Agoraphobia

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 10, 2016
StartDiseasesAgoraphobia

Agoraphobia is an anxiety disorder in which the patient has an irrational fear (phobia) of situations or spaces in which he or she may feel panicked, trapped, or humiliated. Patients who suffer from agoraphobia may go to great lengths to avoid these situations, and in extreme cases may be unable to leave their homes.

Contents

Definition & Facts

Agoraphobia normally occurs in males and females before the age of thirty five, but there have been cases of people developing the disease later in life due to stressful life events such as abuse, death, or being attacked. Some patients with blood relatives who have been previously diagnosed are at risk of being diagnosed themselves more than others.

Symptoms & Complaints

Common symptoms of those who suffer from agoraphobia are the fear of open spaces, the fear of having a panic attack in specific areas, and the fear of locations in which they have previously had a panic attack. Patients with agoraphobia can sometimes be reclusive, refusing to go outside even if it is to receive medical treatment.

Some patients have even been stuck in their own bathroom, being unable to escape due to their immense fear of what could happen outside. Those who suffer from agoraphobia commonly suffer from other illnesses such as separation anxiety disorder, making them fearful of certain individuals leaving the residence without them, or leaving them alone.

Thanatophobia is also common in agoraphobia patients, causing patients to greatly fear death and to dwell on the idea of death more consistently than others. Due to causing confinement, agoraphobia can lead to depression, other mental disorders, alcohol abuse, and drug abuse. Those who suffer from agoraphobia may have trouble keeping in touch with friends and family, running errands, attending work or school, and many other things involved in a daily routine.

Causes

The exact cause for agoraphobia is still unknown. However, many of those who have treated agoraphobia link it to the patient also having other anxiety disorders coupled with a stressful environment, and possibly the abuse of narcotics. Also found in many patients is a difficulty in spatial reasoning. These patients may suffer from a weak vestibular system, which controls their visual perception and proprioception.

Chronic abuse of controlled substances also causes agoraphobia in specific patients. The long term effects of alcohol and substances such as sleeping pills, may cause problems with the brain and its reaction to stressful situations.

Diagnosis & Tests

To be diagnosed with agoraphobia, patients must contact their physicians and have an in-depth interview about the current situations they feel cause panic and all of the medication they currently take. A physical examination may also be involved during the interview with the physician to ensure their are no other illnesses or diseases causing the panic attacks.

If the patient meets all of the criteria provided by the Diagnostics and Statistical Manual of Mental Disorders, they will be officially diagnosed with agoraphobia. If the patient is in severe fear of at least two of the situations provided in the manual such as fear of waiting in line, or fear of getting on a bus, they will be considered for treatment for agoraphobia.

Treatment & Therapy

There are a variety of different treatments in the attempt to cure agoraphobia. In most cases of agoraphobia, both psychotherapy and medications are used together to best help the patient overcome their sickness. The psychotherapy or talk therapy involves the patient having multiple meetings with a therapist or psychologist to discuss with the patient what causes them to experience extreme fear in certain situations and teaching them specific skills in order to help them slowly regain their ability so they can eventually return to their daily activities.

The medication normally involved in treating agoraphobia are antidepressants and anti-anxiety medications. Certain antidepressants that may be prescribed include selective serotonin reputake inhibitors. The anti-anxiety medication can be used as a mild sedative to help the patient feel more at ease when in situations that may cause panic. Multiple different medications might need to be tried before finding the correct combination and amount needed to properly treat the illness.

Prevention & Prophylaxis

Though there is no definitive way to prevent agoraphobia, coping with agoraphobia is possible. When dealing with fearful places, it is advised that the patient face his or her fear rather than avoid the situation entirely, enabling the person to learn how to cope with the problem rather than to avoid the problem. Patients are often encouraged to visit places and realize they are safe while still only mildly afraid to ensure an overwhelming fear of a specific area does not build.

Certain calming skills such as meditation and yoga are strongly recommended for those suffering with agoraphobia. Patients must stick to their treatment plan in order to fully realize the treatment's potential and with constant medical guidance should take all medications routinely.