The term agoraphobia describes and anxiety disorder that involves situations where the subject perceives locations or environments as uncomfortable or dangerous.
People with agoraphobia fear enclosed or open spaces, using public transportation, being in a crowd or standing in a line. Sometimes people are scared of the possibility to be met in airports, shopping malls or other locations.
Agoraphobics develop an anxiety caused by the fear that there won’t be any easy way to escape. Most often agoraphobia develops after a panic attack and people are afraid of the place or the type of place where it occurred.
Post-traumatic stress disorder or obsessive compulsive disorder might also trigger agoraphobia.
Sometimes people might need a companion to get into crowded places.
The classification of agoraphobia varies. In DSM IV it is part of the panic disorder spectrum and it is defined by the fear of panic attacks in certain environments. In DSM V it is described as a separate disorder.
Agoraphobia can be so severe that the patient won’t be able to leave home.
Anyway, is seems there’s a strong connection between agoraphobia and panic attacks as it is thought to be a complication of panic attacks.
Agoraphobia is not a rare disease as it affects about 2.2% or about 3.2 million adults with ages between 18 and 54 in the USA.
The exact causes of agoraphobia are not known yet though there are a few theories such as spatial theory, attachment theory. It might also be caused by the use of certain substances like benzodiazepines.
The symptoms and signs of agoraphobia include fear of being: in crowded places, in place where it is hard to leave, alone and fear of losing control in public places. The signs and symptoms might also include dependence on others, sense of helplessness.
Also symptoms of panic attack might accompany those symptoms of agoraphobia such as excessive sweating, rapid heart rate, trouble breathing, feeling numb or shaky, dizziness, chills, fear of dying or upset stomach.
To diagnose agoraphobia, the criteria and methods used to diagnose panic attacks are used. Of course there’s a specific method to diagnose agoraphobia when there is no history of panic attack.
Most often the treatment is difficult and challenging because most often it involves confronting the fears. It is called exposure treatment.
Medication for agoraphobia includes antidepressants most often. The antidepressants used to treat agoraphobia include benzodiazepines, SSRI (selective serotonin reuptake inhibitor), tricyclic antidepressants and MAO inhibitors.
The benzodiazepines are used most often but if they are used for too long or in doses larger than those prescribed it could cause dependence.
Side effects of benzodiazepines include drowsiness, memory loss, confusion, loss of balance and light-headedness.
Another possible form of treatment might be EDMR (eye movement desensitization and reprograming). Also people could benefit from joining support group or a self-help group.
Agoraphobia develops before age 35 but sometimes even older peoples develop it. The greatest risk factors are panic disorders but there are also a few other risk factors such as having a relative with agoraphobia, stressful life events and a tendency to be anxious or nervous.
Agoraphobia is a disorder that can limit a person’s ability to socialize, attend important events or work. As it can limit a person’s ability to live a full life it is recommended to ask for the specialist help of a doctor as soon as the first symptoms are observed.