AGORAPHOBIA
Agoraphobia is an anxiety disorder characterized by intense fear and avoidance of places or situations where escape might be difficult or where help might not be available if something were to happen.
- Agoraphobia is a more complex condition than what most people assume. They assume it’s simply a fear of open spaces.
- But someone with agoraphobia may be scared of traveling on public transport, visiting a shopping center, or leaving home.
- Agoraphobia is often associated with panic disorders. The National Institutes of Health estimates that one in three people with panic disorder develop agoraphobia.
- Most people with the condition develop it after having one or more panic attacks, making them worry about another attack. This may cause them to avoid places where it may happen again.
- The fear experienced is usually out of proportion to the actual danger of the situation.
- According to experts, panic disorder with agoraphobia tends to be chronic, while the one without it tends to come and go in phases.
- Agoraphobia can begin in childhood but mostly starts in the late teen or early adult years, usually before age 35.
- Older adults can also develop it.
- Those affected are at higher risk of having depression and substance abuse disorder.
CAUSES
Agoraphobia is caused by both environmental and genetic factors.
Risk factors for the condition include:
- A family history of the condition
- Having an anxious or nervous temperament
- Experiencing traumatic events such as abuse, being attack or bereavement
- Having panic disorders or other phobias
SYMPTOMS
Symptoms may include:
- Detachment from other people
- Fear of spending time alone, of places where escape is difficult, or of losing control in public.
- Helplessness
- Avoiding situations or needing a companion such as a relative or friend to go out to public places with you.
Symptoms of panic attacks include:
- Rapid heart rate
- Excessive sweating
- Upset diarrhea
- Feeling a loss of control
- Chest pain or pressure
- Sudden chills
- Trouble breathing or a feeling of choking
- Dizziness
- Tingling
- Facial flushing
DIAGNOSIS AND TREATMENT
Diagnosis is based on a clinical interview and diagnostic guidelines. The doctor will ask questions about symptoms, how often they occur, and in what situations. The doctor may also carry out a physical exam to rule out other conditions that could be causing symptoms. The doctor may also use diagnostic criteria in the Diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association.
TREATMENT
It is uncommon for agoraphobia to resolve without treatment
Treatment options include psychotherapy and medication.
Psychotherapy may be effective to help you understand your condition, how to cope with and tolerate symptoms of anxiety, communicate with others in social situations, and help reduce the feeling of anxiety. The form of psychotherapy used is Cognitive Behavioural therapy (CBT). Therapists who treat the condition may offer initial treatment without the patient needing to visit them in their office.
Medications such as selective serotonin reuptake inhibitors (SSRIs) – antidepressants- are used for the treatment of panic attacks and agoraphobia.
Anti-anxiety medications called benzodiazepines to temporarily relieve anxiety symptoms.