The American Psychiatry Association lists three definitions of the two disorders:
Panic Disorder with Agoraphobia
Panic Disorder without Agoraphobia
Agoraphobia with no history of Panic Disorder
Because not everybody with these conditions seeks treatment, statistics are inaccurate. It is thought that about half of the sufferers of PD also suffer from agoraphobia but clinical data shows that the number is actually much higher. Most people who seek treatment , even those who are addicted to drugs suffer from them both; in which case the problem is a more severe and complicated one.
On the other hand, about two thirds of agoraphobics have panic disorder. A panic disorder is defined after the occurrence of two or more panic attacks as well as the experiencing of fear of further attacks. It is this fear that, if not treated, will lead to agoraphobia. Rather than the well-known “fear of public places” definition popular so far, scientists are turning more and more to the definition of “the fear of fear.”
The fear of having an attack in a public or confined place such as a supermarket or a plane can lead to avoidance behavior. If the first attack happened in a supermarket, then it may be more convenient to order groceries online or ask a friend to pick up a few things next time they go shopping. If it happened in a plane, then maybe travelling by train begins to look more attractive. Slowly but surely, changes are made in behavior that are more inconvenient and time-consuming but mean that perceived danger zones can be avoided.
The problem is that the more these perceived dangers are pampered too, the worse they become. What was “I could have a panic attack if I go to the supermarket” becomes “I will have one.” Soon, shops are avoided altogether. A major symptom of panic disorder is the fear of having a panic attack; agoraphobia then is the fear of that fear. In fact, most clinical research shows that agoraphobia is preceded by the occurrence of panic attacks.
There are many factors involved in the onset of panic disorders and agoraphobia, which may include alcoholism. What makes is difficult to diagnose is that there is not just one cause and one symptom. Causes may be genetic, biochemical, substance abuse or learned behaviors. There are fourteen symptoms listed in DMV:IV, the American Psychiatry Association Diagnostic Manual – at least four need to be experienced in order for a panic disorder to be diagnosed.
Each individual needs to be assessed on an individual basis. Treatment takes time and it too needs to be individually tailored. The most effective long-term therapy is that of Cognitive-Behavior Therapy (CBT). This has been the most researched of all the psychological therapies in the last 40 years but, because of the fact that there are too few trained therapists, access to this treatment is difficult to get.
CBT concentrates on changing the thinking processes (cognition) that lead to the maladaptive behaviours that then result in panic as an automatic response to a situation or place and thus phobia.
Check out this playlist from Orlando treatment center for more information.