A person who suffers from agoraphobia may have difficulty crossing a bridge or staying in a crowd . Spending time in a closed place like the subway or other public transport, a hospital or a cinema, can cause her fears and anxieties. Ditto for the plane or the shopping center. Waiting in a line or standing in line at a store can be difficult for someone with this condition. Not being at home can ultimately be a source of anguish for agoraphobes.
Agoraphobia is often associated with panic disorder , which is an anxiety disorder that appears suddenly and triggers strong symptoms (tachycardia, sweating, dizziness, etc.). The person becomes extremely distressed. The anxiety stems from the fact that she is afraid of being locked up, of not being able to easily leave an enclosed or crowded place. Sometimes, after a panic disorder, the person can no longer go to the place of the previous attack.
Agoraphobia can isolate people who suffer from it, some no longer leaving their homes, especially for fear of having a seizure. This psychiatric illness is one of the neuroses . It can appear at any age and can be cured, although the treatment (based on psychotherapy and medication) is often long.
In general, a person becomes agoraphobic after having had one or more seizures panic in a given location. Fearing to suffer again, in a similar situation, from a new anxiety attack, she can no longer go out and confront herself in a closed place. She avoids the place so as not to suffer from a new panic disorder, which may ultimately prevent her from leaving her home.
Prevalence . More than two in 100 people would be affected by agoraphobia.
Causes . A life event or panic disorder can be the cause of the onset of agoraphobia.
How is agoraphobia diagnosed?
The symptoms of agoraphobia (see Symptoms section) are usually clear enough to make a diagnosis quickly. There are diagnostic grids which make it possible, based on various criteria, to confirm this diagnosis. These charts also exist for various mental disorders.
What are the complications of agoraphobia?
When agoraphobia is severe, the sufferer may in some cases not be able to leave their home. It is therefore no longer a question for her of working or having leisure time. And it can last over time. Agoraphobia can therefore have very serious consequences. In addition, it can be associated with other mental illnesses or contribute to depression, alcoholism, drug use …
What are the symptoms of agoraphobia?
There are typical symptoms of agoraphobia which are:
- Panic attack (panic attack) during exposure to the distressing situation;
- The repetition of seizures during exposure to the distressing situation;
- The anticipated fear of a panic attack;
- The avoidance of distressing situations (leading to a limitation of social life or withdrawal at home);
- Strategies to try to get out of it, such as the need to be accompanied to get out.
The various fears can vary according to each agoraphobic person:
- fear of crowds, or queues;
- fear of staying in an enclosed space;
- fear of being on a bridge, on a bus, train or car;
- fear of not being able to leave this closed place;
- fear of being alone outside of home;
- fear of having an anxiety attack in a public place.
The signs of panic disorder are:
- increased heart rate, palpitations;
- muscle tremors or twitching, chills;
- sweating, hot flashes;
- difficulty in breathing, feeling of breathlessness, suffocation;
- chest pain or discomfort;
- dizziness, feeling dizzy, empty-headed;
- nausea, abdominal discomfort, diarrhea;
- fear of dying, feeling of imminent death;
- afraid of going crazy.
Who are the people at risk for agoraphobia?
Even if all age groups can be affected, agoraphobia usually appears in adulthood, most often before the age of 35. One study 1 suggested that the first seizure appeared on average at age 27. An earlier onset does not mean, which is the case in other psychiatric illnesses, that the symptoms will be more severe. Women are more affected than men.
30 to 50% of people with panic disorder also suffer from agoraphobia.
Risk factors . Being of an anxious nature or having lived through tragic events increases the risk of one day suffering from agoraphobia. Just like having a parent who suffers from this condition.
Can we prevent agoraphobia?
It is difficult to prevent agoraphobia. However, it can be useful to manage your anxiety as well as possible, as soon as the first signs appear, to limit the risks of subsequently developing agoraphobia. This can be done through the help of a mental illness professional.
Our doctor’s opinion about agoraphobia
One of the driving forces behind phobias, which is particularly important to understand, is avoidance. Indeed, the phobic person avoids the situation which scares him. And then she said to herself: luckily I didn’t go, otherwise I would certainly have been unwell. Avoidance therefore reinforces the conviction that one is right to be anxious. The work of cognitive and behavioral therapy (CBT) therefore consists in avoiding avoidance, in facing one’s fears, most often gradually, so as to reduce anxieties.
Some phobias are not only linked to the making of an anxiety loop, but to a particularly distressing event from the past, which has left an emotional trace. It may also be necessary to work on it in therapy.
Are there complementary approaches for agoraphobia?
To relieve agoraphobia, it is helpful to reduce anxiety. This can happen through the practice of yoga or the consumption of certain plants:
Yoga : several studies 2 have shown the interest of this practice in reducing anxiety, some suggesting an effectiveness on panic disorders 3 . Another study 4 suggested the effectiveness of regular exercise in combination with therapy in the treatment of panic disorder.
Hypnosis : it would be, like yoga, effective in the management to fight against anxiety and phobias 5 .
Kava: this plant from the Pacific, known for its relaxing properties, could help people with anxiety. Be careful, however, because kava is not without side effects, especially on the liver.
Acupuncture: this technique would also be effective in the treatment of certain anxiety disorders.
1 Tibi L An admixture analysis of age of onset in agoraphobia. J Affect Disord.
2 Role of yoga in modifying anxiety level in women. Mullur LM, Khodnapur JP, Bagali S, Aithala M, Dhanakshirur GB. Indian J Physiol Pharmacol.
3 Vorkapic CF Reducing the symptomatology of panic disorder: the effects of a yoga program alone and in combination with cognitive-behavioral therapy. Front Psychiatry.
4 Gaudlitz K: Aerobic exercise training facilitates the effectiveness of cognitive behavioral therapy in panic disorder. Depress Anxiety.