Agoraphobia is a type of anxiety disorder in which fear of open space, crowds and public gatherings occurs. Patients are afraid to go out of their home or they are afraid of any kind of situation where they could feel trapped or powerless. Persons with agoraphobia often don’t feel safe in a public place, especially where there are crowds.
Treating agoraphobia can be hard, because usually it means fear confrontation. But, with medication and psychotherapy, a more comfortable life can be managed.
Symptoms
Agoraphobia is a type of phobia that causes fear of panic attack in a public place. Common sources of fear are elevators, sport events, bridges, public transportation, shopping malls, airplanes or crowds.
Typical symptoms for agoraphobia are:
- fear of being alone
- fear of crowded places
- fear of losing control in a public place
- fear of places from which it can be hard to get out, like elevators or trains
- inability to leave the house
- feeling of helplessness
- a too big dependence on others
Besides that, symptoms similar to panic attack can occur:
- troubles with breathing
- dizziness
- excessive sweating
- rapid heart beats
- sweating
- nausea
- diarrhea
- chest pain
- feeling of losing control
- troubles with swallowing
When to go to a doctor
Agoraphobia can seriously limit the ability of social interaction, attendance to important events, even dealing with daily duties.
Some people have safe zones or places where they can go, especially if they are accompanied by a reliable friend or a relative. Sometimes they can get the courage to go somewhere, but they still feel very uncomfortable.
Agoraphobia can often make you feel like a prisoner in your own home. If you think that you will have a panic attack when you go out to a public space, the number of places where you can go becomes smaller and smaller.
Causes
Agoraphobia is usually a complication of a panic disorder. Panic disorder is a type of anxiety disorder where attacks of intense fear occur (panic attacks) which for no reason cause physical symptoms. Panic attacks can be very frightening. When a panic attack occurs, you feel that you are losing control, you think that you are having a heart attack or even that you are dying.
Fear of open space can occur when a panic attack is connected to one or more situations when the attack has happened. You want to avoid similar situations in the attempt of preventing future panic attacks. Persons with agoraphobia especially avoid situations in which it is hard to get out if the panic attack occurs, like stadiums or airplanes.
In some cases, fear that a panic attack can occur is so big that you don’t want to leave the safety of your home. In other cases, you might be able to overcome the fear and most situations while you are accompanied by a person that you trust.
Risk factors
Agoraphobia usually starts in the early 20s, but younger children and older people can also develop fear of open space. Women get diagnosed with agoraphobia more often than men.
The most common risk factors are:
- panic disorders
- experience of a stressful event, including sexual or physical abuse in childhood
- common feeling of anxiety or worry
- alcoholism or drug addiction
Complications
Agoraphobia can seriously limit the activities. In severe cases, people aren’t capable of leaving their home. Without treatment, some people are prisoners in their own homes for years. They are not able to participate in normal everyday activities, like going to the store. Agoraphobia can also lead into depression, discomfort, addiction to alcohol or drugs.
Treatments and medication
Treating agoraphobia usually includes both medication and psychotherapy. Treatment can last for a while, but it can make you feel better.
Medication
Antidepressants and anti-anxiety drugs are medication that are often used to treat agoraphobia and panic attack symptoms. You might need to try a few different medication before you find the one that is best for you.
Selective inhibitors of reuptake of serotonin (SSRI)
Medication in this category for treating panic disorder with agoraphobia include paroxetine and fluoxetine.
Other kinds of antidepressants, like tricyclic antidepressants or inhibitors of oxidase.
While they can successfully treat agoraphobia, they have more side effects than SSRI.
Anti-anxiety medication
They are also called benzodiazepines, and they can help with controlling the symptoms of discomfort and panic attacks. However, they can cause addiction if they are taken in doses larger than prescribed or longer than it is prescribed. The doctor will determine that risk compared to the potential benefit of the medication. Medication in this category that are used for treating panic disorder with agoraphobia include alprazolam and clonazepam.
Antidepressants can cause side effects that look exactly like panic attacks. For that reason, your doctor will probably gradually increase the dosage in the beginning of the treatment, and slowly decrease the dosage when you are ready to get off the medication.
Psychotherapy
A few kinds of psychotherapy or counseling can help with agoraphobia. One of the most common therapies that is used is cognitive behavioural therapy.
Cognitive behavioural therapy has two parts. Cognitive part includes learning about agoraphobia and how to control panic attacks. You will learn which factors can induce the panic attack or panic symptoms, and what is worsening them. You will also learn how to deal with these symptoms.
Behavioural part of cognitive behavioural therapy includes altering unwanted or unhealthy patterns through exposure. This technique helps you to face the place and situation which causes fear and discomfort.
If you have troubles with leaving the house, therapist could come to visit you at your home or at a place where you feel safe.
How to help yourself?
Living with a fear of panic attack can make life harder for anyone with agoraphobia. Professional treatment of agoraphobia can help you overcoming the disorder or with its effective management, so you don’t become a prisoner of your own fears.
- Try not to avoid the situations that you are afraid of
It is hard to go to places or to be in situations that are uncomfortable or induce anxiety symptoms. But, if you go to those places often, that will make them less intimidating and anxious. Family, friends and a therapist can help you work on that.
- Practice relaxing techniques
Persons with agoraphobia can learn how to calm down and prevent the attacks. Meditation and yoga are some of simple relaxing techniques that can help, and you can do them in comfort of your own home.
- Avoid alcohol and drugs
- That can only make the panic or anxiety worse.
- Take drugs according to the instructions
- Also, don’t interrupt the therapy without previous advising with the doctor.
- Take care of yourself
- Get enough rest, eat balanced diet and try to work out every day
Prevention
There is no safe way to prevent fear of open space. However, anxiety gets stronger as you avoid the situations that you are afraid of more. If you have mild fears about going to places that are safe, try going to those places before the fear gets stronger.
Also, if you had panic attacks or panic disorder, start treatment as soon as possible. Because of panic disorder and agoraphobia that are really closely related, treatment of a panic disorder can prevent the development of agoraphobia.