Agoraphobia

1 What is Agoraphobia?

Agoraphobia refers to a condition characterized by the avoidance of situations in which a person might feel trapped.

These situations are otherwise normal, like visiting a crowded place or going away from home. This condition is often unnoticed as patients will avoid the situations that they are scared of.

It is more commonly found in combination with panic disorder. Agoraphobia is also more prevalent among girls and women than men.

It is considered to be a response to emotional stress within. The phobia of being away from safety and help can be genetic and is characterized by rapid heartbeat, dizziness, and disorientation. 

The symptoms start appearing in early adolescence.

Cognitive therapy and exposure therapy are the best treatment strategies to help improve the symptoms.

2 Symptoms

The most common symptom of agoraphobia is the fear of being alone in a crowd or a situation.

The patients may feel scared of crowded places like malls and shopping centers. They may avoid places from where escape is hard.

Some patients refuse to move out of their homes, unless accompanied by someone. They tend to have a sense of helplessness and depend on others for most of their routine activities.

Exposure to trigger situations lead to typical symptoms like rapid heart rate, sweating, and dizziness.

Some other symptoms include:

In some patients, agoraphobia can result in panic disorder characterized by intense fear of situations. They may fear getting a heart attack or dying due to extreme stress.  

Agoraphobia

3 Causes

Exposure to events that trigger anxiety is considered to be the most common cause of agoraphobia.

It is related to a number of environmental risk factors. Certain genetic factors are also involved in the development of agoraphobia.

It is more common among women. The major risk factors of agoraphobia include being extremely nervous, traumatic or stressful events in life, and having a family history of the disease.

Social anxiety disorder and generalized anxiety disorder also increase the chance of developing agoraphobia.

4 Making a Diagnosis

The diagnosis of agoraphobia is often accidental while screening for some other emotional or medical problems.

Symptoms are the best indicators of the disease. Differential diagnosis is based on physical and psychological examinations.

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders gives the criteria for the definitive diagnosis of agoraphobia.

Patients with this condition show fear of two or more of the following situations:

  • Public transportation like buses and trains
  • Using elevators, small rooms, or theaters
  • Waiting in line
  • Going out of the house without anyone else
  • Going to open areas like parking spaces, or large malls

The reason for anxiety stems from the feeling of inability to escape from a situation or to getting help from friends and family.

Although the situation is not as harmful or stressful as perceived, exposure may result in distress or a panic attack.

They tend to avoid these stressful situations for more than six months.

5 Treatment

Medications and psychotherapy are the two major treatment lines for agoraphobia.

  • Psychotherapy – this method helps to reduce the anxiety symptoms when exposed to a trigger. Counseling helps teach skills to avoid anxiety and to face the situations that were previously avoided. Cognitive therapy helps to understand more about the factors that initiate panic attacks or anxiety, and to reduce the fear of these situations. Exposure therapy is used to desensitize the person towards anxiety triggers and help them face the stressful situations without much distress.
  • Medications – anti-anxiety medications and antidepressants are used to relieve the symptoms. Paroxetine, tricyclic antidepressants and fluoxetine are commonly used antidepressants to control agoraphobia. Anti-anxiety medications like benzodiazepines are recommended to relieve symptoms of anxiety.

6 Alternative and Homeopathic Remedies

Many alternative and homeopathic remedies are suggested in the treatment of agoraphobia. However, most of these alternate remedies do not have ample scientific evidence and have many serious side effects.

Aconitum Napellus is a common homeopathic prescription for controlling anxiety disorder.

Gelsemium Sempervirens is used to control symptoms like trembling and palpitations.

Argentum Nitricum is used to prevent anxiety attacks.

Lycopodium Clavatum is used to improve the fear of public places and being in a crowd.

7 Lifestyle and Coping

Professional care is very important for the patient and his/her family to cope with Agoraphobia.

Being compliant with the treatment options and being relaxed help patients to face the triggers more confidently.

Taking care of overall health and avoiding drugs and alcohol is equally important.

8 Risks and Complications

There are several risks and complications of Agoraphobia.

This condition restricts one’s activities considerably.

The patient tends to become very dependent on others for normal tasks.

Other mental disorders, depression, and isolation may develop as a result of agoraphobia.

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