Panic Disorder with Agoraphobia

Panic Disorder can be defined as the presence of recurrent, unexpected Panic Attacks (at least 2), followed by significant concern over having another attack.  A Panic Attack is marked by a discrete period of intense fear or distress in the absence of any real threat.  The attack is sudden in onset and typically peaks in ten minutes or less. This attack is accompanied by at least four of the following somatic and cognitive symptoms:
 
• Heart palpitations
• Sweating
• Trembling
• Shortness of breath or a sense of smothering
• Feelings of choking
• Chest pain
• Nausea
• Dizziness
• Fear of losing control or “going crazy”
• Fear of dying
• Paresthesias
• Chills or hot flashes
• Derealization or Depersonalization

Criteria for Agoraphobia:

• Anxiety about being in places or situations where escape may be difficult or embarrassing
• Fear that help will not be available if a panic attack occurs
• Situations are avoided or, if encountered, are endured under considerable distress

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth  Edition, text Revision. Washington, DC American Psychiatric Association, 2000.

Social Phobia

Social Phobia, aka Social Anxiety Disorder, is defined by a marked and persistent fear of social or performance situations in which embarrassment or humiliation may occur.  The individual feels acutely aware of the perceived scrutiny of others.  When exposed to a feared social situation, he/she feels anxiety, which may precede a Panic Attack, despite awareness that the excessive fear is unreasonable.  This anxiety causes individuals to avoid most social situations or to be incredibly uncomfortable if they must be endured.  Due to the level of distress, individuals with Social Phobia suffer impairment in social, occupational, and/or academic functioning.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth  Edition, text Revision. Washington, DC American Psychiatric Association, 2000.