Agoraphobia

Most people take daily tasks like grocery shopping or taking our children to school for granted. However, for individuals suffering for agoraphobia, errands and social events can create intense anxiety or even panic attacks. The result can be a life drastically altered as the world shrinks to the safety zone of one house. The sufferer may feel trapped or helpless and relationships may suffer as important occasions go missed and the sufferer becomes dependent on others to leave the house or meet their basic needs. However, recent years have seen an increased awareness of this challenging disorder as well as successful treatments to help suffers return to their lives. Read on to learn more.

Definition of Agoraphobia

Derived from the Greek word for marketplace, agoraphobia is an anxiety disorder marked by fear and avoidance of being in open or inescapable places such as crowds, wide-open areas, bridges, and shopping centers.[1,2]

Causes of Agoraphobia

The precise cause of agoraphobia is not known.[2] However, it usually develops as a complication of panic disorder (a type of anxiety disorder involving frightening episodes of intense physical symptoms) and in some cases may develop when a person starts associating panic attacks with the situations where they occurred and then avoiding those environments.[1]

Symptoms of Agoraphobia

Symptoms of agoraphobia fall into three categories: psychological, behavioral, physical.[2]

The psychological symptoms of agoraphobia include fear of going out alone, fear of losing control in public places or areas where escape would be difficult, helplessness, agitation, and a sense of detachment from others or your environment.[1,2]

The behavioral symptoms of agoraphobia include staying in your home for long periods, depending on others to accompany you outside or to do things that require going out in public, and avoiding places such as public transportation, crowds, and lines.[1,2]

Finally, the physical symptoms of agoraphobia are the same as those of a panic attack. These include chest pain, rapid heartbeat, hyperventilating, tightness in the throat, feeling faint or dizzy, nausea or upset stomach, hot flashes, sweating, and trembling.[1,2]

Risk Factors for Agoraphobia

Agoraphobia is twice as common in women than men and typically affects people between the ages of 18 and 35, most often beginning around age 25.[1,2] A number of factors increase the risk of becoming agoraphobic including previous mental illness, a history of childhood trauma, substance abuse problems, stress, and abusive or unhealthy romantic relationships.[1]

Treatment for Agoraphobia

The good news is most people who seek treatment for agoraphobia will see an improvement in symptoms and many achieve a complete recovery.[1] Treatment for agoraphobia typically combines cognitive behavioral therapy and medication.[2]

Cognitive behavior therapy usually lasts between 10 and 20 sessions. It may involve practice putting stressful situations into perspective, helping sufferers recognize and replace patterns of panic-inducing thought, and slowly practicing exposure to panic-inducing situations in real life.[1,2]

Antidepressants from the selective serotonin reuptake inhibitor (SSRI) category are typically the preferred medication for agoraphobia. For more severe cases and those that do not to respond to SSRIs, other types of antidepressants including serotonin-norepinephrine reuptake inhibitors (SNRIs), benzodiazepines, or pregabalin may be prescribed.[1,2]

Seeking Help for Agoraphobia

The very nature of agoraphobia may make it difficult to seek out treatment. Consider starting with a phone call to your doctor or an email to a therapist specializing in panic disorders. They may be willing to meet you in your home for sessions until you are ready to leave the house.

Before your appointment, it may be helpful to write down your symptoms, how long you have been experiencing them, and anything that makes them better or worse. Also note any other medical conditions you have been diagnosed with, any medications you use, mental illnesses in your family history, and traumatic experiences from your recent life or past.

References:

  1. Agoraphobia.NHS Choices. Retrieved from http://www.nhs.uk/Conditions/Agoraphobia/Pages/Symptoms.aspx
  2. Panic Disorder with Agoraphobia.PubMed Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001921/

By C. J. Newton, MA, Counseling.info Editor

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