius but I would hazard a guess that there probably wouldn’t be any. You see the odds are stacked against the voice if the truth be known, because ask yourself this has anything happened to someone you know or there family because they only switched the light off once ? Probably not. Easier said than done though, I can pretty much categorically agree with that because I’ve lived it and still do. The key is to condition the mind to silence the voice. You’ve got the evidence now put forward your case and try to ignore the voice no matter how uncomfortable that it becomes. Them feelings won’t last for ever and eventualy the voice will give up and eventualy subside and you will free yourself from the voice. Case dismissed…

By Brett Pomfrey


I'm a teacher, again


Tonight the pain becomes a central idea,

a notion, a recall, a, sort of, panacea.

Tonight turns life happy toward celebration,

the opportunity to herald a healthy decision.

What happened then could occur tomorrow,

might even be a possibility without my halo,

for the reality of our lives is a fragile pedestal

we could so easily roll backward and fall.

Tonight, ten years ago, I was on a roller coaster

of confusion and self-pity, yet steadfast the driver.

Tonight, begins, yet again, a simpler chapter,

with fresh drawn binding, and quality paper.

Without hope’s love, I could forever lose my release,

in that lair of addiction, from where I’ve found peace.

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We are always going to have wars in our head while recovering from an addiction, that is pretty much a given. But its about collecting the tools from others that are like minded people who have experienced the same things that you are going through, and with a bit of guidance from these fellow comrades showing you what tools to use for which task. You will eventualy with plenty of practice feel at ease with yourself and be able to conquer your demons and fears and keep them at bay while you begin to build the foundations of your fortress with a moat round it and heavily guarded by troops ready for any threat of relapse invasion that comes your way. In layman’s terms what im trying to say is you wouldnt screw a screw in with a hammer would you. Its about obtaining the screw driver and using that to tighten the screw, the same as if you need to hammer a nail in a piece off wood you would take your hammer and and use that because its the right tool for the job and it would have a possitive outcome. Where as if you used a screwdriver to hammer a nail in it would be virtualy imposible to do and that would be a negative outcome. Its the same as the old saying if you like. ALL THE GEAR NO IDEA. you could have the best set off golf clubs man and science has created and that money can buy, but if you cant play golf and dont know which clubs to use the chances are your not going to score on any hole. But with the right information and guidance from someone who’s already learnt to play golf. With practice and perseverance, eventualy you will start to score on some holes and then before long your scoring on all of them more or less because you have been given the information and youve been given the tools and shown what to do with what and then you’ve achieved it with a positive outcome that you would have never got with your own info based on nothing and your potluck lottery approach by chosing a club at random. Nobody said it was going to be easy they just said that it would be worth it. 

By Brett Pomfrey

PANIC !!!!

Panic disorder is a condition where you have recurring panic attacks. Many people with panic disorder also develop agoraphobia. This means you avoid many places, and may not even go out from your home, due to fear of having a panic attack in a public place. Treatment with cognitive behavioural therapy and/or antidepressant medicines works well in over half of cases.

A panic attack is a severe attack of anxiety and fear which occurs suddenly, often without warning, and for no apparent reason. In addition to the anxiety, various other symptoms may also occur during a panic attack. These include one or more of the following:

  • A thumping heart (palpitations).
  • Sweating and trembling.
  • Dry mouth.
  • Hot flushes or chills.
  • Feeling short of breath, sometimes with choking sensations.
  • Chest pains.
  • Feeling sick (nauseated), dizzy, or faint.
  • Fear of dying or going crazy.
  • Numbness, or pins and needles.
  • Feelings of unreality, or being detached from yourself.

The physical symptoms that occur with panic attacks do not mean there is a physical problem with the heart, chest, etc. The symptoms mainly occur because of an overdrive of nervous impulses from the brain to various parts of the body during a panic attack. This overdrive of nervous impulses can lead to the body producing hormones which include adrenaline (epinephrine). This is sometimes referred to as a ‘fight or flight’ response. This kind of reaction is normal in people when we feel we are in danger. During a panic attack the body can react in the same way. 

During a panic attack you tend to over-breathe (hyperventilate). If you over-breathe you blow out too much carbon dioxide which changes the acidity in the blood. This can then cause more symptoms such as confusion and cramps, and make palpitations, dizziness, and pins and needles worse. This can make the attack seem even more frightening, and make you over-breathe even more, and so on. A panic attack usually lasts 5-10 minutes, but sometimes they come in waves for up to two hours.

At least 1 in 10 people have occasional panic attacks. If you have panic disorder it means that you have repeated (recurring) panic attacks. The frequency of attacks can vary. About 1 in 50 people have panic disorder.

In panic disorder, there may be an initial event which causes panic but then the attacks after that are not always predictable. If you have panic disorder, you also have ongoing worry about having further attacks and/or worry about the symptoms that you get during attacks. For example, you may worry that the thumping heart (palpitations) or chest pains that you get with panic attacks are due to a serious heart problem. Some people worry that they may die during a panic attack.

Panic attacks usually occur for no apparent reason. The cause is not clear. Slight abnormalities in the balance of some brain chemicals (neurotransmitters) may play a role. This is probably why medicines used for treatment work well. Anyone can have a panic attack, but they also tend to run in some families. Stressful life events such as bereavement may sometimes trigger a panic attack.

Some people with panic disorder worry about having a panic attack in a public place where it is difficult to get out of, or where help may not be available, or where it can be embarrassing. This may cause them to develop agoraphobia. About 1 in 3 people with panic disorder also develop agoraphobia. See separate leaflet called Agoraphobia.

If you have agoraphobia you have a number of fears of various places and situations. So, for example, you may be afraid to:

  • Be in an open place.
  • Enter shops, crowds, and public places.
  • Travel in trains, buses, or planes.
  • Be on a bridge or in a lift.
  • Be in a cinema, restaurant, etc, where there is no easy exit.
  • Be anywhere far from your home – many people with agoraphobia stay inside their home for most or all of the time.

You may also develop other irrational fears. For example, you may think that exercise or certain foods cause the panic attacks. Because of this you may fear (develop a phobia) for certain foods, or avoid exercise, etc.

To ease a panic attack, or to prevent one from getting worse, breathe as slowly and as deeply as you can. Really focus on your breathing. Learning and using relaxation techniques may help. Many people find that deep breathing exercises are useful. This means taking a long, slow breath in, and very slowly breathing out. If you do this a few times, and concentrate fully on breathing, you may find it quite relaxing.

Some people find that moving from chest breathing to tummy (abdominal) breathing can be helpful. Sitting quietly, try putting one hand on your chest and the other on your abdomen. You should aim to breathe quietly by moving your abdomen with your chest moving very little. This encourages the lower chest muscle (diaphragm) to work efficiently and may help you avoid over-breathing.

No treatment is needed if you have just an occasional panic attack. It may help if you understand about panic attacks. This may reassure you that any physical symptoms you get during a panic attack are not due to a physical disease. It may help to know how to deal with a panic attack.

Treatment can help if you have repeated (recurring) attacks (panic disorder). The main aim of treatment is to reduce the number and severity of panic attacks.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is a type of specialist talking treatment. It is probably the most effective treatment. Studies show that it works well for over half of people with panic disorder (and agoraphobia).

  • Cognitive therapy is based on the idea that certain ways of thinking can trigger, or fuel, certain mental health problems such as panic attacks and agoraphobia. The therapist helps you to understand your current thought patterns. In particular, to identify any harmful, unhelpful, and false ideas or thoughts which you have. For example, the ideas that you may have at the beginning of a panic attack, wrong beliefs about the physical symptoms, how you react to the symptoms, etc. The aim is then to change your ways of thinking to avoid these ideas. Also, to help your thought patterns to be more realistic and helpful. Therapy is usually done in weekly sessions of about 50 minutes each, for several weeks.
  • Behavioural therapy aims to change behaviours which are harmful or not helpful. This may be particularly useful if you have agoraphobia with panic disorder where you avoid various situations or places. The therapist also teaches you how to control anxiety when you face up to the feared situations and places. For example, by using breathing techniques.
  • Cognitive behavioural therapy (CBT) is a mixture of the two where you may benefit from changing both thoughts and behaviours.

If you have CBT and it works, the long-term outlook may be better than with treatment with antidepressants. However, CBT may not be available in every area, and does not suit everyone.

Antidepressant medicines

These usually work well to prevent panic attacks in more than half of cases. (These medicines are often used to treat depression, but have been found to work well for panic disorder too, even if you are not depressed.) They work by interfering with brain chemicals (neurotransmitters) – such as serotonin – which may be involved in causing symptoms of panic.

  • Antidepressants do not work straightaway. It takes 2-4 weeks before their effect builds up and may take up to eight weeks to work fully. A common problem is that some people stop the medicine after a week or so as they feel that it is doing no good. You need to give them time to work.
  • Antidepressants are not tranquillisers, and are not usually addictive.
  • There are several types of antidepressants, each with various pros and cons. For example, they differ in their possible side-effects. However, selective serotonin reuptake inhibitor (SSRI) antidepressants are the ones most commonly used to treat panic disorder.
  • If SSRIs do not work, imipramine or clomipramine is sometimes used.

Note: after first starting an antidepressant, in some people some anxiety symptoms become worse for a few days before they start to improve.

If it works, it is usual to take an antidepressant for panic disorder for at least a year. At the end of a course of treatment, you should not stop an antidepressant suddenly, but you should reduce the dose gradually under the supervision of a doctor. In about half of people who are successfully treated, there is a return of panic attacks when treatment is stopped. An option then is to take an antidepressant long-term. The attacks are less likely to return once you stop antidepressants if you have had a cognitive behavioural course (see below).

A combination of CBT and antidepressants may work better than either treatment alone.

Further help & information



I have heard a lot recently about people who have finaly thrown the towel in and surrendered to there addiction for a period of time, and are now questioning them selves and others about weather this is it. Is this all life is now, I’ve got to continue like this with that feeling of uncertainty and confusion of what I do next and where do I go from here. While all the while we are so desperately searching for something, anything in fact that will fulfill that void that we so crave to fill in order to feel complete. The truth of the matter is that this is normal for someone in recovery to think and feel Like. I should know I still go through it now. As I see it we are addicts and as an addict the mind is always chasing that feeling of great satisfaction and more if the truth be known. But that’s just it you see that’s all that we do know or at least we think we do because like most we have all been in our addiction for Such a long period of time, That we have become accustomed to the thoughts and feelings of our substances and that of the picture that they create. Have you ever heard the famous saying. That if you sit in a barbers shop long enough you will get your haircut. Well have you ever thought that the same can be applied to your addiction. The truth is it did and does. It never started out as an addiction and if we admit it openly and if we are COMPLETLEY honest most of us have had some brilliant times throughout our using, but then it ultimately becomes overwhelming pain overtime if your an addict, because we just don’t know when or how to stop, and it becomes a major problem and we are unable to function normaly in everyday life eventualy. Thats because we stayed in the barbers shop for to long and ended up getting our haircut. But now my life’s different because I chose to go to another new hair salon instead called RECOVERY to see what all the fuss was about there. Well as you can guess I sat there for a while and yeah you guessed it. I had my hair done. And today I have a blonde perm and I love it. I never new just how nice it was to have a perm, you see all them years I had had a short back and sides (ADDICTION) that I eventualy believed that that’s all there was. Things are different today though. I mean don’t get me wrong I still do have bad hair days but ultimately all it takes these days is a quick phone call (to another addict) and I’m back under the dryer chatting away in the salon to the other people (fellowships meetings and recovery groups) and before you know it, it’s looking fantastic once more. I love my new hairstyle they call it SOBRIETY by the way, you should try it. And if you’ve already got it and your having a bad hair day then all I can say is PICK THE PHONE UP AND JUST KEEP COMING BACK. You will have it looking fantastic again in no time.

By Brett Pomfrey