This film mostly regards the efforts of police inspector M. J. Monahan (Holly Hunter) and Dr. Helen Hudson (Sigourney Weaver) to track down a serial killer. However, a significant aspect of the story is that Dr. Hudson suffers acute panic attacks and agoraphobia; a result of Post-Traumatic Stress Disorder (PTSD), or a "nervous breakdown" in her own words (the result of her attempted murder). Consequently, Dr. Hudson, a retired expert on serial killers, tries to aid the police while remaining strictly housebound.

The portrayal of Dr. Hudson's acute panic attacks is reasonably true to life. As depicted in the film, her panic attacks involve a great deal of distress and sometimes disable her to the point of seizure-like collapse and unconsciousness. Also realistic is the fact that her attacks are not always triggered, but also seem to occur spontaneously (a mixture of PTSD and panic disorder). Though her attacks tend to pass quickly, this too is sometimes the case in real life. During her attacks, she sometimes uses the psychological technique of distraction by reciting the names of past American presidents, but this has little affect in her case. She does seem to find some relief by breathing into a paper bag (i.e. hyperventilation theory). Mostly, though, she relies on medication and alcohol to calm her condition, and apparently has little or no reservations about drinking coffee.

Even as someone with a history of panic disorder, agoraphobia and PTSD, I have difficulty criticizing this film. There certainly are people who resemble Dr. Hudson in great detail, and I give the film much credit on this account. Furthermore, I recognize that a general treatise of panic disorder and PTSD would have been somewhat superfluous to the story. Also, it should be remembered that the 1990s were a period of dramatic change in the understanding of such disorders, so the film shouldn't be criticized too harshly.

Despite the film's many good qualities, however, I was concerned that a general audience would be left with some false impressions. First, the language in the film uses terms such as "nervous breakdown," "panic attack" and "agoraphobia" while notably omitting the term PTSD. Though events in the film clearly suggest PTSD, the dialog strongly suggests panic disorder. Consequently, a general audience is left with the impression that Dr. Hudson's condition is panic disorder. This implies that panic disorder not only requires some past trauma, but that severe panic attacks require a severe trauma. Such impressions are simply not true; though the film avoids technical fault by being somewhat ambiguous.

The portrayal of agoraphobia in the film is certainly well done. Though Dr. Hudson's difficulty retrieving her newspaper from the hallway is almost comical, her anxiety and reluctance are obvious. The power of her agoraphobia is later highlighted when she tries to escape an intruder in her apartment. Desperately fighting her anxiety, she clings to the wall and struggles to make progress down the hallway. Optical distortions create a convincing sense of derealization (a common symptom of panic). She pounds her head against the wall and eventually decides to retreat back to her apartment; confronting the intruder and possibly even death is preferable to confronting her agoraphobia. This is all quite realistic for cases of severe agoraphobia.

Towards the end of the film, Dr. Hudson is forced to reexperience her original trauma in meticulous detail. To some degree, this scene suggests that confronting the trauma quickly cures her; but, again, the film is somewhat ambiguous here. In reality, behavioral or exposure therapies work in a similar fashion and are often an effective means of treating agoraphobia. However, PTSD is typically a long lasting condition that is not so quickly cured, when cured at all. In fact, exposure therapy can actually further traumatize a PTSD person if pursued aggressively. Likewise, panic disorder is not so quickly cured. Also, panic disorder is not always psychological, but can be medical in nature and require more than a psychotherapeutic experience.

Overall, I feel the film deserves credit for it's portrayal of agoraphobia and the severity of panic attacks. Despite some ambiguity, the film is rather realistic and helps to promote some degree of public awareness.