What is agoraphobia?
Agoraphobia is an anxiety disorder that involves an extreme and irrational fear of being unable to get out of a difficult or embarrassing situation when there are symptoms like panic or other incapacity. This disorder is characterized by anxiety, which causes people to avoid situations that may feel panic, trapped, helpless, or embarrassing. It can happen alone or together with another mental health condition, such as panic disorder.
This fear usually leads to persistent avoidance behavior. In this case, people begin to stay away from many places and situations where they fear panic may occur.For example, some commonly avoided situations include driving, leaving the comfort of your home, shopping in a mall, traveling by plane, or just being in a crowded place.
Because of these avoidance behaviors, the life of agoraphobia can become very restricted and isolated. Agoraphobia can greatly affect a person’s personal and professional life. For example, increased fear and avoidance can make it difficult for people with agoraphobia to travel on business or visit family and friends. Even small tasks such as going to the store can become extremely difficult.
Fear and avoidance can become so severe that people with phobias become isolated from their homes.
Symptoms of agoraphobia may include:
- Afraid of leaving home
- Fear of open spaces, bridges or shopping malls
- Fear of enclosed spaces or buildings
- Fear of leaving home or being alone in social situations
- Fear of losing control in public places
- Fear of places where escape may be difficult
- Afraid of public transportation
These situations almost always trigger an anxious response, which is out of proportion to the actual danger presented by the situation.
Panic attacks usually precede the onset of agoraphobia. When forced to endure a terrible situation, a person may experience a panic attack, causing symptoms including:
- Chest pain
- Feeling of suffocation
- Unreal feeling
- Shortness of breath
Although many people with agoraphobia also have panic disorder, it is possible to be diagnosed as agoraphobia without a history of panic disorder.When this happens, the person is still afraid of falling into a situation where it is difficult to escape or humiliated. However, they are usually not afraid of a full-blown panic attack.
Instead, they may be afraid of other types of distressing anxiety symptoms or other strong physical problems, such as vomiting or severe migraines. For example, the person may be afraid that they will lose control of their bladder in public or faint without any help.
About one-third to half of people diagnosed with panic disorder also suffer from agoraphobia. The National Institute of Mental Health (NIMH) reports that in any given year, approximately 0.9% of adults in the U.S. population suffer from agoraphobia.This situation usually occurs in adulthood. However, agoraphobia may appear earlier in adolescence.
Agoraphobia and other phobias
The avoidance behavior in agoraphobia is different from the diagnostic criteria for specific phobias. For example:
- People with agoraphobia may avoid traveling by air for fear of a panic attack on an airplane, not necessarily because of phobia or fear of flying.
- People with agoraphobia may avoid crowds and fear the embarrassment of a panic attack in front of many people. This fear is different from social anxiety disorder, which is a separate mental health condition involving anxiety about being negatively evaluated by others.
The exact cause of agoraphobia is unknown, but there are many risk factors that may increase your risk of developing this disease. These include:
- Suffer from another anxiety disorder, such as generalized anxiety disorder or social anxiety disorder
- Another phobia
- Family history of agoraphobia
- History of abuse or trauma
- Brain chemistry
The learned associations can also play a role in the development of agoraphobia. Experiencing a panic attack in a certain situation or environment may lead to fear that this reaction will happen again in the future.
Your doctor will evaluate your symptoms and check for any underlying diseases that may cause you to develop symptoms. You may be asked about your medical history and about the nature, duration, and severity of your anxiety symptoms.
In order to be diagnosed with agoraphobia, you must:of
- Show obvious fear in at least two different situations, such as open spaces, crowded areas, or public transportation
- When you are in this situation, the agoraphobia condition almost always causes an anxiety reaction
- Fear disproportionate to the threat
- Show avoidance behavior or distress that disrupts your normal daily life, work, school, and interpersonal relationships
- Experience these symptoms for at least six months
These symptoms cannot be better explained by another medical or mental condition.
If a person does develop agoraphobia with panic disorder, the symptoms will usually begin within the first year of the person’s repeated and persistent panic attacks. If left untreated, agoraphobia will get worse.
In order to achieve the best results in managing agoraphobia and panic symptoms, it is important to seek treatment as soon as symptoms develop. Treatment options usually include a combination of medication and psychotherapy.
The treatment process may include some systemic desensitization, that is, under the support and guidance of the therapist, the patient gradually faces the avoidance. Some studies have shown that combining exposure therapy with psychodynamic therapy is beneficial for panic disorder accompanied by agoraphobia. In many cases, if a trustworthy friend is with him, this person will better face their fears.
Medications can also be prescribed to help control certain symptoms of agoraphobia.These drugs include:
- Antidepressants include selective serotonin reuptake inhibitors (SSRIs), selective serotonin-norepinephrine inhibitors (SNRIs) and tricyclic antidepressants
- Anti-anxiety drugs such as Klonopin (clonazepam) and Xanax (alprazolam)
In addition to seeking help from a mental health professional, lifestyle changes can also help you better control the symptoms of agoraphobia. These include:
- Practice stress management techniques such as deep breathing, visualization and progressive muscle relaxation to help reduce anxiety
- Eat a healthy and nutritious diet
- Regular physical exercise
- Avoid drugs and alcohol
- Limit caffeine intake
With the support of family and friends and professional help, people who are struggling with agoraphobia can begin to control their condition. Through medication and psychotherapy, agoraphobia patients can eventually reduce panic attacks, reduce avoidance behaviors, and return to a more independent and active life.