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Agoraphobia

Definition

Agoraphobia is an anxiety disorder. It is an irrational fear of being trapped in places or situations where escape is difficult. People with agoraphobia may not be able to leave the house.

Causes

The exact cause of anxiety disorders is not known. Factors that may contribute to the development of agoraphobia include:
Agoraphobia often develops in people with panic disorders. These disorders are associated with frequent and severe panic attacks. Agoraphobia may develop when people begin to avoid certain places or situations to prevent these panic attacks.
Nervous System
female nervous system 3D
Changes or genetic problems in the nervous system (brain and nerves) may contribute to agoraphobia.
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Risk Factors

Factors that may increase your chance of agoraphobia include:

Symptoms

Symptoms include:
Feared situations may trigger a panic attack. Attacks start quickly and peak in about 10 minutes. A panic attack usually includes four or more of the following:
Agoraphobia is also commonly associated with the following conditions:

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. Agoraphobia will be diagnosed by the type and duration of symptoms.
You may be asked questions about your:
There are no tests for agoraphobia or panic disorder. Your doctor may order heart or blood tests done to look for an underlying cause.

Treatment

Treatment aims to help you overcome irrational fears and live more independently. Goals include:
Treatment of agoraphobia is similar to the treatment of panic disorder. Treatments may include:

Cognitive-Behavioral Therapy

Cognitive therapy can help to change troublesome thought patterns. Behavioral therapy will help you learn how you can alter your actions. The combination therapy will help you:
  • Identify and change anxious thoughts
  • Use relaxation techniques to decrease feelings of anxiety
  • Control breathing by taking slower, deeper breaths
  • Cope with physical changes associated with anxiety
  • Confront feared situations

Exposure Therapy

Exposure therapy exposes you to the factor causing the fear while in a safe environment. The sessions often include repeated, detailed imagining of the traumatic experience. The therapy will help people face their fear and gain control of it while it is happening. Exposure therapy methods range anywhere from a gradual approach to the fear to complete confrontation all at once.
Exposure therapy may be done alone or in combination with other treatments.

Medications

Your doctor may prescribe medication as well as therapy. Medication options may include:
  • Antidepressants
  • Benzodiazepines—may cause dependence
  • Other anti-anxiety medicines
It is important to take all medications as instructed by the doctor.

Lifestyle Changes

Stress management may also help. Lifestyle changes to manage stress include:
  • Get some exercise every day
  • Get adequate sleep
  • Avoid caffeine, alcohol and nicotine

Prevention

Agoraphobia often develops as a response to panic attacks. If you have had a panic attack, instead of avoiding the place or situation, seek medical care. Early treatment for panic attacks can help prevent agoraphobia.

RESOURCES

American Psychiatric Association http://www.psych.org

Anxiety Disorders Association of America http://www.adaa.org

Mental Health America http://www.nmha.org

CANADIAN RESOURCES

Canadian Mental Health Association http://www.ontario.cmha.ca

Mental Health Canada http://www.mentalhealthcanada.com

References

Agoraphobia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated November 8, 2012. Accessed March 4, 2013.

Lenders JW, Eisenhofer G, et al. Phaeochromocytoma. Lancet. 2005;20-26;366:665-675.

Panic Disorder & Agoraphobia. Anxiety and Depression Association of America website. Available at: http://www.adaa.org/understanding-anxiety/panic-disorder-agoraphobia. Accessed March 4, 2013.

Phobias. American Psychiatric Association website. Available at: http://www.psychiatry.org/phobias. Accessed March 4, 2013.

Phobias. Mental Health America website. Available at: http://www.mentalhealthamerica.net/go/phobias. Accessed March 4, 2013.

PTSD. American Psychiatric Association website. Available at: http://www.psychiatry.org/ptsd. Accessed March 4, 2013.

Symptoms. Anxiety and Depression Association of America website. Available at: http://www.adaa.org/understanding-anxiety/panic-disorder-agoraphobia/symptoms. Accessed March 4, 2013.

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