Agoraphobia

Agoraphobia is a type of anxiety disorder. Anxiety is intense fear and worry. Agoraphobia is an intense fear of losing control or having a panic attack while in public. During a panic attack, you may experience the following things:

  • Dizziness.

  • Shortness of breath.

  • Chest pain.

  • Sweating.

  • Nausea.

  • Diarrhea.

  • Choking sensation.

  • Trembling or shaking.

  • Fear of going crazy.

  • Fear of dying.

You may fear not being able to escape a situation, being embarrassed, or not having help available to you. This fear can make it difficult to be in crowds, to travel, or even to leave the house. The panic may seem like more than you can cope with.

RISK FACTORS

Agoraphobia can affect people at most any age. It usually starts during the teenage years or in young adulthood. Women have agoraphobia more often than men. No one knows exactly what causes agoraphobia. However, there are certain risk factors that are associated with agoraphobia:

  • Extreme stress, brought on by traumatic situations, such as physical or sexual abuse.

  • History of drug or alcohol abuse.

  • Family history of anxiety.

SYMPTOMS

  • Fear of leaving home.

  • Fear of being someplace where you cannot get out quickly.

  • Feelings of helplessness.

  • Fear of being alone.

DIAGNOSIS

To determine if you have agoraphobia, your caregiver will probably ask you about:

  • Fears you may have.

  • Changes in your behavior because of these fears.

  • Drug and alcohol use.

TREATMENT

Psychotherapy and medicine can help people with agoraphobia. Medicine can work immediately to reduce symptoms of panic or reduce general levels of anxiety, whereas psychotherapy has been demonstrated to show better long-term outcomes. They often are used together.

  • Psychotherapy may include:

  • Cognitive behavioral therapy. This type of therapy helps you figure out what causes your fears. Your fear might be caused by your thoughts or certain situations. The therapy will then help you learn ways to reduce these fears.

  • Exposure therapy. Often, the more fear is avoided, the greater it becomes. Exposure therapy helps you face the things that cause your fears by learning relaxation techniques while you approach what you fear. Meditation and deep breathing are two examples.

  • Medicines for agoraphobia may include:

  • Antidepressants. These drugs affect certain chemicals in your brain. Selective serotonin reuptake inhibitors are one type that can decrease general levels of anxiety and help prevent panic attacks.

  • Benzodiazepines. These drugs block feelings of anxiety and panic. However, prolonged use can lead to physiological and psychological dependence and can cause withdrawal symptoms when discontinued.

  • Beta-blockers. These medicines can keep you from getting excited. They have an effect on the nerve cells that cause that feeling. The drugs help you feel less tense and anxious.

HOME CARE INSTRUCTIONS

  • Take medicine as directed by your caregiver. Follow the directions carefully. Make sure your caregiver knows about all other medicines you take. Do not start any new medicine unless your caregiver says it is okay. Do not take more medicine than is prescribed. Alert your caregiver if you plan to discontinue a medicine that he or she has prescribed to you for anxiety.

  • Try not to avoid fearful situations. Avoidance can increase your fears and could lead to a fear of leaving your home.

  • Learn relaxation techniques. Consider taking a class in meditation or deep breathing to help you stay calm.

  • Consider joining a support group. Ask your caregiver for a list of groups in your area.

  • Do not drink alcohol or use drugs, especially if you are taking medicine for anxiety.

SEEK MEDICAL CARE IF:

  • You are missing major life activities, such as school or work, because of your fears.

  • You have symptoms of depression, such as depressed mood, loss of interest, or negative feelings about yourself.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You cannot leave your home.

  • You have trouble breathing.

  • You have chest pain.

  • You think about hurting yourself or someone else.

FOR MORE INFORMATION

Anxiety Disorders Association of America: www.adaa.org