Panic, Agoraphobia and Simple Phobia
Carol Watkins, MD
“It feels like you’re going to die..”
Most often starts in late adolescence or adulthood
Can occur in children or young adolescents
Panic with agoraphobia is more common that without agoraphobia in youth.
Anxiety about being in a place from which escape might be difficult or embarrassing. Fear of going somewhere associated with previous anxiety.
The individual avoids the feared situation, or if he does not avoid them, experiences discomfort when he goes to these places.
Can occur with or without panic attacks
High rate of co-morbid depression
Adult panic disorder is associated with a high suicide rate
Adult panic disorder associated with increased substance abuse
Adult and child panic disorder is associated with other psychiatric disorders, especially depression and other anxiety disorders
Treatment of Panic Disorder
Moving outside oneself and observing the panic
Adequate sleep, meals, etc.
Zoloft (sertraline) Paxil (paroxetine) Prozac (fluoxetine)
Progressive exposure (family may help although the child must set the pace)
Biphasic onset: Childhood and mid-adulthood
Fairly common “only a problem if it’s a problem”
Treatment includes relaxation and gradual desensitization.
Medications used less frequently