Agoraphobia
Definition:
Agoraphobia is a type of anxiety disorder in which you avoid situations that you're afraid might cause you to panic. You might avoid being alone, leaving your home or any situation where you could feel trapped, embarrassed or helpless if you do panic.
People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. The fears can be so overwhelming that you may be essentially trapped in your own home.
Agoraphobia treatment can be tough because it usually means confronting your fears. But with medications and psychotherapy, you can escape the trap of agoraphobia and live a more enjoyable life.
Symptoms:
Agoraphobia is a type of phobia. 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. Commonly feared places and situations are elevators, sporting events, bridges, public transportation, shopping malls, airplanes, crowds or lines of people.
Typical agoraphobia symptoms include:
Agoraphobia can severely limit your ability to socialize, work, attend important events and even manage the details of daily life, such as running errands.
Some people with agoraphobia have "safe zones," or places they can go without severe worry, especially if accompanied by a trusted friend or relative. Sometimes they may muster up the courage to go somewhere, but they still feel extremely uncomfortable.
Often, however, agoraphobia can make you feel like a prisoner in your own home. If you believe you're going to have a panic attack when you go out in public, you may indeed have one — causing a vicious cycle. The number of places you're able to go may become fewer and fewer.
Don't let agoraphobia make your world smaller. Call your doctor if you have symptoms of agoraphobia.
Causes:
Agoraphobia is usually a complication of panic disorder. Panic disorder is a type of anxiety disorder in which you experience attacks of intense fear (panic attacks) that for no apparent reason trigger intense physical symptoms. Panic attacks can be very frightening. When panic attacks occur, you might think you're losing control, having a heart attack or even dying.
You may develop agoraphobia when you begin to make a connection between your panic attacks and one or more situations in which those attacks have occurred. You may avoid similar situations in an attempt to prevent future panic attacks. People with agoraphobia are especially likely to avoid circumstances in which it would be difficult or embarrassing to escape if a panic attack were to occur, such as in a crowded stadium or an airplane.
In some cases, fear of having a panic attack may be so great that you may not be able to leave the safety of your home. In other cases, you may be able to overcome your fear and tolerate most situations as long as you're accompanied by a trusted companion.
Rarely, agoraphobia may occur without an accompanying panic disorder.
Complications:
Agoraphobia can greatly limit your life's activities. In severe cases, you may not even be able to leave your house. Without treatment, some people become housebound for years. You may not be able to visit with family and friends, go to school or work, walk your dog, run errands or take part in other normal daily activities.
You may become dependent on others for help, such as grocery shopping.
Agoraphobia can also lead to depression and anxiety. And people with agoraphobia may turn to alcohol or substance abuse to help cope with the fear, guilt, hopelessness, isolation and loneliness.
Treatments and drugs:
Agoraphobia treatment usually includes both medication and psychotherapy. It may take some time, but treatments can help you get better.
Medications
Antidepressant and anti-anxiety medications are often 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:
Psychotherapy
Several types of psychotherapy or counseling can help agoraphobia. One common therapy that's used is cognitive behavioral therapy.
Cognitive behavioral therapy has two parts. The cognitive part 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 symptoms, such as using breathing and relaxation techniques.
The behavioral part of cognitive behavioral therapy involves changing unwanted or unhealthy behaviors through desensitization, sometimes called exposure therapy. This technique helps you safely face the places and situations that cause fear and anxiety. A therapist may join you on outings to help you stay safe and comfortable, such as trips to the mall or driving your car. The more you go to feared places and realize you're okay, the more your anxiety will lessen.
If you have trouble leaving your home, you may wonder how you can possibly go to a therapist's office. Therapists who treat agoraphobia will be well aware of this problem. They may offer to see you first 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 email. 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.
Definition:
Agoraphobia is a type of anxiety disorder in which you avoid situations that you're afraid might cause you to panic. You might avoid being alone, leaving your home or any situation where you could feel trapped, embarrassed or helpless if you do panic.
People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. The fears can be so overwhelming that you may be essentially trapped in your own home.
Agoraphobia treatment can be tough because it usually means confronting your fears. But with medications and psychotherapy, you can escape the trap of agoraphobia and live a more enjoyable life.
Symptoms:
Agoraphobia is a type of phobia. 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. Commonly feared places and situations are elevators, sporting events, bridges, public transportation, shopping malls, airplanes, crowds or lines of people.
Typical agoraphobia symptoms include:
- Fear of being alone in any situation
- Fear of being in crowded places
- Fear of losing control in a public place
- Fear of being in places where it may be hard to leave, such as an elevator or train
- Inability to leave your house for long periods (housebound)
- Sense of helplessness
- Overdependence on others
- A sense that your body is unreal
- Lightheadedness
- Trouble breathing
- Dizziness
- Excessive sweating
- Rapid heart rate
- Flushing
- Nausea
- Upset stomach or diarrhea
- Chest pain
- Feeling a loss of control
- Trouble swallowing
Agoraphobia can severely limit your ability to socialize, work, attend important events and even manage the details of daily life, such as running errands.
Some people with agoraphobia have "safe zones," or places they can go without severe worry, especially if accompanied by a trusted friend or relative. Sometimes they may muster up the courage to go somewhere, but they still feel extremely uncomfortable.
Often, however, agoraphobia can make you feel like a prisoner in your own home. If you believe you're going to have a panic attack when you go out in public, you may indeed have one — causing a vicious cycle. The number of places you're able to go may become fewer and fewer.
Don't let agoraphobia make your world smaller. Call your doctor if you have symptoms of agoraphobia.
Causes:
Agoraphobia is usually a complication of panic disorder. Panic disorder is a type of anxiety disorder in which you experience attacks of intense fear (panic attacks) that for no apparent reason trigger intense physical symptoms. Panic attacks can be very frightening. When panic attacks occur, you might think you're losing control, having a heart attack or even dying.
You may develop agoraphobia when you begin to make a connection between your panic attacks and one or more situations in which those attacks have occurred. You may avoid similar situations in an attempt to prevent future panic attacks. People with agoraphobia are especially likely to avoid circumstances in which it would be difficult or embarrassing to escape if a panic attack were to occur, such as in a crowded stadium or an airplane.
In some cases, fear of having a panic attack may be so great that you may not be able to leave the safety of your home. In other cases, you may be able to overcome your fear and tolerate most situations as long as you're accompanied by a trusted companion.
Rarely, agoraphobia may occur without an accompanying panic disorder.
Complications:
Agoraphobia can greatly limit your life's activities. In severe cases, you may not even be able to leave your house. Without treatment, some people become housebound for years. You may not be able to visit with family and friends, go to school or work, walk your dog, run errands or take part in other normal daily activities.
You may become dependent on others for help, such as grocery shopping.
Agoraphobia can also lead to depression and anxiety. And people with agoraphobia may turn to alcohol or substance abuse to help cope with the fear, guilt, hopelessness, isolation and loneliness.
Treatments and drugs:
Agoraphobia treatment usually includes both medication and psychotherapy. It may take some time, but treatments can help you get better.
Medications
Antidepressant and anti-anxiety medications are often 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:
- A selective serotonin reuptake inhibitor (SSRI).
Drugs in this category that are FDA-approved for the treatment of panic
disorder with agoraphobia include paroxetine (Paxil, Paxil CR) and
fluoxetine (Prozac, Prozac Weekly, Sarafem).
- Another type of antidepressant, such as a tricyclic antidepressant or monoamine oxidase inhibitor. While these drugs may effectively treat agoraphobia, they're associated with more side effects than are SSRIs.
- An anti-anxiety medication. Also called benzodiazepines, these drugs can help control symptoms of anxiety and panic attacks. However, these medications can cause dependence if taken in doses larger than prescribed or over a longer period of time than prescribed. Your doctor will weigh this risk against the potential benefit of this class of drugs. Drugs in this category that are FDA-approved for the treatment of panic disorder with agoraphobia include alprazolam (Xanax) and clonazepam (Klonopin).
Psychotherapy
Several types of psychotherapy or counseling can help agoraphobia. One common therapy that's used is cognitive behavioral therapy.
Cognitive behavioral therapy has two parts. The cognitive part 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 symptoms, such as using breathing and relaxation techniques.
The behavioral part of cognitive behavioral therapy involves changing unwanted or unhealthy behaviors through desensitization, sometimes called exposure therapy. This technique helps you safely face the places and situations that cause fear and anxiety. A therapist may join you on outings to help you stay safe and comfortable, such as trips to the mall or driving your car. The more you go to feared places and realize you're okay, the more your anxiety will lessen.
If you have trouble leaving your home, you may wonder how you can possibly go to a therapist's office. Therapists who treat agoraphobia will be well aware of this problem. They may offer to see you first 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 email. 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.
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