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Agoraphobia

Agoraphobia is the fear of being in places where help might not be available, and is usually manifested by fear of crowds, being outside alone, extreme or irrational fear of crowded spaces, or enclosed public places.

Commonly feared places and situations are elevators, sporting events, lines, bridges, public transportation, shopping malls, airports, and airplanes.

Agoraphobia often accompanies another anxiety disorder, such as panic disorder or a specific phobia such as social anxiety. If it occurs with panic disorder, the onset is usually in the 20s, and women are affected more often than men. People with this disorder may become housebound for years, which is likely to hurt social and interpersonal relationships.

Symptoms

    * Fear of being alone
    * Fear of losing control in a public place
    * Fear of being in places where escape might be difficult
    * Becoming housebound for prolonged periods of time
    * Feelings of detachment or estrangement from others
    * Feelings of helplessness
    * Dependence on others
    * Feeling that the body is unreal
    * Feeling that the environment is unreal
    * Anxiety or panic attack (acute severe anxiety)
    * Unusual temper or agitation with trembling or twitching

Additional symptoms that may occur:

    * Lightheadedness, near fainting
    * Dizziness
    * Excessive sweating
    * Skin flushing
    * Breathing difficulty
    * Chest pain
    * Heartbeat sensations
    * Nausea and vomiting
    * Numbness and tingling
    * Abdominal distress that occurs when upset
    * Confused or disordered thoughts
    * Intense fear of going crazy
    * Intense fear of dying



Signs and Tests
  

The individual may have a history of phobias, or family, friends, or the affected person may tell the health care provider about agoraphobic behavior. This person may sweat, have a rapid pulse (heart rate), or have high blood pressure.

Treatment  

The goal of treatment is to help the phobic person function effectively. The success of treatment usually depends upon the severity of the phobia.

Systematic desensitization is a technique used to treat phobias. The person is asked to relax, then imagine the things that cause the anxiety, working from the least fearful to the most fearful. Graded real-life exposure has also been used with success to help people overcome their fears. Anti-anxiety and antidepressant medications are often used to help relieve the symptoms associated with phobias. Phobias tend to be chronic, but respond well to treatment.

Complications  

Some phobias may affect job performance, school, or social functioning. Call for an appointment with your health care provider if symptoms suggestive of agoraphobia develop.

Prevention  

As with other panic disorders, prevention may not be possible. Early intervention may reduce the severity of the condition.

For more on social phobia, see "Understanding Social Phobia - Confronting Your Fears".



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