Agoraphobia
You took an escalator to your office and suddenly felt frightened. You came out anxious and sweating. Almost similar situation occurred when you took the escalator in the shopping mall. There were too many people around and you almost felt stranded in there. Similar situations have occurred during flights, sports grounds, cinemas theatres, and many other places. You described it to a friend and you were consoled not o worry about it. The friend came with you on your next excursion and you felt better. You are confused. You may have agoraphobia!
About Agoraphobia
Agoraphobia is fear of unfamiliar environment. You may get anxious and frightened in stadiums, market places, escalators, trains, aircrafts, shopping malls, and many more places. The fear can get intense enough to cause anxiety and even leave you confined to your house.
If you suffer from agoraphobia you may be in grip of fear. You may fear crowded places like a market place or parties, and feel miserable in closed environments like an elevator or aircraft. You feel like getting back home if it is too long since you left home. You are afraid to be alone and become dependent on others. You feel helpless and may develop physical signs like a fast breathing and heart rate, sweating, flushing, chest pain, upset stomach, and feeling of vomiting, and a feeling of light head.
Agoraphobia can occur at any age though it mainly affects adolescents and young adults, and commonly occurs in women. You have a higher risk of agoraphobia if you get anxious and nervous easily or suffer from panic disorder. You may have developed agoraphobia after a stressful life event like loss of a loved one, a broken marriage, or an unfortunate incidence of sexual abuse.
The worst consequence of agoraphobia is the tendency to confine oneself at home. This perpetuates the vicious cycle of anxiety. You may get over anxious and then depressed. You may even fall prey to alcohol or drug abuse to cope with the anxiety, isolation, and loneliness. You may become dependent on a friend or family member and lose your independence.
Causes
Agoraphobia is an unexplained fear and anxiety. The cause is not well understood. When there are physical signs, agoraphobia is believed to be a type of panic disorder. In this disorder, the individual loses control over oneself and feels frightened enough to simulate a situation of a heart attack. Agoraphobia can then be described as a situational panic attack, on that occurs in particular places or circumstances.
Diagnosis
Agoraphobia is diagnosed based upon the narration of the symptoms during an interview with a doctor. A constant fear and tendency to avoid a place or situation which is not familiar, is difficult to get out of, and in which one has experienced anxiety earlier, is almost diagnostic of the disorder. These may resemble panic disorder or social phobia. In some situations, you may need to undergo a detailed psychological interview with your doctor or health care provider.
Treatment
Agoraphobia can be treated with medicines for anxiety or depression. The common drugs that help fight anxiety are alprazolam and clonazepam that belong of the class of benzodiazepines. To fight depression, you may be prescribed one of the antidepressants like the selective serotonin reuptake inhibitors (SSRIs) or the tricyclic antidepressanst (TCAs) or monoamine oxidase (MAO) inhibitors. The SSRIs include drugs like sertraline, fluoxetine and paroxetine. TCAs include amitriptyline, doxepin, desipramine, and others. MAO inhibitors include phenelzine and tranylcypromine. You will need careful dosing with these agents as these should be gradually increased in dose and gradually withdrawn. Besides this, these medicines may show reactions with other medicines that you may be taking for other medical conditions like convulsions, bleeding disorders, or some antibiotics taken to treat infections. You may need to refrain from alcohol and even some foods like cheese and grapes when on MAO inhibitor therapy.
Psychotherapy forms the mainstay of therapy. You may need to undergo cognitive behavior therapy. Your psychologist or psychiatrist will help you to learn how to control the panic symptoms and anxiety. You may be able to identify the main triggers and learn to avoid them. You may also need exposure therapy where you will be made to confront the stimulant situation that can precipitate the panic attack and you will progressively learn how to avoid the fear and anxiety. Seek help from family members and friends. Some breathing and relaxation techniques, meditation, and yoga can help. You may need both medical and psychotherapy.
Counseling is very effective in panic disorders. You may find ample time and space to express your fears and discuss your symptoms. It will enable you to make choices and decisions. Take one of your family members with you when you for counseling. Since you may not be very comfortable to leave home, you can try one of the online counselors.
Prevention
Prevention of agoraphobia is challenging. You need to help yourself. When you experience mild fear, do not give up. Try and be in the place for a little longer. You can ask one of your family members or friends to help you to get acclimatized to the place or situation. If you suffer from panic disorder, get it treated. This will prevent agoraphobia. Participate in a support group and complete all your treatment plans. Avoid alcohol or smoking. Include exercise in your daily routine. Eat a healthy diet and develop a hobby. Learn to go easy. Relax and avoid too much of tension and anxiety for anything in life.
Live fearless
Do not drown in your own fears. Get out of home and seek help. Release yourself. Agoraphobia may not be easy to handle, but with will power and help from the loved ones, you can overcome it.
