Agoraphobia

Agoraphobia

Agoraphobia

Agoraphobia is a type of anxiety disorder that is characterized by intense fear of being in situations, such as crowded places like shopping malls or metro stations, where escape can be seemingly difficult or help might not be readily available.

Exact causes are unknown and can occur in individuals who have had a panic attack and are afraid of being in similar situations that could trigger another panic attack.

Prevalence

The average age of onset of agoraphobia is 17 years old and, in two thirds of cases, before the age of 35. Women are four times more likely to be diagnosed with agoraphobia than men.

Stressful or traumatic events can contribute to the development of agoraphobia. People who have a family history of adjustment disorder are at increased risk of developing this condition.

Symptoms of Agoraphobia:

People with agoraphobia who find themselves in stressful situations can develop the physical and psychological or emotional symptoms of a panic attack.

Physical

  • Palpitations (an awareness of the heart beating faster than usual)
  • Hyperventilating (rapid breathing)
  • Chest pain or other chest issues
  • Lightheadedness
  • Choking
  • Sweating
  • Nausea
  • Trembling

Psychological

  • A sense of impending doom and loss of control
  • Avoidance of situations that will trigger the anxiety symptoms
  • Adoption of “safety behaviors” such as shopping online rather than going out to the mall
  • Fear of spending time alone
  • Fear of dying
  • Fear of places without an easy exit
  • Fear of publicly losing control or “going crazy”
  • Strong sense that the world and their body is not real
  • Not leaving home for extended periods
  • Easily triggered temper issues
  • Hot flushes or chills
  • Very dependent on others from being unable to leave the house

Diagnosing Agoraphobia:

In addition to the presence of symptoms, a diagnosis can be made after a physical exam and an interview with a mental health professional or a doctor to make sure something else is not causing the symptoms.

For diagnosis, DSM-5 lists a disproportionate anxiety or fear of at least two situations:

  • Being on a plane, bus, or train
  • Being in enclosed spaces like cinemas or shops
  • Being in a crowd or a line
  • Being in open spaces
  • Being alone anywhere outside one’s home

Agoraphobia complications:

The most common complications of agoraphobia are:

  • Depression
  • Substance use disorders
  • An increased risk of suicide

In some cases, the reach of the condition goes beyond the individual and impacts the family and friends. It can impact work, causing financial issues, or impact relationships because of being afraid or feeling too depressed to go out. In severe cases, the condition can cause individuals to remain inside their homes for years, as well as lead to other mental disorders and to abusing alcohol or drugs.

Treatment for Agoraphobia:

Treatment options available for agoraphobia can include:

  • Talking therapies such as cognitive-behavioral therapy – the intent is to help make individuals feel better and return to a more functional life by exploring and changing their thought patterns.
  • Medication such as selective serotonin reuptake inhibitors. Anti-anxiety or antidepressant medications may also be a part of a treatment plan but may take a number of weeks before they bring any relief.
  • Systematic desensitization or gradual exposure therapy – can be highly effective in the treatment of adjustment disorder.

Symptoms of Agoraphobia:

People with agoraphobia who find themselves in stressful situations can develop the physical and psychological or emotional symptoms of a panic attack.

Physical

  • Palpitations (an awareness of the heart beating faster than usual)
  • Hyperventilating (rapid breathing)
  • Chest pain or other chest issues
  • Lightheadedness
  • Choking
  • Sweating
  • Nausea
  • Trembling

Psychological

  • A sense of impending doom and loss of control
  • Avoidance of situations that will trigger the anxiety symptoms
  • Adoption of “safety behaviors” such as shopping online rather than going out to the mall
  • Fear of spending time alone
  • Fear of dying
  • Fear of places without an easy exit
  • Fear of publicly losing control or “going crazy”
  • Strong sense that the world and their body is not real
  • Not leaving home for extended periods
  • Easily triggered temper issues
  • Hot flushes or chills
  • Very dependent on others from being unable to leave the house

Diagnosing Agoraphobia:

In addition to the presence of symptoms, a diagnosis can be made after a physical exam and an interview with a mental health professional or a doctor to make sure something else is not causing the symptoms.

For diagnosis, DSM-5 lists a disproportionate anxiety or fear of at least two situations:

  • Being on a plane, bus, or train
  • Being in enclosed spaces like cinemas or shops
  • Being in a crowd or a line
  • Being in open spaces
  • Being alone anywhere outside one’s home

Agoraphobia complications:

The most common complications of agoraphobia are:

  • Depression
  • Substance use disorders
  • An increased risk of suicide

In some cases, the reach of the condition goes beyond the individual and impacts the family and friends. It can impact work, causing financial issues, or impact relationships because of being afraid or feeling too depressed to go out. In severe cases, the condition can cause individuals to remain inside their homes for years, as well as lead to other mental disorders and to abusing alcohol or drugs.

Treatment for Agoraphobia:

Treatment options available for agoraphobia can include:

  • Talking therapies such as cognitive-behavioral therapy – the intent is to help make individuals feel better and return to a more functional life by exploring and changing their thought patterns.
  • Medication such as selective serotonin reuptake inhibitors. Anti-anxiety or antidepressant medications may also be a part of a treatment plan but may take a number of weeks before they bring any relief.
  • Systematic desensitization or gradual exposure therapy – can be highly effective in the treatment of adjustment disorder.
Sources MAYO CLINIC – Agoraphobia Symptoms | NIMH – Symptoms and changes from DSM 4 | MAYO CLINIC – Symptoms | HEALTHLINE – Causes | ADAA – Agoraphobia and Depression | PSYCHOLOGY TODAY – Diagnosis