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Agoraphobia is a type of anxiety disorder related to fear. With agoraphobia, you fear being in places where it may be difficult or embarrassing to get out quickly or where you may have a panic attack and can't get help. Because of your fears, you avoid places where you think you may have a panic attack or panic-like symptoms. People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. Commonly feared places and situations are elevators, sporting events, lines, bridges, public transportation, driving, shopping malls and airplanes. The fears can be so overwhelming that some people are essentially trapped in their own homes - it's the only place they feel truly safe, so they don't venture out into public at all. Agoraphobia treatment can be challenging because it usually means confronting your fears. A combination of medications and psychotherapy can help you escape the trap of agoraphobia and live a more enjoyable life.
Complications of Agoraphobia
Causes of Agoraphobia
Signs & Symptoms of Agoraphobia
A phobia is the excessive fear of a specific object, circumstance or situation. Agoraphobia is excessive worry about having a panic attack in a public place. Typical agoraphobia symptoms include:
In addition, you may also have signs and symptoms similar to a panic attack, including:
Diagnosis of Agoraphobia
Agoraphobia is diagnosed based on signs and symptoms, as well as a thorough psychological interview with your doctor. You may also have a physical exam. A physical exam is important because some of the signs and symptoms of a panic attack are similar to those of other conditions. To be diagnosed with agoraphobia, someone must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
For agoraphobia to be diagnosed, you must meet these criteria:
In addition, your mental health provider will try to determine if you might have panic disorder, social phobia or another specific type of phobia, rather than agoraphobia, since these all can resemble one another.
Treatments of Agoraphobia
As with many other mental disorders, agoraphobia treatment typically includes a combination of medication and psychotherapy. Treatment of agoraphobia is often successful, and you can overcome agoraphobia and learn to keep it under control.
Antidepressant and anti-anxiety medications are commonly used to treat agoraphobia and panic symptoms. You may have to try several different medications before you find one that works best for you.
Your doctor is likely to prescribe one or both of the following:
Several types of psychotherapy or counseling can help agoraphobia. One common therapy used is cognitive behavioral therapy. Cognitive behavioral therapy has two parts. The cognitive portion involves learning more about agoraphobia and panic attacks and how to control them. You learn what factors may trigger a panic attack or panic-like symptoms, and what makes them worse. You also learn how to cope with these distressing symptoms, such as using breathing and relaxation techniques. The behavioral portion of cognitive behavioral therapy involves changing unwanted or unhealthy behaviors through desensitization, sometimes called exposure therapy. This technique helps you safely confront the places and situations that cause fear and anxiety. A therapist may accompany you on excursions to help you remain safe and comfortable, such as trips to the mall or driving your car. Through gradually practicing going to feared places, people with agoraphobia learn that the fears don't come true and that their anxiety goes away with time. If you have trouble leaving your home, you may wonder how you can possibly venture out to a therapist's office. Therapists who treat agoraphobia will be well aware of this problem. They may offer initial appointments in your home, or they may meet you in one of your safe zones. They may also offer some sessions over the phone or through e-mail. Look for a therapist who can help you find alternatives to in-office appointments, at least in the early part of your treatment. You may also try taking a trusted relative or friend to your appointment who can offer comfort and help, if needed.
Prevention of Agoraphobia
When to seek Medical Advice
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