Agoraphobia

GinaMarie Guarino, LMHC

Agoraphobia

People who suffer from agoraphobia may have an intense fear of certain places and situations. These fears typically develop as a result of having a panic attack. People who suffer from agoraphobia fear having a panic attack. From that fear, they associate relatively innocuous situations with having a panic attack. This causes them to avoid this feared environment or situation to prevent future panic attacks.

Agoraphobia alone is not a diagnosable disorder. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), agoraphobia is a condition that mayor may not be present in people who suffer from panic disorder.

Symptoms of Agoraphobia

A person who suffers from agoraphobia will be fearful of situations in which they feel out of control. Situations that may cause fear or panic for people with agoraphobia may include:

  • Crowded spaces
  • Enclosed spaces
  • Social gatherings
  • Public transportation
  • Environment outside their own house
  • Potentially awkward or embarrassing situations
  • A loss of control over the environment
  • Exposure to triggers for panic attacks

Any of these situations may cause uncomfortable symptoms, like:

  • Panic attacks
  • Anxiety attacks
  • Mood swings
  • Irritability
  • Social anxiety
  • Distress at the thought of leaving the house
  • Distress at the thought of entering a triggering situation or environment
  • Neglecting or ignoring personal needs to avoid leaving the home or entering a triggering situation
    • Hygiene, medication, appointments, work, school, etc.
  • Only leaving the house when absolutely necessary
  • Intense embarrassment and shame associated with the condition
  • Intense fear of being outside or in a situation in which they feel exposed
    • Public places, like parks, public transportation, grocery stores, etc.

Causes of Agoraphobia

The primary cause of agoraphobia is a failure to handle stress, which results in panic attacks. Panic attacks cause the nervous system to become hypersensitive. This causes the affected person to be vulnerable to symptoms of anxiety and panic disorder.

Causes of agoraphobia include:

  • A history of panic attacks. Agoraphobia develops as the result of panic disorder. This means that a history of panic attacks must exist for a condition to be considered agoraphobia. The behaviors of agoraphobia in effort to prevent the affected person from having another panic attack.
  • Social anxiety.People who suffer from agoraphobia tend to be fearful about embarrassing or hurtful encounters with others.
  • A history of abuse. A person who has experienced a traumatic event or abuse is more likely to develop agoraphobia than someone who has not. The emotional distress triggers panic attacks and the poor development of coping skills for anxiety.
  • A fear of contamination. In severe cases of agoraphobia, the affected person has an intense fear of germs. This will cause the affected person to avoid all places and situations that may cause the spread of germs.

Treatment Options for Agoraphobia

Agoraphobia is considered a progressive disorder. This means that it is triggered by something and becomes worse if no intervention is taken. Early intervention is key for recovery from agoraphobia.

Effective treatment options for agoraphobia include:

Cognitive Behavioral Therapy (CBT). CBT teaches patients with agoraphobia how to discern between actual high-risk situations and situations that are triggered by agoraphobia.

Exposure Therapy. Exposure therapy exposes the patient to feared situations to lessen the intensity of the fear response. The feared situations begin as mild exposure, and progress to more frequent and intense exposure.

Eye Movement Desensitization and Reprocessing (EMDR). EMDR is a technique used to stimulate other areas of the brain when recalling a distressing situation. This causes the distressing situation to be associated with areas of the brain that do not trigger a stress response. The goal is to lessen the overall stress response of triggers.

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