Disease: Agoraphobia

Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.

With agoraphobia, you fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line or being in a crowd. The anxiety is caused by fear that there's no easy way to escape or seek help if intense anxiety develops. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to fear another attack and avoid the place where it occurred.

People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. You may feel that you need a companion, such as a relative or friend, to go with you to public places. The fears can be so overwhelming that you may feel unable to leave your home.

Agoraphobia treatment can be challenging because it usually means confronting your fears. But with talk therapy (psychotherapy) and medications, you can escape the trap of agoraphobia and live a more enjoyable life.

Source: http://www.mayoclinic.com

Typical agoraphobia symptoms include:

  • Fear of being alone in any situation
  • Fear of being in crowded places
  • Fear of losing control in a public place
  • Fear of being in places where it may be hard to leave, such as an elevator or train
  • Inability to leave your home (housebound) or only able to leave it if someone else goes with you
  • Sense of helplessness
  • Overdependence on others

In addition, you may have signs and symptoms of a panic attack, such as:

  • Rapid heart rate
  • Excessive sweating
  • Trouble breathing
  • Feeling shaky, numb or tingling
  • Chest pain or pressure
  • Lightheadedness or dizziness
  • Sudden flushing or chills
  • Upset stomach or diarrhea
  • Feeling a loss of control
  • Fear of dying

Panic disorder and agoraphobia

Some people have a panic disorder in addition to agoraphobia. Panic disorder is a type of anxiety disorder in which you experience sudden attacks of extreme fear that reach a peak within a few minutes and trigger intense physical symptoms (panic attacks). You might think that you're totally losing control, having a heart attack or even dying.

Fear of another panic attack can lead to avoiding similar circumstances or the place where it occurred in an attempt to prevent future panic attacks.

When to see a doctor

Agoraphobia can severely limit your ability to socialize, work, attend important events and even manage the details of daily life, such as running errands.

Don't let agoraphobia make your world smaller. Call your health care provider if you have symptoms.

Source: http://www.mayoclinic.com

Having panic disorder or other phobias, or experiencing stressful life events, may play a major role in the development of agoraphobia.

Source: http://www.mayoclinic.com

Agoraphobia is diagnosed based on signs and symptoms, as well as an in-depth interview with your health care provider. You may also have a physical exam to rule out other conditions that could be causing your symptoms.

To be diagnosed with agoraphobia, you must meet criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

Diagnostic criteria for agoraphobia include severe fear or anxiety about two or more of the following situations:

  • Using public transportation, such as a bus or plane
  • Being in an open space, such as a parking lot, bridge or large mall
  • Being in an enclosed space, such as a movie theater, meeting room or small store
  • Waiting in a line or being in a crowd
  • Being out of your home alone

These situations cause anxiety because you fear you won't be able to escape or find help if you develop panic-like symptoms or other disabling or embarrassing symptoms.

In addition, diagnostic criteria for agoraphobia include:

  • Fear or anxiety that almost always results from exposure to a situation
  • Avoidance of the situation, needing a companion to go with you or endurance of this situation with extreme distress
  • Fear or anxiety that's out of proportion to the actual danger posed by the situation
  • Significant distress or problems with social situations, work or other areas in your life caused by the fear, anxiety or avoidance
  • Persistent phobia and avoidance, usually lasting six months or longer

Source: http://www.mayoclinic.com

Agoraphobia can greatly limit your life's activities. If your agoraphobia is severe, you may not even be able to leave your home. Without treatment, some people become housebound for years. You may not be able to visit with family and friends, go to school or work, run errands, or take part in other normal daily activities. You may become dependent on others for help.

Agoraphobia can also lead to or be associated with:

  • Depression
  • Other mental health disorders, including other phobias and other anxiety disorders
  • Alcohol or drug misuse to try to cope with the fear, guilt, hopelessness, isolation and loneliness

Source: http://www.mayoclinic.com

There's no sure way to prevent agoraphobia. However, anxiety tends to increase the more you avoid situations that you fear. If you start to have mild fears about going places that are safe, try to practice going to those places before your fear becomes overwhelming. If this is too hard to do on your own, ask a family member or friend to go with you, or seek professional help.

If you experience anxiety going places or have panic attacks, get treatment as soon as possible. Get help early to keep symptoms from getting worse. Anxiety, like many other mental health conditions, can be harder to treat if you wait.

Source: http://www.mayoclinic.com

Certain dietary and herbal supplements claim to have calming and anti-anxiety benefits. Before you take any of these for agoraphobia, talk with your health care provider. Although these supplements are available without a prescription, they still pose possible health risks in some people.

For example, the herbal supplement called kava appeared to be a promising treatment for anxiety, but reports of serious liver damage — even with short-term use — caused several European countries and Canada to pull it off the market. The Food and Drug Administration has issued warnings but not banned sales in the United States. Avoid using kava until more rigorous safety studies are done, especially if you have liver problems or take medications that affect your liver.

Source: http://www.mayoclinic.com

Living with agoraphobia can make life difficult. Professional treatment can help you overcome this disorder or manage it effectively so you don't become a prisoner to your fears.

You can also take these steps to cope and care for yourself when you have agoraphobia:

  • Stick to your treatment plan. Take medications as directed. Keep therapy appointments. Consistency can make a big difference, especially when it comes to taking your medication.
  • Try not to avoid feared situations. It's hard to go to places or be in situations that make you uncomfortable or that bring on symptoms of anxiety. But practicing going to more and more places can make them less frightening and anxiety provoking. Family, friends and your therapist can help you work on this.
  • Learn calming skills. Working with your health care professional, you can learn how to calm and soothe yourself. You can practice these skills on your own, especially at the first hint of anxiety.
  • Practice relaxation techniques. Meditation, yoga and imagery are simple relaxation techniques that may help — and you can do them in the comfort of your own home. Practice these techniques when you aren't anxious or worried, and then put them into action during stressful situations.
  • Avoid alcohol and illegal drugs. These substances can worsen your panic or anxiety symptoms.
  • Take care of yourself. Get enough sleep, be physically active every day, and eat a healthy diet, including lots of vegetables and fruits.

Source: http://www.mayoclinic.com

Agoraphobia usually starts before age 35, but older adults also can develop it. Women are diagnosed with agoraphobia more often than men are.

In addition to having panic disorder or other phobias, agoraphobia risk factors include:

  • Having a tendency to be nervous or anxious
  • Experiencing stressful life events, such as abuse, the death of a parent or being attacked
  • Having a blood relative with agoraphobia

Source: http://www.mayoclinic.com

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