Panic disorder and agoraphobia often coexist with other problems, including other anxiety disorders including simple phobias, social phobia, obsessive compulsive disorder, depression and substance abuse. About 30% of people with panic disorder use alcohol and 17% use drugs, such as cocaine and marijuana. Most often people with panic disorder start using alcohol and/or drugs in an unsuccessful attempt to cope with their anxiety. In the long run, for a number of different reasons, alcohol and drug use only increases anxiety for people with panic disorder. Alcohol and drug use only make the problem worse.
Appropriate diagnosis and treatment of other disorders such as substance abuse or depression are important to treat panic disorder and agoraphobia successfully.
People with panic disorder and agoraphobia may also be more likely than others to have irritable bowel syndrome (IBS) and perhaps other unexplained medical problems such as chest pain not associated with a heart attack or chronic fatigue.
People with panic disorder often develop irrational fears of specific events or situations that they associate with the possibility of having a panic attack. Fear of heights and fear of crossing bridges are examples of simple phobias.
This is a persistent fear of situations in which the person may be exposed to scrutiny by others and/or fears acting in a way that will be embarrassing or humiliating.
About half of all patients with panic will have an episode of clinical depression sometime during their lives. Major depression is marked by a number of symptoms that can include persistent sadness or feelings of emptiness, a sense of hopelessness, feelings of guilt, problems sleeping, loss of interest or pleasure in ordinary activities, fatigue or decreased energy, and difficulty concentrating, remembering, and making decisions.
In OCD, a person becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing but extremely difficult to overcome. Rituals such as counting, hand washing, checking, and repeating may occupy much of the person's time and interfere with other activities.
About 30 percent of people with panic disorder abuse alcohol. A person who has alcoholism in addition to panic disorder needs specialized care for the alcoholism along with treatment for the panic disorder. Often the alcoholism will be treated first.
As in the case of alcoholism, drug abuse is more common in people with panic disorder than in the population at large. In fact, about 17 percent of people with panic disorder abuse drugs. The drug problems often need to be addressed prior to treatment for panic disorder.
The person with this syndrome experiences intermittent bouts of gastrointestinal cramps and diarrhea or constipation, often occurring during a period of stress. Because the symptoms are so pronounced, panic disorder is often not diagnosed when it occurs in a person with irritable bowel syndrome.
