Agoraphobia is a serious psychiatric disorder that afflicts millions of adults. If you or someone you love struggles with agoraphobia, you know that it can be a severely debilitating disorder. Individuals with this disorder are frequently portrayed as having "a fear of everything." However, the underlying issue for agoraphobics is the often paralyzing fear that they’ll either find themselves essentially trapped in a situation or place – unable to leave without considerable difficulty or embarrassment – or that they’ll start to panic and no one will be able to help them.
Some people with agoraphobia are able to put themselves in these anxiety-provoking situations. However, the dread it elicits is usually quite intense. Others, however, avoid the fearful situations altogether. The pay-off of such avoidance is extremely powerful; as a result they literally become prisoners in their own home, never daring to venture outside. Even the smallest tasks, like picking up their child from school or running an errand, become impossible for them to do.
Severe agoraphobia can prevent you from keeping a job outside your home, not to mention having any semblance of a normal life. It takes a severe toll on relationships, work, finances, and self-esteem – not to mention the ability to simply enjoy life. Without treatment, painful isolation and constant avoidance often end up defining the life of anyone who suffers from this challenging disorder.
Types and Symptoms of Agoraphobia
In the DSM, the diagnostic manual used by psychiatrists, psychologists, and other mental health professionals, two types of agoraphobia are currently listed. They are:
- Panic disorder with agoraphobia
- Agoraphobia without a history of panic disorder
For most people with agoraphobia, the fear often involves one or more of the following:
- Being alone, somewhere away from home or even in their own home
- Losing control while they are in front of people
- Being in a crowded place
- Being in a confined place, such as an elevator, car, plane, or boat – essentially any place from which they can’t leave if they want to
Additional symptoms may include:
- Becoming very dependent on one or more other people
- An inability to leave their home
- Feelings of helplessness
The symptoms of agoraphobia make it very difficult, if not impossible, to live a normal life. While some become confined to their home because of their fears, others have a few "safe places" where they feel confident that nothing will trigger their anxiety.
Causes of Agoraphobia
As with many psychiatric disorders, science has not revealed the exact cause of agoraphobia. However, there are two factors that may play a role in its development. These include a history of previous panic attacks and the long-term use of certain medications, such as tranquilizers or other types of sedatives.
Who is at Risk?
Since agoraphobia typically develops in the late teens or early twenties, adolescents and young adults have the greatest risk of developing it. Females are more likely to develop the disorder than males. Other risk factors include a history of panic disorder or anxiety, a history of abuse during childhood, and problems with alcohol and drug abuse or addiction.
Fortunately, agoraphobia can be treated, although one of the biggest obstacles is getting the person out of the house and to the treatment setting. This dilemma can make some people with agoraphobia feel that their situation is hopeless. They believe treatment isn’t an option for them because of their crippling anxiety.
The solution to this may be as simple as looking in the phone book for mental health professionals who specialize in treating agoraphobia. Understanding the catch22 of getting treatment for agoraphobia, some therapists will actually make an appointment to meet with you at your home. They may also offer sessions via phone or email. Just knowing that these alternatives are available can bring incredible hope to anyone with severe agoraphobia.
Treatment for agoraphobia typically includes a combination of psychotherapy and medication. Medications that are used for other anxiety disorders are also often used to treat agoraphobia. These include antidepressants (SSRIs such as Paxil and Prozac or SNRIs such as Cymbalta or Effexor) and benzodiazepines (e.g. Klonopin or Xanax). Other types of medication, such as atypical antidepressants, tricyclics, and beta blockers, may also be used depending on a variety of factors.
Due to the risk of dependence, caution must always be used when treating agoraphobia with benzodiazepines. While antidepressants can be taken over a long period of time, benzodiazepines – if taken daily – should generally not be used longer than 4 weeks.
Medication can help reduce symptoms of anxiety as well as prevent or reduce panic attacks and symptoms. For someone with severe agoraphobia, medication may be necessary in order for them to participate in therapy.
One of the most effective types of therapy for agoraphobia is cognitive behavioral therapy. It helps you identify negative or irrational thought patterns that cause or contribute to your anxiety. A skilled therapist can help you replace old, unhealthy thought patterns with new ones that will empower you. You will also be able to learn and practice new behaviors that will help you gain control over your symptoms. Other types of therapy may be beneficial as well.
Agoraphobia doesn’t need to ruin your life. With proper treatment, you can learn to manage and overcome the gripping anxiety that keeps you from living the life you deserve.