This, not uncommonly, disrupts their relationships and their occupational advancement. They are often tremulous as a result of their fear of ridicule or criticism and concurrently fear that the tremulousness will be noted. The person is aware of the problem but feels powerless to do anything about it. Obviously, they then avoid such settings. There is the fear of having an anxiety attack, and if the outings are attempted, they are executed with great fear and loathing.
People can have panic attacks with or without agoraphobia.
Agoraphobia often represents more the avoidant pattern that emerges when the fear of impending panic is tied to specific events or potential events. The person creates for themselves, based often upon minimal past experiences, a series of anticipatory states in which they contemplate, obsess over potential outcome and, often, thereby, assure that outcome. Desensitization procedures and psychotherapy with and without medication if often very helpful to these patients who need to amass a series of successful experiences to offset the fears that they are developing while isolating themselves. The Disorder can be characterized by a sense of detachment, feeling as though things are unreal, forgetting parts of the event, and reduced awareness of daily activities. The patient can have recurrent thoughts, dreams and sense of reliving the event.