Agoraphobia - Fear of open spaces or crowds

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Agoraphobia is a condition where the sufferer becomes anxious in environments that are unfamiliar or where he or she perceives that they have little contol.Triggers for this anxiety may include wide open spaces, crowds or traveling. Agoraphobia is often, but not always, compounded by a fear of social embarrassment, as the agoraphobic fears the onset of a panic attack and appearing distraught in public.

This fear of open spaces is not so much fear of the open space itself but rather fear of exposure during a panic attack, or fears that a panic attack will occur and the agoraphobic person will not be able to escape the situation. Usually by the time a person becomes agoraphobic, intense anxiety and regular but unpredictable panic attacks have been a problem for some time. Agoraphobia is usually found after a person has diagnose agoraphobia a certain set of criteria must be met first

Agoraphobics most often start out with simple panic disorder, a condition marked by unpredictable attacks of intense fear coupled with physical symptoms such as shortness of breath, chest tightness or chest pain, dizziness, nausea, intense terror confusion, a sense of unreality, and tingling or numbness in the hands, feet, and face. Agoraphobia is one of a number of emotional and mental illnesses that fall under the general diagnostic category of anxiety disorders.

Symptoms:-

When someone suffering from agoraphobia is exposed to an unfamiliar open space with no exit routes, they often experience symptoms similar to an anxiety attack their heart begins to pound and the pace quickens. Breathing becomes labored. Sweat begins to break out and feeling of nausea emerges. Those who are severely-afflicted can even experience chest pains and a palpable sense that they may die.

Fear of being in a crowd, standing in line, riding in a car, bus. Having imaginary security area where you feel safe. Anxiety increases, the futher from that are you go. Feeling housebound. One of the most distinguishing features of agoraphobia is that the person will experience extreme anxiety in any situation where it can be difficult to escape,

Someone with agoraphobia is often afraid of being in a situation where they are too far away from home, or being home alone. Those who suffer from agoraphobia feel highly uncomfortable in crowded places like malls, theaters or sports arenas.
One of the most distinguishing features of agoraphobia is that the person will experience extreme anxiety in any situation where it can be difficult to escape, or it may be embarrassing to leave. Agoraphobics will avoid crowds, public places, contracted areas, and other similar situations

Treatments:-

Cognitive behavioral treatments:-

Exposure treatment can provide lasting relief to the majority of patients with panic discorder and agoraphobia. Disappearance of residual and subclinical agoraphobic avoidance, and not simply of panic attacks, should be the aim of exposure therapy.

Cognitive restructuring has also proved useful in treating agoraphobia. This treatment involves coaching a participant through a diagnostic discussion, with the intent of substituting irrational, counterproductive beliefs with more factual and beneficial ones.

Psychopharmaceutical Treatments:-

Anti-depressant medications most commonly used to treat anxiety disorders are mainly in the SSRI class and include sertraline, paroxetine and fluoxetine. Benzodiazepine tranquilizers, MAO inhibitors and tricyclic antideperssants are also commonly prescribed for treatment of agoraphobia. Antidepressants should be used in conjuction with exposure as a form of self help or with congnitive behavior therapy.

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