What is Agoraphobia? How to Treat Fear of Being Outdoors and Outside the Home?

Agoraphobia is an anxiety disorder that causes you to fear and avoid places or situations that may cause you to feel panic, entrapment, helplessness, or shame.[1] You fear predictable events, such as using public transport, being in open or closed spaces, waiting in line, or being in a crowd.

Anxiety stems from the fear that there is no easy way to escape when it intensifies. Most people with agoraphobia have developed this phobia after one or more panic attacks, causing them to fear possible further attacks and try to avoid places where they might be again.

Most agoraphobic people do not feel safe, especially in crowded public areas. You may need to have a relative or friend in public places. The fear can be so intense that you feel like you can’t leave the house.

Agoraphobia can significantly limit your life. If your agoraphobia is severe, you may not even be able to leave your home. Many people without treatment may not leave their homes for years. You may not be able to visit family and friends, go to school or work, do your daily chores, or participate in activities. You may become dependent on the help of others.

Agoraphobia, depression, and alcohol or drug use may cause or be associated with other mental disorders.

Signs and Symptoms
leaving home alone,
From waiting in line or crowds,
From enclosed spaces such as elevators, small shops or cinemas,
From open areas such as parking lots, bridges, recreation areas,
Avoid using public transport such as buses, planes and trains
Anxiety caused by agoraphobia are common symptoms of agoraphobia.

These situations cause anxiety because you fear not being able to escape or find help if you panic or fall into an embarrassing situation. In addition:

Fear or anxiety is almost always caused by exposure.
Your level of fear or anxiety is out of proportion to the possible danger of the situation.
You avoid the anxiety-inducing situation, for example, you take a companion with you, or you maintain the condition and experience extreme stress.
The fear, anxiety and avoidance created by this experience; cause stress and problems in your social life, work or other parts of your life.
This phobia or avoidance lasts for six months or more.

Panic Disorder and Agoraphobia
Some individuals have panic disorder and agoraphobia. Panic disorder is an anxiety disorder that causes sudden and extreme fear attacks (known as panic attacks) that peak within a few minutes and trigger severe physical symptoms. In moments during the episode, You may think you have entirely lost control, had a heart attack, or even died.

The fear of having a panic attack may cause the behaviour of avoiding situations and places that have previously been attacked to prevent another attack.

Panic attack symptoms may include:

Accelerated heartbeat,
Difficulty breathing or feeling of suffocation
Chest pain or feeling of pressure,
dizziness or loss of balance,
tremors, numbness and tingling,
excessive sweating,
Sudden flushing and goosebumps
Stomach upset or diarrhoea,
feeling of loss of control,
The fear of death.
Disease-Associated Genes, Causative Factors and Risk Factors

Reasons
Biology, health status, genetics, temperament, environmental stress and pain experiences may play a role in the development of agoraphobia.[2], [3]

Risk factors
Agoraphobia can begin in childhood but usually in late adolescence or early adulthood under 35. It can also develop at older ages. Women are diagnosed with agoraphobia more often than men. Risk factors for agoraphobia include:

Having panic disorder or other phobias
Excessive fear or avoidance response to panic attacks,
Having had stressful experiences, such as being abused, parental death, or being assaulted.
A nervous or anxious temperament
Having a family history of agoraphobia.

Diagnostic Methods
The diagnosis of agoraphobia can be made based on:

Signs and symptoms,
Interviews with your doctor or mental health professionals,
and Physical examination to rule out other factors that may be causing the symptoms
Agoraphobia criteria are listed in the “DSM-5” published by the American Psychiatric Society.
Treatments or Methods of Administration
In treating agoraphobia, psychotherapy and meditation are generally used together.[4] Although it takes time, therapy can help you get better.

Psychotherapy
is working with a therapist to gain practical skills by setting goals to reduce anxiety symptoms. Cognitive Behavioral Therapy is one of the most effective therapies for many anxiety disorders, including agoraphobia.[5]

  • ^ A. P. Association. (2013). Diagnostic And Statistical Manual Of Mental Disorders Dsm-5. ISBN: 9780890425558. American Psychiatric Association Publishing.
  • ^ L. Yardley, et al. (1995). Relationship Between Balance System Function And Agoraphobic Avoidance. Behaviour Research and Therapy, sf: 435-439. doi: 10.1016/0005-7967(94)00060-W. | Link
  • ^ R. G. Jacob, et al. (2006). Panic, Agoraphobia, And Vestibular Dysfunction. American Journal of Psychiatry, sf: 503-512. doi: 10.1176/ajp.153.4.503. | Link
  • ^ R. J. Wyatt, et al. (2008). Wyatt’s Practical Psychiatric Practice, Third Edition: Forms And Protocols For Clinical Use. ISBN: 9781585626878. American Psychiatric Publishing.
  • ^ A. Pompoli, et al. (2016). Psychological Therapies For Panic Disorder With Or Without Agoraphobia In Adults: A Network Meta-Analysis. Wiley. doi: 10.1002/14651858.CD011004.pub2. | Link

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