Agoraphobia is an anxiety disorder. The people with agoraphobia
avoid being in certain places or situations. They are afraid about
having no way to escape or be overwhelmed with panic and having no
help. An intense fear of driving, flying, crossing bridges, or
being in shops are examples. The patients may become afraid of
their reactions to these situations and this fear in itself can be
disabling. In extreme cases, the agoraphobic person may never
Agoraphobia is often the end stage of panic disorder. Panic
disorder is characterized by severe frequent panic attacks marked
by a sense of impending doom. A person may be called agoraphobic
when he/she tries to avoid situations, which he/she feels might
trigger a panic attack.
How does it occur?
The exact cause is unknown. As with other types of mental illness,
both genetic and environmental factors play a role.
What are the symptoms?
Agoraphobia may be the cause if a person often avoids going to
places or doing things because of the fear of having no way to
Typical symptoms of panic attack may be:
* Palpitations or suddenly fast heartbeat
* Sweating even when it is not hot
* Trembling or shaking
* Shortness of breath, feeling of not getting enough air
* Feeling of choking or chest pain
* Fear of going crazy, losing control of body functions or
* Numbness or detachment
* Chills or hot flashes.
Panic attacks may occur several times a day, or the attacks may be
scattered, occurring only occasionally. Even occasional attacks
can lead to fear of returning to a place or doing something
associated with a past attack. A panic attack may last 10-15
minutes, or longer, after which the person may be exhausted.
Women have agoraphobia two to four times more often than men. The
condition tends to run in families. Agoraphobia may cause a person
to avoid going places or doing things because of the fear of
having a panic attack, of having no way to escape.
How is it diagnosed?
The doctor will enquire about the symptoms. Other common causes of
the symptoms, such as a medical illness or a drug or alcohol
problem should be ruled out. This requires a medical examination
What is the treatment?
The treatment depends on how the disorder interferes with the
routine life. Agoraphobia can be treated by various therapies.
These include behaviour therapy, relaxation therapy, cognitive
therapy, visual imagery techniques and medications
(antidepressants and anti-anxiety drugs) to prevent panic attacks.
The most effective treatments usually require that the person be
exposed to the feared situation repeatedly, perhaps accompanied by
a trusted companion, until they learn that the experience (such as
crossing a bridge or riding in an elevator) is not dangerous.
The main classifications of
medications prescribed for agoraphobia are:
1) Benzodiazepines: Prescribed for agoraphobia to
reduce anxiety symptoms. These are tranquilizers and sleeping
pills. You have probably heard of some of the most common types of
benzodiazepines which are Ativan, Xanax, Valium, and Restoril. The
main drawback with benzodiazepines is that they can be habit
forming and withdrawal can cause the same anxiety or agoraphobia
symptoms they were meant to relieve.
Prescribed to people with agoraphobia because they can block panic
attacks (in addition to treating depression).
SSRIs (Selective Serotonin Reuptake Inhibitors)are the most
commonly used because they don't produce as many side effects as
older, less frequently prescribed types of anti-depressants
(Monoamine Oxidase Inhibitors and Tricyclic Anti-depressants).
SSRIs include Prozac, Paxil, Zoloft.
Recently, SSNRIs (Selective Serotonin and Noreprenephrine Reuptake
Inhibitors) like Effexor have increased in popularity for patients
with panic-related disorders. The main difference between these
drugs and SSRI's is that they effect the brainís levels of
noreprenephrine in addition to serotonin and aren't as likely to
produce sexual side effects.
Although anti-depressants are not habit forming like the
benzodiazepines, some of them produce undesirable side effects
like weight gain and reduced sex drive. They also produce harsh
withdrawal effects in many people, especially Effexor.
3) Anti-convulsants: Most
commonly used for epilepsy but known to stabilize mood and reduce
frequency and intensity of panic attacks.
4) Beta blockers: most
commonly used to reduce high blood pressure but also known to
reduce physical symptoms of anxiety.
5) Buspar: a slower acting
tranquilizer with fewer side effects than benzodiazepines.
How long does agoraphobia last?
Without treatment agoraphobia can last for many years, even for a
can be done to help?
Discuss the issue with a doctor who is knowledgeable about the
condition. Realise that the anxiety problem can be overcome. Do
not use alcohol or other drugs to overcome anxiety. Learn as much
as possible about agoraphobia, anxiety, and panic. Join a support
group of others with similar problems, and share experiences and
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