Agoraphobia is a condition in which an individual feels an overwhelming, intense sense of fear and avoids places or situations where escape might be difficult or help might be unavailable should sudden, panic-like symptoms develop. Some people even avoid normal, everyday activities, such as grocery shopping or driving. The condition is best treated with a specific form of short-term psychotherapy called cognitive behavioral therapy.
Agoraphobia is a type of phobia. However, it rarely occurs in the absence of panic disorder.
Some people's lives become so restricted by agoraphobia that they avoid normal, everyday activities such as grocery shopping or driving. In some cases, they become housebound. Or, they may be able to confront a feared situation only if accompanied by a spouse or other trusted person. Basically, these people avoid any situation in which they would feel helpless if a panic attack were to occur.
Approximately 3.2 million American adults ages 18 to 54 (about 2.2 percent of people in this age group) in a given year, have agoraphobia.
Other facts about agoraphobia include:
About one in three people with panic disorder develop agoraphobia
Women are more likely than men to have agoraphobia.
Early treatment of panic disorder can often prevent agoraphobia.
If you break down the word agoraphobia, you can quickly see what it means. A phobia is a fear of something. Agora comes from the Greek language, and refers to a place where people meet, or more specifically a marketplace. So agoraphobia is the fear of being in crowded or open spaces.
Sometimes agoraphobia is thought of as the fear of being out in the open, but that isn't strictly correct. People suffering from agoraphobia are more often fearful of places where they are crowded in, where getting away would be difficult. A person with agoraphobia may be reluctant to leave their house, but it is usually not simply being outdoors that frightens them.
Situations such as being in a crowded building, a long hallway, a large, exposed place, or any unfamiliar territory can be intensely disturbing to someone with agoraphobia. Agoraphobia is most associated with being unable to get to a safe location, or the feeling of being exposed and unprotected. A return to familiar territory may relieve the symptoms of an agoraphobia related panic attack.
Symptoms of agoraphobia can range from mild feelings of discomfort or anxiety in large, crowded spaces, to intense fear and panic attacks. Agoraphobia is actually diagnosed differently according to whether the patient experiences panic disorders or not. In fact, many different psychological disorders can share symptoms with agoraphobia, such as social phobia, separation anxiety disorder, and depression. A professional diagnosis is required to determine whether a person has agoraphobia or not.
People with agoraphobia commonly avoid crowded events, busy facilities, and public transportation. In addition to such avoidances, other agoraphobia symptoms include anxiety, hyperventilation, and accelerated heartbeat.
One of the most telltale agoraphobia symptoms is avoidance. People with the condition tend to avoid instances where they are exposed to other people. At the onset of the condition, the avoidance may not be severe, making it difficult for outsiders to notice. However, as the condition develops, public avoidance can become extreme and debilitating. In some instances, the condition becomes so severe that sufferers will rarely leave their homes.
Due to the nature of this condition, it should not be surprising that one of the most common agoraphobia symptoms is anxiety. It is normal for people to worry or to become anxious about certain things. Anxiety, however, is a permanent or semi-permanent state of mind that can be accompanied by physical and psychological symptoms for people with agoraphobia. The anxiety stems from the fear of having a panic attack that people will witness or from humiliation that will be caused when the sufferer tries to withdraw to avoid having others witness such an attack.
This condition is often characterized by disorientation. The phobia and the irrational thoughts associated with it can be so overwhelming that a person can lose her sense of direction, become confused, or lose the ability to concentrate. In addition to these symptoms of agoraphobia, there are also many physical effects, such as dizziness.
Hyperventilation is one of the most common physical symptoms. Hyperventilation is over-breathing. When a person hyperventilates, she may begin taking breaths that are deeper than necessary or she may breath at an abnormally fast pace. For people with agoraphobia, this can occur before they are forced to enter situation they fear, such as boarding a subway, or it can occur while they are in such a situation.
Accelerated heartbeat is also common. In many instances, when agoraphobic individuals feel trapped or fear that they will be trapped, their hearts begin to race. This may continue as long as they are confronted with or remain in a situation that presents fear.
The anguish they feel may be visible to others. Agoraphobia symptoms include flushing of the skin, which may be very noticeable when individuals have lighter skin tones. Even if others do not notice changes in skin color, they may be able to notice displays of being hot since many agoraphobic individuals feel that their body temperatures increases.
There are several possible treatments for patients with agoraphobia. If other disorders contribute to the agoraphobia, or compound it, these can be treated separately. Helping patients to take control of their fear by slowly exposing them to environments which may cause them fear and anxiety can decrease the agoraphobia symptoms.
Patients can determine which situations trigger their agoraphobia, and make an effort to overcome these fears. By slowly dealing with each situation in a way that feels safe, the patient can learn to deal with their fears and face them rather than allowing the fear to control them. A patient who is afraid of shopping malls might start by visiting a small corner store until he or she feels comfortable. Once a small step is overcome, the patient will be ready to try to push his or her comfort zone a little further. A doctor or mental health professional will be able to help design a program, and provide advice and medication if necessary.
One common treatment for agoraphobia is Cognitive Behavioral Therapy (CBT), a psychotherapy or counseling method that focuses on controlling the trigger and symptoms of anxiety. Another treatment for agoraphobia is medication. Doctors often prescribe anti-anxiety drugs, such as Prozac and Zoloft. Combined with relaxation techniques, treatment for agoraphobia is often successful, allowing patients to live normal lives.
Anxiety disorders such as agoraphobia are mental health disorders that are most commonly treated with psychotherapy and medication. One of the most commonly used psychotherapy treatments for agoraphobia is CBT. In CBT, an individual is taught how to identify the situations or environments that can trigger anxiety. Some common locations that produce anxiety are elevators, shopping malls, theaters, and airplanes The anxiety, when heightened, can lead to panic attacks, and this can often restrict an individual's activities.
CBT also teaches patients coping skills to control the symptoms of anxiety, such as racing pulse, or difficulty breathing. Deep breathing and relaxation techniques are frequently used to control the agoraphobia symptoms if they are triggered. CBT also teaches clients to gradually change behaviors that are created by anxiety. An individual with a fear or crowded or public places may be encouraged to visit these places for short periods of time while using relaxation techniques to control the anxiety response. Over time, the excursions are lengthened, allowing the individual to gradually desensitize himself from the fear of the location or situation.
In some cases agoraphobia can be so severe and debilitating that it can cause an individual to avoid public places entirely. When the symptoms of anxiety and panic are on-going and severe, medical treatment may combine CBT with medication to provide treatment for agoraphobia. Selective serotonin reuptake inhibitors (SSRI), including Prozac and Zoloft, are commonly used to treat agoraphobia. These medications help reduce the symptoms and frequency of panic attacks, allowing people to engage in daily activities without the extreme stress and anxiety symptoms of agoraphobia.
Doctors and mental health clinicians typically suggest that medication be used in combination with CBT as treatment for agoraphobia. Most experts agree that medication can ease symptoms, but that behavioral changes and coping skills are also very important in the long-term management of an anxiety disorder such as agoraphobia. With increased use of relaxation methods and self-calming techniques, patients can often minimize anxiety and maintain normal functioning without frequent panic attacks. The key to treatment is identifying and controlling the anxiety in order to allow a patient to return to his normal daily activities.