Agoraphobia is an anxiety disorder. There are two types of Agoraphobia: Agoraphobia with Panic Disorder, and Agoraphobia without a history of Panic Disorder. Most people who are Agoraphobic do have Panic Disorder.
Definition of Agoraphobia
Agoraphobia is a condition in which people fear being in places or situations that are outside of their familiar environment, because they are afraid of having a panic attack or any individual panic-like symptom which may cause them embarrassment, or cause them to need help or want to flee.
Some typical places and situations that are feared include:
- Being outside or far from home
- Being home alone
- Being in a crowd
- Standing in line
- Traveling on public transportation or in cars
- Elevators
- Crowded places
- Crossing bridges
In order to meet the criteria for Agoraphobia, people must either:
- Avoid the situations that they fear;
- Endure the situations with marked anxiety and distress, or;
- Require the company of a companion in order to endure the situations.
If the anxiety or avoidance is better accounted for by a different disorder, such as social phobia (fear of certain social situations) or a specific phobia (i.e. fear of heights) then agoraphobia is not diagnosed.
What is Panic Disorder with Agoraphobia?
Those who have panic disorder with agoraphobia exhibit the characteristics of agoraphobia and they also have a history of panic disorder. Their fear is primarily focused on having a panic attack.
According to the American Psychiatric Association's Diagnostic and Statistical Manual Of Mental Disorders, Fourth Edition (DSM-IV), this disorder is diagnosed three times as often in women as in men and approximately one-third to one-half of people with panic disorder also have agoraphobia.
What is Agoraphobia without History of Panic Disorder?
Agoraphobics who do not have panic disorder are not afraid of having a panic attack per se, but are afraid of having any physical panic-type symptom, such as dizziness or diarrhea. The fear may include any embarrassing symptom, such as loss of bladder control or a fear of fainting and being left on the sidewalk, or a fear of cardiac arrest.
If there is an underlying fainting or cardiac disorder, the fear about the medical condition has to be clearly in excess of what would “normally” be associated with the person’s medical condition, in order for agoraphobia to be diagnosed.
This disorder is far more prevalent in females than in males, according to the DSM-IV.
Prognosis for Living with and Overcoming Agoraphobia
Some people with agoraphobia limit their responsibilities so that they do not have to travel much or be in public situations. Some people can go many places without any anxiety but some places cause distress. Some agoraphobics cannot leave their front door. Some agoraphobics and their family members feel very frustrated by this condition. But there is hope.
Treatment for Agoraphobia
Some anti-depressant and anti-anxiety medications can be helpful in treating agoraphobia. In addition, cognitive-behavioral therapy with a specialist in agoraphobia treatment can be very effective.
The therapist will typically use a combination of relaxation training, examining and changing anxiety-producing thoughts, and exposure therapy that is known as systematic desensitization. This is not as difficult as it sounds. Agoraphobics are asked to approach the things they fear in extremely small, manageable doses and are trained to keep their anxiety at a low level. This technique can be extremely effective and is definitely worth seeking out.
To find an agoraphobia specialist, contact the Anxiety Disorders Association of America.
Agoraphobia is a fear of being in public places where a panic attack or other uncomfortable physical symptoms might occur. This condition is not that difficult to treat and there is no reason to suffer in silence and isolation. There are also many self-help books available but there is no substitute for having the proper treatment (cognitive-behavioral treatment) with an expert in agoraphobia treatment.
Anyone with troubling symptoms should seek out their health or mental health care practitioner. This article is for general information and is not a substitute for personal mental health or medical care.
Lisa C. DeLuca - Lisa C. DeLuca is a psychotherapist/social worker who works with families and teens. She also treats panic and anxiety disorders.
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