Agoraphobia and Panic Disorder in Adolescence

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Panic disorder is a type of anxiety disorder that is often diagnosed in adults. Age of onset for panic disorder typically occurs in late adolescence and early adulthood but can begin in the early teen years or even childhood. Teenagers with panic disorder often experience the condition in ways similar to adults.

When a professional treats a teenager with this condition, she will diagnose the teen as having panic disorder with or without agoraphobia. Although not as common, it's possible to be diagnosed with agoraphobia without panic disorder. The following provides information on the diagnosis of panic disorder with agoraphobia in teenagers:

The Symptoms of Panic Disorder

Panic disorder is characterized by heightened anxiety and panic attacks. Marked by fear and apprehension, panic attacks involve a wide range of mental, emotional, and physical symptoms. Teenagers with panic disorder may experience these attacks through a combination of frightening somatic sensations and disturbing thoughts and perceptions. Some of the most common physical symptoms of panic attacks include rapid heartbeat, excessive sweating, trembling or shaking, shortness of breath, difficulty breathing, and chest pain.

These attacks are often accompanied by feelings of losing touch with oneself and one’s surroundings. Known as derealization and depersonalization, these symptoms can make a teenager feel as if he's escaping from reality. Given how scary these symptoms can be, it's not uncommon for a teenager to think that his panic attack is a life-threatening medical condition. Many teens that experience panic attacks become afraid that they're going to lose control, go crazy, or even possibly die from the attack.

Panic Disorder With Agoraphobia

Since panic attacks can be a terrifying experience, many teenagers with panic disorder will try to avoid them at all costs. This often means that the teen will start avoiding different places, circumstances, and situations that they believe are contributing to their experience with panic attacks. Approximately one-third of panic disorder sufferers will develop a separate mental health condition known as agoraphobia. This disorder involves a fear of having a panic attack in places or situations from which it would be difficult and/or embarrassing to escape.

Teens with agoraphobia will often experience their fears in clusters of similar avoidances. For instance, a teenager suffering from agoraphobia may become afraid of crowds, staying away from large groups—such as the school cafeteria, malls, sporting events, or other social situations. Some may become afraid of transportation, becoming fearful of driving on the freeway or being on a school bus.

Some teens may become so fearful of different circumstances that they only feel safe within a small radius outside their homes.

Avoidance can become so extreme, that just leaving the house causes a severe amount of anxiety, and the teen becomes homebound with agoraphobia.

Getting Help

Considering how concerned teens can be about fitting in, it's not surprising that many teens with panic disorder feel embarrassed about their condition. However, the severity of this condition may become worse when this shame develops into avoidance behaviors and agoraphobia.

The signs and symptoms of agoraphobia often develop within the first year of the teen's onset of panic attacks. If left untreated, the fears and avoidance behaviors associated with agoraphobia can worsen. In order to manage panic disorder and agoraphobia, it's important to seek treatment early on. Common treatment options involve a combination of psychotherapy and medication.

Treatment may also involve a technique known as systematic desensitization, in which the teen is gradually exposed to avoided and feared situations. Facing these situations can be made easier with the assistance and support of a loved one.

Through the support of professionals, friends, and family, a teenager with agoraphobia can begin to cope with his/her condition. By following through with recommended treatment plans, a teenager with both panic disorder and agoraphobia can be expected to experience less anxiety, and fewer panic attacks and avoidance, returning to an active life like most teenagers.

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  • American Psychiatric Association. (2000). Diagnostic and Statistical Manual of MentalDisorders, 4th ed., text revision. Washington, DC: Author.