Panic Disorder and Agoraphobia
Students with Panic Disorder experience unexpected and repeated panic attacks. This is typically followed by at least one month of concern about having additional attacks and/or a fear of something bad happening because of the panic attack (i.e. going crazy, losing control, or dying). In addition to having panic disorder, many students will also develop agoraphobia, although these two diagnoses can exist independently so that a student can have panic disorder, or agoraphobia, or both. Students with agoraphobia experience significant fear of being in at least two locations where escape appears difficult or they might be unable to get help, and therefore will avoid these situations as much as possible. Examples of situations include, small classrooms or classroom without a window, riding in elevators, being in assemblies, or being in a remote area of campus, and more.
A panic attack is a sudden rush of intense fear or discomfort, which reaches a peak within 10 minutes, and includes at least four of the following physical sensations or thoughts:
- Racing or pounding heart
- Shaking or trembling
- Shortness of breath or feelings of being smothered
- Feeling of choking
- Chest pain or discomfort
- Chills or hot flashes
- Nausea or upset stomach
- Dizziness or lightheadedness
- A sense of things being unreal or feeling detached from oneself (derealization)
- Numbness or tingling sensations
- Fear of losing control or “going crazy”
- Fear of dying
Note: Panic attacks are fairly common, and having one does not mean that the student has panic disorder. Panic attacks become a problem when the youth worries about having more attacks, or fears something bad will happen because of a panic attack. Also, panic attacks can occur in other anxiety disorders. For example, students with a phobia of dogs might have a panic attack when they are near a dog. In this case, however, the panic attack is expected, and the student is afraid of the dog, not the panic attack. In panic disorder, the panic attacks are unexpected or there is no clear reason for the panic attack to have occurred.
How panic disorder and agoraphobia impacts the student at school
Given that a panic attack typically peaks within 10 minutes and is harmless to the individual, it is remarkable how invasive the presence of panic disorder and/or agoraphobia can be to the student. Students with these disorders live in constant fear that their body will betray them, and cause them to experience symptoms that make them feel as though they are losing control, going crazy, or even dying. If you have ever had a panic attack yourself (approximately 30% of people will have a panic attack in their lifetime), you may be in a position to truly understand. As a result, students remain on high alert for any sign a panic attack might be imminent. This can create difficulties concentrating and focusing in class, completing assignments on time or at all, participating in classroom discussions, going on field trips, and more. Since the symptoms of panic attacks happen internally, teachers and other students are often completely unaware that the student with panic disorder and/or agoraphobia is having an attack. As a result, peers can tease or criticize the student for opting out of activities, and teachers may be irritated that the student is falling behind or loosing focus in class. Sadly this only magnifies the student’s perception that they are loosing control or going crazy, as they may believe they are the only one experiencing such symptoms.