Agoraphobia

AGORAPHOBIA

Agoraphobia is an anxiety disorder in which you fear being in inescapable places or situations. Those experiencing agoraphobia feel panicked about escaping public places. The anxiety induces a fearful thought as if something were to happen, there would be no escapable route or support available. 

Another common fear from an individual in a potential public crisis, is the ability to access assistance immediately. People with agoraphobia fear feeling trapped, helpless, or embarrassed in a given situation, usually in public spaces. 

Some examples of agoraphobia include the following: 

✅ avoiding public transportation
✅ never riding an elevator 
✅ avoids standing in line or large crowds
✅ consistent fear to leave one’s home 
✅ heart palpitations 
✅ consistent sweating 
✅ fear of losing control
✅ fear of dying 
✅ fear of enclosed spaces
✅ never returning to a place where one had a previous panic attack

Causes of Agoraphobia

While the exact cause of agoraphobia remains unknown, there are many contributing factors. Living with other phobias is likely to make someone more susceptible for agoraphobia. Other risk factors include:

💡 depression
💡 a history of abuse and/or trauma 
💡 the presence of another panic disorder
💡 substance abuse problems 
💡 having generalized anxiety disorder
💡 family history of agoraphobia 
💡 obsessive compulsive disorder 

Misconceptions About Agoraphobia

Agoraphobia is not as common as other anxiety disorders causing a gap in awareness and education. Myths and stigmas arise from the lack of discussion causing harmful labels and misconceptions. Here are the most common myths regarding agoraphobia diagnosis: 

🚫 not going outside 
🚫 laziness 
🚫 introversion/being antisocial 
🚫 fear of germs 
🚫 a form of attention seeking behavior
🚫 will never experience a normal life 
🚫 a fear of leaving the house causing one to never leave the house

Signs and Symptoms of Agoraphobia

Signs one may be experiencing agoraphobia are linked to persistent feelings of fear causing anxiety or avoidance typically lasting 6 months or longer. Typical symptoms of agoraphobia include the following:

🚩 fear of leaving home by yourself
🚩  consistent shakiness 
🚩  fear of waiting in line
🚩  difficulty focusing 
🚩  fear of riding a bus, plane or train
🚩  irritability
🚩  fear of travel
🚩  fatigue 
🚩  fear of open spaces with no escape
🚩  frequent panic attacks
🚩  dysfunctional thoughts that do not match social context 

Agoraphobia can also be without a panic disorder with the following signs and symptoms:

🚩 The fear or anxiety typically results from exposure to a given situation 
🚩  Finding yourself avoiding situations one normally would not
🚩  Needing a friend or companion to accompany you places
🚩  Experiencing great distress during social situations 
🚩  Avoiding certain situations for six months or longer

Diagnosing Agoraphobia

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a guideline for practitioners to evaluate symptoms leading to a diagnosis. Symptoms of agoraphobia present similarly to a panic attack. Provided below are symptoms used by mental health providers for diagnosing an individual with agoraphobia:

⚠️ palpitations and accelerated heart rate
⚠️ nausea or abdominal pain
⚠️ sweating
⚠️ dizziness or feeling lightheaded
⚠️ trembling or shaking
⚠️ disassociation 
⚠️ shortness of breath
⚠️ chills or hot flashes 
⚠️ choking
⚠️ fear of dying or losing control
⚠️ chest pains 

According to the DSM-5,  when diagnosing agoraphobia, individuals will experience symptoms of anxiety relating to two (or more) of the following situations:

⚠️ using public transportation 
⚠️ being in open spaces 
⚠️ being in an enclosed space
⚠️ standing in line or being in a crowd 
⚠️ being outside of one’s home, alone

Conditions Commonly Mistaken for Agoraphobia

Since the symptoms of agoraphobia go hand-in-hand with other panic disorders, it can be challenging to pinpoint. Likewise, only 1% – 2% of individuals in the United States have been diagnosed with agoraphobia making it more rare. Some conditions mistaken for agoraphobia include: 

✳️  generalized anxiety disorder 
✳️  obsessive compulsive disorder 
✳️  depression

Treating Agoraphobia

There are many ways agoraphobia can be treated and will differ based on individual needs. A combination of methods is most likely to help. Some of those include:

🧬 cognitive behavioral therapy
🧬 maintaining a well balanced diet
🧬 exposure therapy
🧬 exercise, dance and/or movement therapy
🧬 family therapy
🧬 daily meditation / mindfulness practice 
🧬 medication management
🧬 breathing exercises 

As some natural remedies are not proven to treat anxiety disorders and can create a negative  interference with prescribed medications. Make sure to consult with your doctor before using natural remedies for the treatment of agoraphobia.

Healthcare Professionals Who Treat Agoraphobia

For the best results in a successful treatment of agoraphobia, seek providers that have specialities in the assessment, treatment, diagnosis, and continuing support of patients diagnosed with agoraphobia. 

Many medical and mental health providers are familiar with the diagnosis of agoraphobia.  However if your chosen provider is not, they should always provide a knowledgeable referral source. Specialized providers will have the capabilities to diagnose using various testing methods to decrease the likelihood of misdiagnoses and unnecessary treatments. 

If you choose to utilize medication, psychotherapy should always be incorporated in treatment planning. 

The following are professionals involved in the treatment of agoraphobia:

🧠 physicians
🧠 social workers
🧠 psychiatrists
🧠 pediatricians
🧠 psychologists
🧠 nurse practitioners

Recognizing Immediate Need for Agoraphobia Treatment

Remember, you are the expert in your life. That means- the decision to seek help is based on your perception and servivty. When there is a noticeable change in daily tasks and a concern for wellbeing it is critical to consider reaching out for professional help. 

Another key sign of distress is tension in relationships as they are likely to be the first area affected by the diagnosis. Not only relationships with other people but also your relationships with yourself, your home, hygiene, work, enjoyable activities, and health. If there is a sense something does not feel “right” then follow that “gut feeling” and seek support. 

Here are some warning signs for when immediate help may be needed:

🚨 increased irritability, anger, and defiance
🚨 if symptoms lead to substance abuse
🚨 drastic change of mood and emotions
🚨 self harm
🚨 suicidal thoughts

Agoraphobia Professional Organizations

There are a few professional organizations that offer support programs for those suffering from agoraphobia. Some of these include: 

https://www.mayoclinic.org/diseases-conditions/agoraphobia/symptoms-causes/syc-20355987
https://www.therecoveryvillage.com/mental-health/agoraphobia/related/agoraphobia-myths/
https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t10/
https://www.healthline.com/health/agoraphobia#diagnosis
https://www.goodtherapy.org/learn-about-therapy/issues/agoraphobia/get-help
https://adaa.org/find-help/find-support/support-groups/panic-disorder-and-agoraphobia-support-group
https://www.mayoclinic.org/diseases-conditions/agoraphobia/diagnosis-treatment/drc-20355993
https://www.sparrow.org/departments-conditions/conditions/agoraphobia
https://adaa.org/understanding-anxiety/additional-disorders/agoraphobia
https://www.psychiatryadvisor.com/home/topics/anxiety/agoraphobia-an-evolving-understanding-of-definitions-and-treatment/*
https://www.mayoclinic.org/diseases-conditions/agoraphobia/diagnosis-treatment/drc-20355993