Agoraphobia

The agoraphobia definition has progressed in recent years as the disorder has become better understood. Once thought of as simply the fear of leaving the house or the fear of open spaces, researchers now believe that the primary fears involved in agoraphobia are more complicated.

Agoraphobia is rooted in a fear of vulnerability, exposure and humiliation. Consequently, not only do sufferers of agoraphobia feel anxious in open spaces, they may also find crowded, confined spaces just as troublesome. Any place or situation in which they feel they cannot easily escape to somewhere they consider safe can induce great anxiety for sufferers of this phobia.

Many doctors believe that agoraphobia is a complication of panic disorder. Panic disorder is an anxiety disorder characterized by repeated panic attacks. For people with panic disorder and agoraphobia, the fear of exposure is often related to a fear of having a panic attack in an unfamiliar place or in front of a group of strangers.

Symptoms of Agoraphobia

The ongoing, chronic signs of agoraphobia are the behavioral symptoms of fear and avoidance. These symptoms include:

• Avoidance of crowded areas
• Avoidance of wide, open spaces
• Fear of being alone, especially in public
• Fear of being embarrassed in front of others
• Fear of leaving the house.

People with agoraphobia may have a few places outside the home where they feel safe, and will try to limit their activities to those places. They may also be dependent on friends and family to accompany them on errands to places where they feel vulnerable. Often, even the thought of going to an "unsafe" place will bring about feelings of anxiety.

When forced to be somewhere in which they feel exposed or trapped, people with agoraphobia may have a panic attack. These symptoms are physiological rather than behavioral, and may include:

• Chest pain
• Chills or hot flashes
• Dizziness
• Increased heart rate
• Nausea
• Shortness of breath
• Sudden, profuse sweating.

Agoraphobia Treatment

Agoraphobia can be treated with medication and psychotherapy. A combination of both approaches is commonly used. If the patient also has panic disorder, the treatment plan must incorporate controlling panic attacks as well.

Antidepressants are usually the first kind of medicine prescribed for agoraphobia. Of these, selective serotonin reuptake inhibitors (SSRIs) are the most common. Many of these drugs are also effective treatments for panic disorder. Anti-anxiety drugs may also be necessary for those patients who have had repeated panic attacks.

Cognitive behavioral psychotherapy can be an effective means for agoraphobia patients to learn coping mechanisms for handling their fears and anxiety. The aim is to change the patient's thinking patterns and their responses to anxiety evoking situations.