Agoraphobia
Agoraphobia is a type of anxiety disorder that causes people to avoid places and situations that might cause them to feel:
• trapped
• scared
• helpless
• embarrassed
• panicked
You fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd.
The anxiety is caused by fear that there’s no easy way to escape or get help if the anxiety intensifies. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to worry about having another attack and avoid the places where it may happen again.
People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. You may feel that you need a companion, such as a relative or friend, to go with you to public places. The fear can be so overwhelming that you may feel unable to leave your home.
Symptoms –
Agoraphobia often coincides with panic attacks. Panic attacks are a series of symptoms that sometimes occur in people with anxiety and other mental health disorders. Panic attacks can include a wide range of severe physical symptoms, such as:
• chest pain
• a racing heart
• shortness of breath
• dizziness
• trembling
• choking
• sweating
• hot flashes
• chills
• nausea
• diarrhea
• numbness
• tingling sensations
People with agoraphobia may experience panic attacks whenever they enter a stressful or uncomfortable situation, which further enhances their fear of being in an uncomfortable situation.
Causes –
The specific reasons why agoraphobia develops remain unclear, but changes in the areas of the brain that control the fear response may play a role.
The DSM-5 lists three types which includes –
• Environmental factors: Agoraphobia may develop after experiencing a crime, abuse, or a traumatic event.
• Genetic factors: There are signs that people can inherit it.
• Temperamental factors: Some people appear to be more prone to anxiety-related disorders.
Regarding the apparent link between panic disorder and agoraphobia, the DSM-5 reports that 30–50% of people with agoraphobia had a panic disorder diagnosis or panic attacks before the agoraphobia symptoms arose.
Risk Factors –
Risk factors for developing agoraphobia include:
• Having panic attacks or other phobias.
• Having a nervous or anxious nature.
• Experiencing stressful life events, such as the death of a loved one, being attacked, or being abused.
• Responding to panic attacks with excess fear and apprehension.
• Having a relative with agoraphobia.
Diagnosis –
A lot of the symptoms caused by agoraphobia are the same as those of other medical conditions like heart disease, stomach issues, and breathing problems. So you may make several trips to the doctor or emergency room before you and your doctor figure out what’s really going on.
Your doctor may ask:
• Do you find it scary or stressful to leave your house?
• Do you have to avoid some places or situations?
• What happens if you end up in one of them?
They’ll do a physical exam and maybe some tests to rule out any other medical problems. If they don’t find a physical reason for your symptoms, they’ll probably recommend that you see a psychiatrist or therapist.
At your session, you’ll answer questions about your feelings and your behavior.
Treatment –
There are a number of different treatments for agoraphobia. You’ll most likely need a combination of treatment methods.
▪︎Therapy
• Psychotherapy
Psychotherapy, also known as talk therapy, involves meeting with a therapist or other mental health professional on a regular basis. This gives you the opportunity to talk about your fears and any issues that may be contributing to your fears. Psychotherapy is often combined with medications for optimum effectiveness. It’s generally a short-term treatment that can be stopped once you’re able to cope with your fears and anxiety.
• Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is the most common form of psychotherapy used to treat people with agoraphobia. CBT can help you understand the distorted feelings and views associated with agoraphobia. It can also teach you how to work through stressful situations by replacing the distorted thoughts with healthy thoughts, allowing you to regain a sense of control in your life.
• Exposure Therapy
Exposure therapy can also help you overcome your fears. In this type of therapy, you’re gently and slowly exposed to the situations or places you fear. This may make your fear diminish over time.
• Medications
Certain medications can help relieve your agoraphobia or panic attack symptoms. These include:
• selective serotonin reuptake inhibitors, such as paroxetine (Paxil) or fluoxetine (Prozac)
• selective serotonin and norepinephrine reuptake inhibitors, such as venlafaxine (Effexor) or duloxetine (Cymbalta)
• tricyclic antidepressants, such as amitriptyline (Elavil) or nortriptyline (Pamelor)
• anti-anxiety medications, such as alprazolam (Xanax) or clonazepam (Klonopin)
• Lifestyle Changes
Lifestyle changes won’t necessarily treat agoraphobia, but they may help reduce everyday anxiety. You may want to try:
• exercising regularly to increase the production of brain chemicals that make you feel happier and more relaxed
• eating a healthy diet that consists of whole grains, vegetables, and lean protein so you feel better overall
• practicing daily meditation or deep breathing exercises to reduce anxiety and fight the onset of panic attacks
You’ll probably take medicine for at least 6 months to a year. If you feel better and no longer are stressed when you’re in places that used to scare you, your doctor may begin tapering off your medicine.
It isn’t always possible to prevent agoraphobia. However, early treatment for anxiety or panic disorders may help. With treatment, you have a good chance of getting better. Treatment tends to be easier and faster when it’s started earlier, so if you suspect you have agoraphobia, don’t hesitate to seek help. This disorder can be quite debilitating since it prevents you from participating in everyday activities. There’s no cure, but treatment can greatly relieve your symptoms and improve your quality of life.
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