A type of anxiety disorders that cause fear and avoidance of places or situations that cause panic or feelings of being trapped, helpless, or embarrassed is called agoraphobia. People with this anxiety disorder usually experience fear due to an actual or upcoming event or situation. For example, some people experience fear when using public transport, staying in enclosed spaces or crowds, or standing in line.
This type of anxiety occurs due to fear because it is not possible to escape or get help if it gets overwhelming. As a result, such people try to avoid situations because of fears, including getting lost, falling, having diarrhea, or not being able to get to a bathroom. In most cases, people with agoraphobia have one or more panic attacks, which cause concerns about having another attack.
People with agoraphobia usually need a companion (including a friend or family member) to go to public places. In some cases, the fear can be so overwhelming that you may feel you cannot leave your home.
However, a lot of people recover with medicines and cognitive behavioral therapy. These treatments help lessen the symptoms and improve your quality of life.
Symptoms
Usually, people with agoraphobia have a fear of:
- Open spaces (including parking lots, bridges, or malls)
- Begin in public transport (such as a bus, plane, or train)
- Enclosed spaces (including movie theaters, elevators, or small stores)
- Crowded places
- Staying home alone
Previous situations cause anxiety because you fear that you won’t be able to escape or find help during a panic attack. Sometimes, people may fear having other embarrassing or disabling symptoms such as dizziness, fainting, diarrhea, or falling.
Additionally, people with this anxiety disorder have major distress or problems linked with social situations, work, and other areas of life.
Panic Disorder and Agoraphobia
Sometimes, people develop panic disorder (another type of anxiety disorder) along with agoraphobia. It causes panic attacks, which are sudden feelings of extreme fear that usually reach their peak within several minutes and may trigger multiple physical symptoms. Some people may feel like they completely lose control, have a heart attack (myocardial infarction), or even die. However, fear of other panic attacks causes you to avoid situations that may lead to these attacks. Check below some panic attack symptoms:
- Fast heart rhythm
- Chest pressure or pain
- Lightheadedness
- Dizziness
- Increased sweating
- Fear of dying
- Sudden flushing or chills
- Numbness or tingling
- Stomach upset
- Diarrhea
- Breathing problems
This anxiety disorder can severely limit your ability to work, attend important events, socialize, and manage the details of daily life (including running errands).
Causes
Healthcare professionals do not know the exact cause of agoraphobia, but they think a combination of genetics, environmental factors, and certain health conditions plays a role in the development of this type of anxiety.
Risk Factors
While this type of anxiety may start during childhood, it is often diagnosed in late teens or early adulthood (before 35 years old). Moreover, agoraphobia mostly affects females than males. Check below some factors that can increase the risk of developing the disease:
- Panic disorder
- Excessive fear reactions (also called phobias)
- Unusual response to panic attacks, which includes too much fear and avoidance
- Stressful life events (such as abuse, death of a loved one, and others)
- Personality disorders
- A family history of agoraphobia – If you have a parent or sibling with this condition, your risk of developing it significantly increases.
What Happens if Agoraphobia is Left Untreated?
This mental disorder can severely limit your life’s activities, and sometimes can be so severe that you cannot leave your home. If you ignore the symptoms and do not get treatment, it may lead to certain complications. These include major depressive disorder, misuse of illegal drugs or alcohol, and suicidal thoughts or even behavior.
How to Prevent Agoraphobia?
Unfortunately, there is no sure way to prevent this mental disorder. That’s why people with agoraphobia tend to avoid places and situations that they fear. You can try to practice going to places over and over again if you notice mild fears about going to those places. It may help you feel more comfortable in those places. If it does not help, it is advised to ask for help from your family, friends, or a healthcare professional.
Seek medical help if you experience panic attacks. As long as you wait, as difficulty becomes in treating this type of anxiety. In other words, early diagnosis and treatment are the key.
Diagnosis
Usually, this condition is diagnosed based on the following tests and things:
- Your symptoms
- An interview with your healthcare professional
- A physical examination to exclude other conditions that cause similar symptoms to agoraphobia
Treatment
The primary treatment for people with agoraphobia is psychotherapy (talk therapy) and medications. In most cases, it takes some time to notice improvements.
Psychotherapy
This treatment involves a therapist who helps set goals and learn practical skills to reduce anxiety symptoms. One of the most effective talk therapies is cognitive behavioral therapy. It focuses on teaching specific skills that help you tolerate anxiety better and return to the activities you have avoided before due to the condition. In most cases, cognitive behavioral therapy is a short-term treatment. It often helps to learn the following things:
- Factors that trigger the symptoms and panic attacks
- Ways to cope with and tolerate anxiety symptoms
- How to challenge your concerns, including bad things that may happen in social situations
- Exposure therapy involves ways to approach feared and avoided situations in a predictable, controllable, and repetitive manner
People who cannot leave their homes may wonder how to go to a therapist’s office. However, mental health professionals are usually aware of this problem. There are some ways a therapist can help you. These include meeting in a place that you consider safe, video sessions, phone calls, or through email.
When the agoraphobia is severe, you may need a residential program, which includes staying in a hospital for a period to get treatment for this disorder. Moreover, they may need a trusted relative or friend for the therapist’s appointment.
Medicines
There are some antidepressants that are usually prescribed by doctors for people with agoraphobia. However, the most effective medicines for anxiety disorder are antidepressants.
- Antidepressants – Doctors usually recommend selective serotonin reuptake inhibitors (SSRIs) such as Fluoxetine and Sertraline. This group of medicines can also be used to treat major depression.
- Anti-anxiety medication – Mental health professionals often prescribe Benzodiazepines (also known as sedatives) to lessen anxiety symptoms. However, these medications should be used for short periods because they can be habit-forming. Furthermore, Benzodiazepines should not be used if you experience other mental problems (such as substance misuse) along with agoraphobia.
Frequently Asked Questions
Does agoraphobia qualify for disability?
According to the Social Security Administration (SSA), agoraphobia can be disabling because it causes a person to avoid certain places and situations that he/she fears.
What do people with agoraphobia avoid?
Check below some situations that are often avoided by people with this mental disorder because of fear and anxiety:
- Crowds
- Places outside their home
- Public transport (such as trains, planes, and others)
- Large and open spaces
If you think you have this anxiety disorder, do not hesitate to see a mental health professional.
What is the best medicine for agoraphobia?
The most effective medications for agoraphobia are selective serotonin reuptake inhibitors (SSRIs) such as Sertraline and serotonin-norepinephrine reuptake inhibitors (SNRIs). However, doctors may prescribe additional medicines such as Benzodiazepines to lessen symptoms of anxiety. Ask your healthcare provider if you have additional questions.
