Agoraphobia and Panic Disorder: Understanding the Symptoms, Diagnosis, and Treatment Options
DOI:
https://doi.org/10.56294/hl2025610Keywords:
panic disorder (PD), Diagnosis, Agoraphobia, symptoms, Treatment OptionsAbstract
Agoraphobia with panic disorder (PD) is a phobia-anxiety condition that makes sufferers avoid situations or locations where it could feel embarrassed or be unable to leave or get help in case of a PD. Agoraphobia has been associated with recurrent PD syndrome over the last 50 years, and in many instances, it is regarded to represent the normal progression or complication of PD. Even though agoraphobia with PD is quite common in patients receiving primary care, medical professionals often fail to recognize and adequately treat the disease. These medications alleviate the usually associated depression symptoms as well. Selective Serotonin Reuptake Inhibitor (SSRI) are well-tolerated and effective for both anxious and depressive symptoms, making the primary option for treating agoraphobia with PD in the short, medium, and long term. SSRIs which are less likely to cause withdrawal symptoms after abrupt discontinuation should be used for long-term prophylaxis. Tricyclic Antidepressant (TCA) can be a second-line therapy for PD if SSRIs don't work, although venlafaxine hasn't been researched long-term. High-potency medications are advantageous choices for short-term therapy since ithas been shown to have a quick start of anti-anxiety action, having favorable benefits. Cognitive-Behavioral Therapy (CBT), which is the non-pharmacological approach that has gotten the most research, can be employed with a variety of patients depending on how easily it is accessible.
References
1. Goodwin GM. The overlap between anxiety, depression, and obsessive-compulsive disorder. Dialogues in clinical neuroscience. 2015 Sep 30;17(3):249-60.https://doi.org/10.31887/DCNS.2015.17.3/ggoodwin
2. Stein DJ, Scott KM, De Jonge P, Kessler RC. Epidemiology of anxiety disorders: from surveys to nosology and back. Dialogues in clinical neuroscience. 2017 Jun 30;19(2):127-36.https://doi.org/10.31887/DCNS.2017.19.2/dstein
3. Stech EP, Grierson AB, Chen AZ, Sharrock MJ, Mahoney AE, Newby JM. Intensive one-week internet-delivered cognitive behavioral therapy for panic disorder and agoraphobia: A pilot study. Internet interventions. 2020 Apr 1;20:100315.https://doi.org/10.1016/j.invent.2020.100315
4. Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues in clinical neuroscience. 2015 Sep 30;17(3):327-35.https://doi.org/10.31887/DCNS.2015.17.3/bbandelow
5. Scott AJ, Bisby MA, Heriseanu AI, Hathway T, Karin E, Gandy M, Dudeney J, Staples LG, Titov N, Dear BF. Understanding the untreated course of anxiety disorders in treatment-seeking samples: A systematic review and meta-analysis. Journal of anxiety disorders. 2022 Jun 1;89:102590.https://doi.org/10.1016/j.janxdis.2022.102590
6. Apolinário-Hagen J, Drüge M, Fritsche L. Cognitive behavioral therapy, mindfulness-based cognitive therapy and acceptance commitment therapy for anxiety disorders: integrating traditional with digital treatment approaches. Anxiety disorders: Rethinking and understanding recent discoveries. 2020:291-329.https://doi.org/10.1007/978-981-32-9705-0_17
7. Rakitzi S. Agoraphobia. InClinical Psychology and Cognitive Behavioral Psychotherapy: Recovery in Mental Health 2023 Apr 1 (pp. 65-71). Cham: Springer International Publishing.https://doi.org/10.1007/978-3-031-27837-2_8
8. Cohen JN, Kaplan SC. Understanding and treating anxiety disorders: a psychodynamic approach. Clinical Handbook of Anxiety Disorders: From Theory to Practice. 2020:315-32.https://doi.org/10.1007/978-3-030-30687-8_17
9. Davies MR, Buckman JE, Adey BN, Armour C, Bradley JR, Curzons SC, Davies HL, Davis KA, Goldsmith KA, Hirsch CR, Hotopf M. Comparison of symptom-based versus self-reported diagnostic measures of anxiety and depression disorders in the GLAD and COPING cohorts. Journal of Anxiety Disorders. 2022 Jan 1; 85:102491.https://doi.org/10.1016/j.janxdis.2021.102491
10. Scott AJ, Sharpe L, Thayer Z, Miller LA, Nikpour A, Parratt K, Wong T, Gandy M. How frequently is anxiety and depression identified and treated in hospital and community samples of adults with epilepsy?. Epilepsy & Behavior. 2021 Feb 1;115:107703.https://doi.org/10.1016/j.yebeh.2020.107703
11. Patel TA, Schubert FT, Hom MA, Cougle JR. Correlates of treatment seeking in individuals with social anxiety disorder: Findings from a nationally representative sample. Journal of Anxiety Disorders. 2022 Oct 1; 91:102616.https://doi.org/10.1016/j.janxdis.2022.102616
12. Weisel KK, Zarski AC, Berger T, Krieger T, Moser CT, Schaub MP, Görlich D, Berking M, Ebert DD. User experience and effects of an individually tailored transdiagnostic internet-based and mobile-supported intervention for anxiety disorders: mixed-methods study. Journal of Medical Internet Research. 2020 Sep 16;22(9):e16450.https://doi.org/10.2196/16450
13. Koyuncu A, İnce E, Ertekin E, Tükel R. Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges. Drugs in context. 2019 Apr 2; 8:212573.https://doi.org/10.7573/dic.212573
14. Arnfred B, Bang P, Hjorthøj C, Christensen CW, Moeller KS, Hvenegaard M, Agerskov L, Gausboel UK, Soe D, Wiborg P, Smith CI. Group cognitive behavioural therapy with virtual reality exposure versus group cognitive behavioural therapy with in vivo exposure for social anxiety disorder and agoraphobia: a protocol for a randomised clinical trial. BMJ open. 2022 Feb 1;12(2):e051147.doi:10.1136/bmjopen-2021-051147
15. Wiebe A, Kannen K, Selaskowski B, Mehren A, Thöne AK, Pramme L, Blumenthal N, Li M, Asché L, Jonas S, Bey K. Virtual reality in the diagnostic and therapy for mental disorders: A systematic review. Clinical Psychology Review. 2022 Dec 1; 98:102213.https://doi.org/10.1016/j.cpr.2022.102213
16. Park SC, Kim YK. Anxiety disorders in the DSM-5: changes, controversies, and future directions. Anxiety Disorders: Rethinking and Understanding Recent Discoveries. 2020:187-96.https://doi.org/10.1007/978-981-32-9705-0_12
17. Simon N, Hollander E, Rothbaum BO, Stein DJ, editors. The american psychiatric association publishing textbook of anxiety, trauma, and ocd-related disorders. American Psychiatric Pub; 2020 Apr 2.
18. Bandelow B. Current and novel psychopharmacological drugs for anxiety disorders. Anxiety disorders: Rethinking and understanding recent discoveries. 2020:347-65.https://doi.org/10.1007/978-981-32-9705-0_19
19. Fawcett EJ, Fairbrother N, Cox ML, White IR, Fawcett JM. The prevalence of anxiety disorders during pregnancy and the postpartum period: a multivariate Bayesian meta-analysis. The Journal of clinical psychiatry. 2019 Jul 23;80(4):1181.
20. Walter HJ, Bukstein OG, Abright AR, Keable H, Ramtekkar U, Ripperger-Suhler J, Rockhill C. Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry. 2020 Oct 1;59(10):1107-24.https://doi.org/10.1016/j.jaac.2020.05.005
21. Lorenzo LS. Beyond the ‘normal’worries: Detection and treatment of perinatal anxiety and anxiety disorders. BJPsych Advances. 2023 May;29(3):187-97.https://doi.org/10.1192/bja.2022.922.
22. Ebenfeld L, Stegemann SK, Lehr D, Ebert DD, Funk B, Riper H, Berking M. A mobile application for panic disorder and agoraphobia: Insights from a multi-methods feasibility study. Internet Interventions. 2020 Mar 1; 19:100296.https://doi.org/10.1016/j.invent.2019.100296
23. Good BJ, Kleinman AM. Culture and anxiety: Cross-cultural evidence for the patterning of anxiety disorders. InAnxiety and the anxiety disorders 2019 Jan 22 (pp. 297-324). Routledge.
24. Russell PD, Judkins JL, Blessing A, Moore B, Morissette SB. Incidences of anxiety disorders among active-duty service members between 1999 and 2018. Journal of Anxiety Disorders. 2022 Oct 1; 91:102608.https://doi.org/10.1016/j.janxdis.2022.102608
25. Luong HK, Drummond SP, Norton PJ. Elements of the therapeutic relationship in CBT for anxiety disorders: A systematic review. Journal of anxiety disorders. 2020 Dec 1;76:102322.https://doi.org/10.1016/j.janxdis.2020.102322.
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Copyright (c) 2025 Devraj Singh Chouhan, Saumya Das, Prateek Garg, Nagireddy Mounika, Swamyvel Sethuraman, Nittin Sharma (Author)
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