Agoraphobia is a specific phobia characterised by a fear of being trapped in situations from which one cannot easily escape or seek help if necessary. Such, actual or anticipated, situations could include taking public transportation, going to a shopping mall, standing in line, driving a car, or simply leaving their house. When these clients are put in these situations, they experience panic attack symptoms such as increased heartbeat, rapid breathing, sweating, and nausea, even if they are aware of the irrationality of their fears. These symptoms can negatively affect the individual’s life and prevent them from functioning in life to their fullest. Other feelings and thoughts can also trigger agoraphobia such as embarrassment, helplessness, losing control, or feeling trapped. Furthermore, frequent panic attacks in certain situations can lead the person to avoid them altogether, especially if they are going alone. This isolates agoraphobic clients, which heavily affects their personal and professional life. Agoraphobia may develop after experiencing several panic attacks. Clients fear having another panic attack, which leads them to avoid going to the places where panic attacks occurred.
Symptoms:
The main symptoms of agoraphobia, according to the DSM-5, include:
- Fear or anxiety about two (or more) of these situations listed below:
- Taking public transportation
- Being in open spaces (such as parking areas)
- Being in confined places (such as cinemas)
- Waiting in a line or being in a crowded area
- Going outside (their home) alone
- The client fears or avoids anxiety-inducing situations due to the fear of not being able to escape them or seek help.
- The agoraphobic situations almost always trigger fear or anxiety.
- The agoraphobic situations are almost always avoided, need the presence of another person, or experienced with significant fear or anxiety.
- The fear and anxiety experienced are usually out of proportion to the actual threat posed by these situations.
- The disorder is causing significant distress to the point of affecting the client’s daily social, occupational, or other areas of functioning.
Every year, approximately 1%–1.7% of adolescents and adults worldwide experience symptoms consistent with agoraphobia. Agoraphobia affects women twice as much as it does men.
Agoraphobia can be debilitating as it prevents clients from participating in daily activities, and while it may be difficult to avoid agoraphobia, it is possible to find treatment methods to manage its symptoms. Early intervention is the optimal option for treating agoraphobia, minimising the impact of its symptoms, and improving the client’s quality of life. Agoraphobia is typically persistent and chronic. Unless the agoraphobia is treated, complete remission is uncommon (around 10%).
Agoraphobia can seriously restrict a client's ability to socialise, work, attend major events, and even handle day-to-day tasks like grocery shopping. If you are experiencing any of the above signs or symptoms, please contact your doctor.
Agoraphobia is mainly treated using a combination of psychotherapy and medication to help to reduce the severity and frequency of symptoms. The goal of these treatments is to improve one's daily life functioning.
Psychotherapy:
The use of psychotherapy is critical because it helps clients become aware of their disorder, including its symptoms and causes, as well as learn to manage agoraphobia in the long term. They are made more aware of the triggers behind their fears and anxiety and what can make them worse.
Cognitive behavioural therapy (CBT) is one of the most widely used treatments for agoraphobia, as it helps clients learn new coping strategies, thinking patterns, and stress and anxiety management techniques, for them to manage their symptoms.
Exposure therapy is a technique that is commonly used in CBT treatments. Exposure therapy, specifically systematic desensitization, involves clients being encouraged to gradually expose themselves to agoraphobic situations and face their anxieties and uncomfortable feelings. Exposure therapy is commonly combined with relaxation techniques that can help clients cope with their anxious feelings.
Medications:
Certain antidepressants are frequently used to treat agoraphobia, and anti-anxiety medications are also sometimes used on a limited basis.
- Selective serotonin reuptake inhibitors (SSRIs)
- Selective serotonin and norepinephrine reuptake inhibitors (SSNRIs)
- Tricyclic antidepressants
- Anti-anxiety medications (Benzodiazepines)
Self-care and lifestyle strategies for managing symptoms:
There are useful strategies that clients can apply themselves to cope with their symptoms, and these include:
- Practising relaxation techniques, such as breathing exercises, yoga, or meditation
- Exercising on a regular basis
- Maintaining a healthy, well-balanced diet
- Having a healthy sleep schedule
- Avoiding alcohol drinks or drinks that include caffeine
- Avoiding recreational drugs
