While a child is not likely to develop agoraphobia, it is possible. Or of sitting in the middle of a long row of other people—like in a classroom or theater. Rather, they may be afraid of having some other type of distressing anxiety symptom or other intense physical issues, such as vomiting or having a severe migraine. For instance, the person may be afraid that they will lose control of their bladder in public or faint without any help being available. The success of treatment usually depends on the severity of the phobia. The person is first taught, then practices, techniques of relaxation.
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What are the symptoms of agoraphobia?
Some patients with anxiety disorders may benefit from the combination or sequential use of psychotherapy and pharmacotherapy treatment modalities. The combined approach is said to offer rapid relief, high effectiveness, and a low relapse rate. Treatment with high-potency benzodiazepines is usually continued for six months to a year. One drawback of these medications is that patients may experience withdrawal symptoms—malaise, weakness, and other unpleasant side effects—when the treatment is discontinued. Reducing the dose gradually generally minimizes such problems.
Emergency Care
When relaxed, the individual imagines the components of the phobia, working from the least fearful to the most fearful. People with agoraphobia may become housebound for years, resulting in impairment of their relationships. It has been estimated that more than one-third of people with agoraphobia do not leave their homes and are unable to work. As you can see, these items are very specific and situationally-focused. In other words, you don’t rate how much you panic in general, but how much you experience specific thoughts while encountering specific situations.
How is agoraphobia diagnosed?
You may be asked about your medical history and you will be asked about the nature, duration, and severity of your anxiety symptoms. Approximately one-third to half of those diagnosed with panic disorder will also develop agoraphobia. The National Institute of Mental Health (NIMH) reports that agoraphobia occurs to approximately 0.9% of adults in the U.S. population in any given year.
Agoraphobia: What Causes It and How to Treat It
When this occurs, the person still has a fear of being stuck in a situation where escape would be difficult or humiliating. However, they generally do not fear having full-blown panic attacks. In panic disorder, panic attacks recur, and the person develops an intense fear of having another attack. This fear—called anticipatory anxiety or fear of fear—is present most of the time and can seriously interfere with the person's life, even when a panic attack is not in progress. The majority of people with panic disorder showed signs of agoraphobia and anxiety before they developed panic disorder.
Cognitive therapy can teach you new ways to think about or face situations that cause panic and help you be less afraid. Sometimes your therapist may suggest exposure therapy, in which you gradually start to do some of the things that make you anxious. If you have it, your fears keep you from getting out into the world.
The process usually starts with imagining yourself in progressively more anxiety-provoking situations and using relaxation techniques to combat your feelings of anxiety. Biology — including health conditions and genetics — personality, stress and learning experiences may all play a role in the development of agoraphobia. Exposure and response prevention is a type of therapy that’s used to treat agoraphobia.
Symptoms and Causes
You work your way to the end of the list, when you can either imagine a panic-inducing situation without panicking or can actually leave the house without panicking. By Katharina Star, PhDKatharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. Determination of which drug to use is based on considerations of safety, efficacy, and the personal needs of the patient. People with agoraphobia can be seriously disabled by their condition. There are many drugs that your doctor might suggest for agoraphobia, but the most common are antidepressants.
Since caffeine, certain illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, they should be avoided. Check with your physician or pharmacist before taking any additional medications. Many people with anxiety disorders benefit from joining a self-help or support group and sharing their problems and achievements with others.
But with proper treatment — usually a form of therapy called cognitive behavioral therapy and medicines — you can escape the trap of agoraphobia and live a more enjoyable life. Extended periods of isolation may increase the risk of developing agoraphobia. For example, fear caused by the COVID-19 pandemic combined with isolation caused by social distancing and quarantines has increased anxiety for many Americans.
The two main types of medications for treating agoraphobia are antidepressants and benzodiazepines for anxiety. The therapeutic approach may include some systematic desensitization, in which the person gradually confronts avoided situations with the support and guidance of their therapist. Some research has shown that integrating exposure therapy with psychodynamic treatment has been beneficial in panic disorder with agoraphobia. Many times, the person will fare better in facing their fears if accompanied by a trusted friend. Although many people with agoraphobia will also have panic disorder, it is possible to be diagnosed with agoraphobia without having a history of panic disorder.
If a person does develop agoraphobia with panic disorder, symptoms typically begin to occur within the first year that the person starts having recurring and persistent panic attacks. A person may be described as having agoraphobia if other mental disorders or medical conditions do not provide a better explanation for the symptoms. Additionally, it is common for people with agoraphobia to also abuse alcohol and sedative medication as a way of coping with their distress. But with treatment, you can manage the symptoms and lead a full life. If agoraphobia or any anxiety disorder affects the way you live your life, talk to a healthcare provider.
Anxiety, like many other mental health conditions, can be harder to treat if you wait. Agoraphobia is an anxiety disorder that involves an extreme and irrational fear of being unable to escape a difficult or embarrassing situation. People fear they will experience panic or other incapacitating symptoms when trapped in a public and inescapable setting. Using cognitive behavioral therapy (CBT), a mental healthcare provider can help you recognize thoughts that cause you anxiety. In the study, as predicted, scores on the PAI were related to all facets of panic and agoraphobic symptoms, even after the research team controlled for other possible factors.
According to The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), agoraphobia is frequently diagnosed along with panic and other anxiety disorders. Once you have successfully managed your anxiety in your imagination, you can use your relaxation techniques in real-life situations. This technique can be learned through a variety of self-help resources and applications, but it can be more helpful to learn desensitization through the guidance of a professional therapist.
Initial onset is typically in late adolescence or early adulthood, although agoraphobia can occur in childhood as well. By Lisa FritscherLisa Fritscher is a freelance writer and editor with a deep interest in phobias and other mental health topics. Applied relaxation is a series of exercises that help you notice when you start to feel tense and learn how to relax your muscles and ease that tension.
Eventually, you’ll be able to take part in activities that produce anxiety, and you’ll know how to manage your emotions. Over time, therapy can train your brain to think and respond differently. Bolster that coping efficacy, and your panic should subside. The goal of systematic desensitization is to become gradually desensitized to the triggers that are causing your distress.
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