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Agoraphobia is fear of public places, in which a person feels trapped or fears having a panic attack in public. Like panic disorder, agoraphobia is one of several anxiety disorders. Agoraphobia may occur with or without panic disorder, but it is most frequently seen with panic disorder.
Translated as 'fear of the market place', this common phobia (4% prevalence) presents as a fear of being away from home, with avoidance of travelling, walking down a road, and shops being common presentations. This can be a very disabling condition, since the patient can be too unwell to ever leave home, particularly by themselves. It is often associated with claustrophobia, a fear of enclosed spaces.
Agoraphobia can be a chronic, disabling condition which causes people to suffer in silence when those around them cannot understand. You are not alone. Seek support and treatment now, explain your condition to loved ones, and you will be on your way to recovery.
The term agoraphobia has been widely misunderstood. Its literal definition suggests a fear of open spacers. However, this is an incomplete and misleading view. Agoraphobics are not necessarily afraid of open spacers. Rather, they are afraid of having panicky feelings, wherever. these fearful feelings may occur. For many, they happen at home, in houses of worship, or in crowded supermarkets, places that are certainly not "open".
Agoraphobia can lead to extreme anxiety and avoidance, leading some victims to become housebound, unable to leave a very small safe zone.
A person may fear having anxiety attacks, losing control, or embarrassing him/herself in such situations. Many people remain in a painful state of anxious anticipation because of these fears. Some become restricted or housebound while others function normally but with great difficulty, often attempting to hide their discomfort.
What are the causes of Agoraphobia?
Agoraphobia is a disorder that most often accompanies other anxiety disorders, such as panic disorder or specific phobias.
If it occurs with panic disorder, the onset is usually during the 20's, and women are affected more often than men. People with this disorder may become house bound for years, which is likely to hurt social and interpersonal relationships.
What are the symptoms of Agoraphobia?
- Lightheadedness , near Fainting
- Fear of being alone
- Heartbeat sensations
- Excessive sweating
- Fear of losing control in a public place
- Skin flushing
- Breathing difficulty
- Fear of being in places where escape might be difficult
- Becoming house bound for prolonged periods
- Nausea and vomiting
- Feelings of detachment or estrangement from others
- Confused or disordered thoughts Intense fear of going crazy
- Feelings of helplessness
- Abdominal distress that occurs when upset
- Dependence upon others
- Chest pain
- Feeling that the body is unreal
- Numbness and tingling
- Feeling that the environment is unreal
- Intense fear of dying
What are the treatment of Agoraphobia?
The goal of treatment is to help the phobic person function effectively. The success of treatment usually depends upon the severity of the phobia.
The early treatment of anxiety helps avoid the escalation of symptoms into agoraphobic behavior. Agoraphobia is responsive to both therapeutic and medical treatment. The most difficult part of treatment for agoraphobia is maintaining regular treatment appointments. People suffering with agoraphobia often have difficulty getting to the office of a psychologist, and frequently cancel appointments because of their fears. This must be addressed as part of treatment.
- Systematic desensitization is a technique used to treat phobias. The person is asked to relax, then imagine the things that cause the anxiety, working from the least fearful to the most fearful. Graded real-life exposure has also been used with success to help people overcome their fears.
- Patient education - Patients need to understand their condition and receive reassurance that they are not "going crazy" and that their condition can be managed. Because they may have received some explanation that their symptoms are caused by a medical disease, they need to be educated about agoraphobia.
- Exposure with response prevention is a very effective behavior therapy for people with agoraphobia. In this treatment, the patient (1) is exposed to a situation that causes anxiety or panic and then (2) learns to "ride out" the distress until the anxiety or attack passes. The duration of exposure gradually increases with each session. This treatment works best if the patient is not taking tranquilizers because tranquilizers can prevent the experience of anxiety.
- Medication - Antianxiety and antidepressive medications are often used to help relieve the symptoms associated with phobias. Antidepressant medications (except buproprion, Wellbutrin®) have been shown to reduce the occurrence of panic attacks. Some studies have shown paroxetine (Paxil®) to be quite effective. Benzodiazepines are effective in treating anticipatory anxiety as well as symptoms of panic attacks.
As with other panic disorders, prevention may not be possible. Early intervention may reduce the severity of the condition.
Facts and Tips about Agoraphobia
- The term agoraphobia was coined by the German neurologist Westphal in 1871.
- Agoraphobia develops when a person begins to avoid phobic situations like driving, crowded placces, standing in line, being alone and social gatherings.
- Agoraphobia usually develops in middle-aged individuals usually a lifelong problem unless treated. About twice as many women than men suffer from agoraphobia.
- Agoraphobics may experience panic attacks, if they feel trapped, insecure and far from their personal comfort zone.
- There are no laboratory tests available to diagnose agoraphobia.
- Agoraphobia can be treated with Cognitive behavioural therapy and Psychotherapy and group therapy.