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Agoraphobia


Agoraphobia or agoraphobia is an excessive fear or anxiety of places or situations that make the sufferer feel panicked, embarrassed, helpless, or trapped. Generally, agoraphobia occurs when the sufferer has experienced one or more panic attacks.

Situations or places that can cause a phobia in each person is different. Some people are afraid of certain conditions or situations, such as crowds, others are afraid of more specific things, such as blood or certain animals.

People with agoraphobia will feel excessive fear and anxiety in several places and conditions, such as public places, closed spaces, crowds, and conditions that make it difficult to get help. Usually, people with agoraphobia need relatives or friends to accompany them to public places.

Causes of Agoraphobia

Agoraphobia generally arises when a person has experienced more than one panic attack in a certain place or condition. This causes agoraphobia sufferers to fear and avoid the place or condition.

The exact cause of agoraphobia is not known. This condition can be experienced by a person since childhood, but is more common in women who are teenagers or young adults (less than 35 years).

Risk factors for agoraphobia

There are several factors that can increase a person's risk of developing agoraphobia, namely:

  • There is a fear of being the victim of a crime, having an accident, or contracting a certain disease
  • Trauma from previous experiences, such as losing a family member or experiencing torture
  • Have had another mental disorder, such as depression, bulimia, or anorexia nervosa
  • Suffering from a disorder in the part of the brain that controls fear
  • Have another type of phobia
  • Has an anxious and nervous nature
  • Have a family member who suffers from agoraphobia
  • Having an unhappy relationship with a partner, such as having a partner who is too restrictive

Symptoms of Agoraphobia

The main symptoms of agoraphobia are fear and anxiety that arise every time the sufferer thinks about, experiences, or is in certain places or conditions, such as:

  • Being in an open space, such as a large parking lot, park, or mall
  • Being in an enclosed space, such as a movie theater, meeting room, or elevator
  • Being outside the house alone
  • Using public transportation, such as bus or train
  • Waiting in line or being in a crowd

These symptoms will disappear when the sufferer stops thinking or gets out of the place and condition.

The fear and anxiety experienced by agoraphobia sufferers will generally cause physical, cognitive (thought patterns), and behavioral symptoms. The following is an explanation of the three symptoms:

Physical symptoms

The anxiety and fear experienced by people with agoraphobia can produce a variety of physical symptoms similar to panic attacks, such as:

  • Heart is pounding
  • Rapid breathing (hyperventilation)
  • Chest pain
  • Body feels hot and sweaty
  • Tinnitus
  • Trembling, numbness, or tingling
  • Stomach pain or diarrhea
  • Difficulty swallowing or choking
  • Feeling unwell or feeling like passing out

Cognitive symptoms

In addition to physical symptoms, people with agoraphobia may also experience cognitive symptoms. People with agoraphobia will generally feel embarrassed, look stupid, and lose their clear mind when in the aforementioned conditions or places.

Behavioral symptoms

The fear and anxiety experienced by people with agoraphobia can also lead to behavioral changes, such as:

  • Avoid situations that are prone to panic attacks, such as being on public transport, waiting in line, or in crowded places
  • Feeling afraid to leave the house
  • Need a friend to go outside the house

When to go to the doctor

You are advised to go to a psychologist or psychiatrist if you experience the above symptoms. Especially when the symptoms experienced often appear and have interfered with activities. Immediately see a doctor if there is a desire to hurt yourself or or commit suicide.

Diagnosis Agoraphobia

To diagnose agoraphobia, the doctor will ask about the symptoms the patient is experiencing. A physical examination and investigations, such as blood tests, will only be done to make sure the symptoms you are experiencing are not caused by another disease.

Next, the doctor will use the diagnostic and statistical manual of mental disorder (DSM-5) method to diagnose agoraphobia.

Treatment of Agoraphobia

Treatment of agoraphobia aims to relieve fear and panic, as well as teach patients how to control themselves properly when thinking about or dealing with feared situations. Below are some of the treatment methods used:

Psychotherapy

Counseling with psychologists and psychiatrists can help patients deal with their fears. Some types of psychotherapy that can be done to treat agoraphobia are:

  • Cognitive behavioral therapy or cognitive behavioral therapy (CBT), to make the patient more confident, bold, and think more positively to a situation or a place to be feared
  • Exposure therapy (desensitization), to reduce the fear experienced and assume something feared is normal
  • Relaxation therapy, to stretch muscles, while reducing the level of tension experienced when dealing with feared situations

Drugs

Drugs are used to treat complaints and symptoms that arise when the patient has agoraphobia. The drugs used include:

  • Serotonin-binding inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors ( SNRIs), or pregabalin , to relieve anxiety disorders and improve mood
  • Benzodiapines , to treat severe acute anxiety disorders

Self-help program

This program aims to help patients control their responses to things that make them panic or stress. This program consists of:

  • Lifestyle changes, such as getting enough sleep , eating nutritious foods, and reducing consumption of caffeinated or alcoholic foods and drinks
  • Relaxation , such as performing breathing techniques to help the patient relax more when dealing with agoraphobia triggers
  • Distracting the mind from the feared thing or situation, for example by looking at the movement of the clock or imagining positive things, until the panic disappears
  • Stay still and try not to run to safety when having a panic attack, to change the patient's mindset towards the feared place or condition
  • Join a group of people with agoraphobia, to share experiences and how to overcome anxiety due to agoraphobia

Complications of Agoraphobia

Severe agoraphobia that is not treated can make the sufferer always afraid, anxious, and panicked, when thinking about, experiencing, or being in the feared places and situations. Patients become unable to leave the house, go to school, or work, and cannot carry out normal daily activities.

This condition can also make sufferers have dependence on others. In addition, agoraphobia can make sufferers more susceptible to:

  • Depression
  • Mental disorders, such as anxiety disorders
  • Alcohol or drug dependence

Prevention of Agoraphobia

Until now, there has been no definite way to prevent agoraphobia. However, there are several ways you can do to reduce the intensity of the anxiety and fear that arises, namely:

  • Don't avoid going somewhere or doing certain things that are actually safe and normal.
  • Talk and ask for help from family or close friends to help you cope with your feelings
  • Consult a psychologist or psychiatrist, so that the agoraphobia you experience does not get worse and more difficult to treat.
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