Panic Disorder manifests itself in panic attacks, which are sudden bursts of intense fear or dread which occur suddenly and are accompanied by physical sensations such as an increased heart rate, shortness of breath, sweating, lightheadedness, dizziness, feelings of choking, trembling or shaking, gastrointestinal upset, numbness or tingling, and feelings of unreality or detachment. Panic attacks are not dangerous but given that the cause of the panic attack it is not usually clear to the person (at least early on in the development of the condition), the person typically misinterprets the sensations a sign of impending catastrophe. Typical “catastrophes” include having a heart attack or stroke, passing out, losing control, and going crazy. It is not unusual for the person to go to an emergency room where it is determined that there is no medical basis for their symptoms and a diagnosis of panic is made.
Panic disorder may be accompanied by agoraphobia, which is the avoidance of places or situations from which escape may be difficult or embarrassing. Usually in agoraphobia the person fears having a panic attack in certain situations. However, sometimes agoraphobia occurs in the absence of Panic Disorder. In such cases, the person usually fears panic-like symptoms, such as loss of bowel control, feeling dizzy, or falling over.
Agoraphobia usually develops after that the person has experienced one or more panic attacks and then worries about having another one in a public place, leading to avoidance of such places or intense anxiety if the place or situation is encountered. This leads to a constricted lifestyle where the person confines themselves to what they consider to be safe surroundings that they can leave easily or get help if needed. Typically, people with agoraphobia restrict themselves to work, familiar nearby stores, and the homes of people they know well. They usually avoid crowded places, isolated places, bridges, tunnels, highways with infrequent off-ramps, and in some cases, being home alone. In severe cases, the person rarely, if ever, leaves their home.