Agoraphobia is a type of anxiety disorder. A person with agoraphobia fears leaving environments they know or feel safe. People with agoraphobia see their home as the only safe place in severe cases; They may avoid leaving their homes for days, months or even years. People with agoraphobia can often avoid being in places where they think it would be difficult to escape immediately, such as shopping malls, public transport, and open places (parking lots, etc.) or closed places (theatres, etc.). Agoraphobia is especially common in people with panic disorder. According to researchers, panic disorder with agoraphobia tends to be chronic, while panic disorder without agoraphobia tends to come and go in stages. Experts also report in Comprehensive Psychiatry in April 2014.stated that it coexisted with obsessive compulsive disorder (OCD).

WHAT IS AGORAPHOBIA?

Agoraphobia is a serious type of anxiety disorder characterized by an irrational and intense fear of being trapped in a particular place or being unable to escape. Agoraphobia can trigger intense fear and anxiety in situations where escape may be difficult or difficult to reach. Common examples of situations or places that cause fear and anxiety include waiting in line at a bank or supermarket checkout, sitting in the middle of a long line in a theater or classroom, and using public transport such as a bus or plane.

Situations that can trigger fear in people with agoraphobia include:

  • Crowded or closed areas
  • Open and remote areas
  • being away from home

WHAT CAUSES AGORAPHOBIA?

There are a number of theories as to what can cause agoraphobia. Although the exact cause of agoraphobia is not known, it is believed to result from the interaction of biological, psychological and environmental factors. For example, extreme introversion is associated with an increased likelihood of being diagnosed with agoraphobia. People with avoidant, dependent, and involved personality traits may also be more likely to develop agoraphobia.

The mental health theory (psychoanalytic theory), which focuses on how people respond to internal emotional conflicts, defines agoraphobia as the result of a feeling of emptiness arising from an unresolved Oedipal conflict. While agoraphobia, like some mental disorders, is associated with a number of psychological and environmental risk factors, it may occur for some individuals due to a genetic component.

WHAT ARE THE RİSK FACTORS FOR AGORAPHOBİA?

Agoraphobia can develop at any age; however, symptoms usually appear between the ages of 25-35 and affect women more often than men.

People who feel discriminated against are thought to be at higher risk of suffering from a number of anxiety disorders, including agoraphobia.

Having a history of panic attacks is also a risk factor for the development of agoraphobia. Agoraphobic individuals are also at risk of experiencing panic attacks. Other anxiety disorders that tend to co-occur with agoraphobia include social anxiety disorder (social phobia) and generalized anxiety disorder.

In summary, risk factors for agoraphobia may include:

  • People with panic attacks
  • People with an anxious / nervous temperament
  • Individuals with a family history of agoraphobia or panic disorder
  • Stressful life events such as abuse, death of a parent, being attacked, or bullying a child
  • Environmental stressors including trauma (physical or emotional), unemployment, and low socioeconomic status
  • Struggling with other phobias

WHAT ARE THE SYMPTOMS OF AGORAPHOBIA?

The primary symptom of agoraphobia is anxiety about certain situations in which escape may be difficult or inevitable. Common situations that cause anxiety in people with agoraphobia include:

  • waiting in line
  • crowds
  • restaurants
  • movie theaters
  • Appointments
  • using public transport

Anxiety can affect the body in a variety of ways, and each person can experience anxiety very differently. Indeed, there are many symptoms associated with agoraphobia. Some of the symptoms may include:

  • high heart rate
  • a feeling of fear or dread
  • Sleep disturbance, feeling tired
  • concentration disorder
  • excessive sweating
  • dry mouth
  • difficulty breathing
  • chest pain
  • Shake
  • nausea and diarrhea
  • The urge to escape from the current situation
  • dizziness
  • difficulty swallowing
  • feeling like you’re going to faint
  • Fear of death

HOW IS AGORAPHOBIA DIAGNOSED?

Agoraphobia is not anxiety about a single situation. A person with agoraphobia is extremely anxious about at least two of the following:

  • Using public transport (Taxis, buses, trains, boats, planes, etc.)
  • Parking lots, marketplaces, bridges, etc. be in places
  • Being in closed areas such as elevators, theaters and cinemas
  • Being in long queues and crowds
  • leaving the house without anyone else

Your doctor will likely ask a number of questions that may aid in the diagnosis. He or she may ask the doctor questions such as:

  • What symptoms do you have that worry you?
  • When did you first notice these symptoms?
  • In which situations do the symptoms increase the most?
  • What are the factors that increase or decrease the severity of the symptoms?
  • Do you avoid any situation or place because you fear it will trigger your symptoms?
  • How do your symptoms affect your social life?
  • Have you been diagnosed with any medical conditions?
  • Have you ever received treatment for your psychological disorders?
  • Have you ever thought of hurting yourself?
  • Do you use alcohol or recreational drugs? How often?

Agoraphobia can be diagnosed based on:

  • signs and symptoms
  • In-depth interview with the doctor
  • Detailed examination to rule out other conditions that may be causing your symptoms
  • The criteria for agoraphobia listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, may also be helpful in diagnosis.

HOW IS AGORAPHOBIA TREATED?

Treatment options for agoraphobia depend on the specific symptoms a person is experiencing and how severely they are affected. Simple approaches in treatment; exercise, relaxation techniques, improved sleep hygiene, identifying and eliminating stressors, and spending time with natural support groups (family and friends). All of these can relieve symptoms and improve a person’s quality of life. Most patients will benefit from an element of psychological therapy, including cognitive behavioral therapy.

In general, antidepressants are more effective than anti-anxiety drugs in the treatment of agoraphobia. However, there are some undesirable side effects that affected individuals should be aware of before starting this treatment.

For example, some antidepressant medicines have been associated with a number of unwanted side effects, some of which are listed below:

  • Nausea
  • weight gain
  • feeling tired
  • dizziness, irritability
  • Worry
  • Decreased sex drive in adults

As an alternative to drug therapy, cognitive behavioral therapy has been shown to be effective for some individuals suffering from agoraphobia. Through cognitive behavioral therapy, individuals affected by agoraphobia can learn to develop important skills to help them better manage and cope with anxiety-related symptoms.

People who are repeatedly exposed to the things they fear most through exposure therapy will eventually become desensitized to these situations and be able to face them more confidently. Exposure therapy is a popular therapy for patients with agoraphobia. In exposure therapy, the person gradually confronts fears. For example, a person who is afraid of leaving the house alone may start by stepping outside of their house or walking around their house.

Treatment can be complicated because patients have difficulty in going to their appointments due to their fears. Because of this, some therapists may go to an agoraphobic patient’s home to do the first sessions.

FREQUENTLY ASKED QUESTİONS ABOUT AGORAPHOBİA 

What is the connection between Covid-19 restrictions and agoraphobia?

For some people with agoraphobia, the meaning of quarantine and social distancing measures to limit the spread of Covid-19 has been a matter of debate. According to the Anxiety and Depression Association of America; especially for those with panic disorder, living conditions during the pandemic likely exacerbated symptoms or caused regression in people who had made some progress in their treatment.

Is it possible to prevent agoraphobia?

Because agoraphobia often develops as a fearful response to having a panic attack, prevention of agoraphobia often focuses on developing ways to cope with the anxiety about the possibility of another panic attack without leaving the person’s home. The previously described treatments for agoraphobia are often also used to prevent the development of agoraphobia.

On the other hand, agoraphobia can be managed with some lifestyle changes such as:

  • avoiding alcohol, drugs, and caffeine
  • A healthy and balanced diet
  • do regular exercise
  • practicing breathing exercises

What are self-help tips for agoraphobia?

The key to overcoming agoraphobia is learning to control the symptoms of anxiety and being able to address feared situations.

In the treatment of agoraphobia, a doctor should definitely be consulted. However, there are also some methods that the person can apply on their own.

Breathing should be slow : Hyperventilation, that is, breathing very quickly and shallowly, can make panic attack symptoms worse. It is important for the person to slow down their breathing. With each inhalation, concentrate on the expansion of the abdomen, not the chest.

Relaxation techniques should be used: Gradual muscle relaxation movements, regular exercises should be done. It is known that regular exercise reduces anxiety levels. The doctor should be consulted for more information and advice.

One must learn about one’s own situation: Overcoming agoraphobia involves understanding how anxiety affects the mind and body.

Exposure can be increased gradually: This practice involves confronting the feared environment in a controlled manner. With regular practice, the fear of places or situations will be alleviated. This technique is also known as systematic desensitization.

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