The word “Agoraphobia“ comes from the ancient Greek word “agora,” referring to a place of assembly or marketplace.
The condition is often misunderstood as a fear of open spaces but is, in reality, more complex. Agoraphobia may invoke a fear of crowds, bridges or of being alone outside.
Agoraphobia has its classic onset in early adult life, the peak ages being between 18 and 30. It is very rare for agoraphobia to develop from its beginnings after the age of 30 although, some people appear in outpatients clinics in their 30s and 40s, stating that this is the first episode.
However, in many of these people, you can find a history of fear situations during school life and transient episodes of anxiety in public places at other times in their life. If, however, phobic symptoms truly start without any history whatsoever in the 40s or 50s, it is likely that they are part of another syndrome, possibly a depressive illness.
Agoraphobia is usually diagnosed following an interview with a healthcare professional, ordinarily within the field of psychiatry. The specialist will assess the signs and symptoms. Family or friends may help by describing the person’s behavior. A physical exam may rule out other conditions that could potentially be causing the symptoms.
The diagnostic criteria for agoraphobia within DSM-5 include anxiety or extreme fear regarding being in at least two of the following situations, characterized by being difficult to escape from or find help:
- on public transport in
- an open space
- in an enclosed space or crowd
- or be out of the home alone
Additional diagnostic criteria include:
- fear or anxiety that normally relates to a particular situation
- fear or anxiety out of proportion to the actual danger of the situation
- avoidance of a situation or requiring a companion to deal with it
- the endurance of a situation with extreme distress
- distress or problems in areas of life caused by fear, anxiety or avoidance
long-term persistent phobia and avoidance
Here are some key points about agoraphobia.
Agoraphobia often develops after having one or more panic attacks . It can lead to various fears, such as the fear of open spaces and the fear of places where escape is difficult, such as elevators. Agoraphobia can make it difficult for a person to leave their house.
Physical symptoms include chest pains, dizziness, and shortness of breath. Agoraphobia is often treated medically with antidepressants or anxiety-reducing medicine. Most people with agoraphobia can get better through treatment.
Agoraphobia is usually treated with a combination of medication and psychotherapy. Treatment is effective for most people with agoraphobia, but it can be harder to treat if people do not get early help.
Healthcare professionals can prescribe either one or both of the following types of medication. Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that can be prescribed to treat agoraphobia. Other types of antidepressants can also be prescribed, but the adverse effects may be greater.
Anti-anxiety medications, also known as benzodiazepines, are sedatives that can relieve the symptoms of anxiety in the short term. Benzodiazepines can be habit-forming. The antidepressants may start on a higher dosage and slowly decrease when the treatment is ready to finish.
Starting and ending a course of antidepressants can sometimes lead to side effects that are similar to a panic attack, and caution is therefore advised.
Psychotherapy involves working with a therapist to reduce symptoms of anxiety so that the person will feel safer and able to function better. Cognitive-behavioral therapy ( CBT ) focuses on changing the thoughts that cause the condition.
The person may learn:
- that it is unlikely that fears will come true that anxiety decreases over time, and that symptoms can be managed until it does how to cope with the symptoms
- how to understand and control a distorted view of stress-inducing situation
- s how to recognize and replace thoughts that cause panic how to manage stress .
One task might be to imagine the situations that cause anxiety, working from the least to the most fearful. Therapists who treat agoraphobia may offer initial treatment without the patient needing to visit the therapist’s office. Options may include telephone or online therapy, home visits, or treatment sessions in a place that the patient considers safe. Family support can also help by showing understanding and by not pushing the individual too far.
- sticking to a recommended treatment plan
- learning how to relax and achieve or maintain a sense of calm
- trying to face feared situations, as this can make them less frightening
- avoiding alcohol and recreational drugs
- staying healthful with physical activity, a balanced diet, and enough sleep.
Where to get help
- your doctor
- clinical psychologist
- your local community health centre
- make an appointment with us .
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