Agoraphobia refers to a fear of any place where escape may be difficult, including large open spaces or crowds, as well as various means of travel.
- Fear or anxiety about:
- being outside of the home alone
- using public transportation
- being in enclosed places (stores, movie theaters)
- standing in line or being in a crowd
- being in open spaces (markets, parking lots)
- being in places where escape might be difficult
- Active avoidance of all situations that provoke fear and anxiety
- Becoming housebound for prolonged periods
- Feelings of detachment or estrangement from others
- Feelings of helplessness
- Dependence upon others
- Anxiety or panic attack (acute severe anxiety)
The etiology of most anxiety disorders, although not fully understood, has come into sharper focus in the last decade. In broad terms, the likelihood of developing anxiety involves a combination of life experiences, psychological traits, and/or genetic factors. Heritability for agoraphobia is reported to be 61 percent, making it the phobia most strongly linked to the genetic factor that represents predisposition to phobias. Some of the environmental factors that are known to be associated with the development of agoraphobia are experiencing stressful events (the death of a parent, being attacked or mugged) and being raised in a household characterized by little warmth and high levels of over protection.
The goal of treatment is to help the agoraphobic person function effectively. The success of treatment usually depends upon the severity of the phobia. Systematic desensitization, also called “exposure therapy,” is a behavioral technique used to treat phobias. It is based on having the person relax, then imagine the components of the phobia, working from the least fearful to the most fearful. Graded real-life exposure has also been used with success to help people overcome their fears. This technique involves exposure to real aversive situations, progressing from less to more extreme situations. For example, a person might be in contact with a few people before they progressively spend time with large groups of people in order to overcome a fear of crowds. The individual will work with a therapist to develop coping strategies such as relaxation and breathing techniques. While “in-vivo” or real-life exposure is ideal, imagined exposure is an acceptable alternative in desensitization exercises. Treating agoraphobia with exposure therapy reduces anxiety and improves morale and quality of life within 75 percent of cases.
Other types of therapy, such as cognitive therapy, assertiveness training, biofeedback, hypnosis, meditation, relaxation, or couples therapy were found to be helpful for some patients. Cognitive behavioral therapy (CBT) is a combination of cognitive therapy, which can modify or eliminate thought patterns contributing to the patient’s symptoms, and behavioral therapy, which aims to help the patient change his or her behavior.
Source : Psychology Today