Agoraphobia

Phobia can be defined as irrational fear of something that can interfere with normal activities. There are many types of phobia which are basically anxiety disorder and can be fully treated. Agoraphobia is fear of public places where there is large number of people. They would avoid taking part in any social events and avoid places that might cause them panic attack. For instance, it makes them impossible to use public transport system and remain in open places for long. They avoid living in a crowd and prefer to be isolated.

This type of irrational fear would cause intense anxiety in them and they often become helpless and give them a feeling of getting trapped. This feeling would worsen their fear causing panic attack. They can get comfort only if they find suitable companion like friend or close relative while in public places. Many times, this fear would disable them to leave their home independently. However, with proper cognitive behavior therapy and medications it can be cured.

Facts on Agoraphobia :

  • Agoraphobia is reported to occur in 2-7% of total population in the world.
  • In simple terms, agoraphobia can be defined as fear of being outside.
  • Experiencing stressful events or having anxiety disorder can cause agoraphobia.
  • Agoraphobia can be difficult to diagnose, since people having this disorder will always tend to avoid situations or events that makes them stressed.
  • It can cause symptoms like intense fear, dizziness and even panic attack.
  • Agoraphobia begins in early adolescence and may continue till your death if you are not seeking any treatment.
  • If the patient seeks medical care, agoraphobia can be fully treated.
  • Women who are single or divorced can develop agoraphobia and feel insecure most of the time.

Symptoms :

The person with agoraphobia can develop intense fear while being in public places or crowd. He would develop fear to be alone and avoid going to public events in the fear of losing control. They would avoid traveling alone in train or public buses where it can be difficult to get down until the stop comes.

In severe cases, such people will not leave their home alone and always rely on someone to visit event the nearest public place. They have a sense of helplessness and fear and due to this feeling they become dependent on others very often.

Symptoms of Panic Attack :

In many cases, people with agoraphobia develop panic attack which can cause palpitation, excess of sweating, rapid heartbeat, a feeling of numbness in hands and legs, tightness in chest, sudden flushes and chills, sudden diarrhea, drowsiness and loss of control. In extreme fear they would feel like dying if not possible to escape immediately from the place. The intense fear would trigger these physical reactions and they often feel like losing control.

Causes :

Not one cause can contribute for developing anxiety disorder like agoraphobia. It can be triggered by stressful events in your life and over exposure to anxiety prone events. Agoraphobia can be inherited and tend to run in families. If you have a close relative with agoraphobia you have increased risk for developing it.

Girls in their adolescent age having repeated exposure to stressful events have high risk of developing agoraphobia. When compared with men, women have increased chance of getting it. If you are living with anxiety or if you are always nervous about something, you have high risk for developing this disorder, irrespective of your age.

Complications :

In extreme cases, agoraphobia can make one incapable to leave the home, without the help of known person or relative. It can interfere with daily activities like going to office or school and become over-dependent on others in the long run. If left untreated, it can cause other mental disorders like depression, anxiety disorder and drive you to become addicted easily.

Diagnosis :

Often, people with agoraphobia will not admit their problem and they would remain normal by avoiding visiting public places or being in a crowd. As per the guidelines of DSM manual of psychiatric disorders, a person is said to have agoraphobia, if he has problem in using any public transportation, if he develops anxiety/fear to be in open space for long, if he has problem for waiting in a line and if he has fear to remain in closed spaces like theater or small room alone.

The doctor would gather complete physical record of the patient, and collects information from his parents or friends about his response in such situations. In severe cases, such people will have problems to go to workplace without someone’s help and they avoid public places in the fear of losing control. Your doctor may refer the case to psychiatrist who may ask series of questions to diagnose the disorder.

Treatment :

Agoraphobia can be treated with combined approach of psychotherapy and drugs. Your therapist will use counseling techniques and cognitive behavior therapy which starts with very slow exposure of social places with progressive increase of exposure to public places aided with behavior modification. She would teach you to develop specific skills to attend school or office without anybody’s help and slowly allow you to visit public place with repeated motivation.

With this approach, your symptoms would gradually reduce and you will learn how to cope with the fear and in due course, you can remain in crowd without having any fear or anxiety. Your therapist will teach you the techniques of handling unwanted behavior and very soon you will realize that your fears are irrational and will never come true.

  • Drugs :

For people with severe anxiety due to agoraphobia medications are prescribed. Antidepressant drugs like Prozac, Paxil are given for treating panic disorder. This belongs to SSRI group of medications which would block the signals that arouses fear. Alternatively tricyclic anti-depressants are given to some patients. To effectively manage the anxiety symptoms, your doctor may prescribe benzodiazepine like Clonazepam or alprazolam.

But this might cause sedative feeling and hence recommended only for short term. And any type of antidepressant drugs can cause side effects and you need to seek immediate medical care if you have symptoms like blurred vision, dizziness, tremors and sexual dysfunction while taking these drugs. People who are addicted to alcohol or substance due to intense fear will have hard time in recovering completely from this disorder.

Prevention :

You cannot prevent developing agoraphobia but you can identify the ways to cope up with sudden stressful events. The best way to deal with agoraphobia in the initial stages is to practice visiting public places or situations that causes fear in you. Seek help from your doctor if you feel it difficult to be alone with public places. The more delay you make in taking treatment, the more will be the outcome of fear and anxiety. Practice yoga and meditation that would calm your mind and strengthen your will power.

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