A common misconception is that agoraphobia is a fear of public places or open spaces. In reality, a diagnosis of agoraphobia is much more than a common fear. Agoraphobia is a specific type of phobia which is severe enough to debilitate your life. If you have agoraphobia, you will readjust your life to avoid your fear. You may be too afraid leave your home or comfort zone. In addition, you may experience physical symptoms when confronted with the fear or even when thinking about it. Thus, agoraphobia is often diagnosed along with panic disorder.
Agoraphobia is also frequently combined with severe depression, as the isolation can cause the loss of employment and opportunities to enjoy a social life. There is a danger of suicide, and alcohol abuse or dependence on other substances often complicates treatment.
Signs of Agoraphobia
If you have an agoraphobia, you will more than likely become severely anxious when leaving a comfort zone (often your home), entering new areas, travelling alone and/or being in public places. Agoraphobia is typically a degenerative disorder meaning that it gradually gets worse. Over time, you may avoid leaving your comfort zone unless you are with a trusted friend and later you may avoid leaving your home at all. When this behavioral change occurs, it is called avoidance. Avoidance interferes with your daily functioning. You may no longer be able to work or go to school and even tasks like grocery shopping may become impossible to perform because of the disorder.
How Prevalent Is Agoraphobia?
Approximately 4% of adults are affected by agoraphobia; in the United States, over 3 million people, whose ages range from late adolescence to middle age, have been diagnosed with this disorder, with the rates for women twice those for men.
Examples of Agoraphobia
The world-famous chef, author and television personality, Paula Deen, recently admitted that she was confined to her home for 20 years because of agoraphobia. In her words, “I was on a 20-year roller coaster ride with agoraphobia. I didn’t know what I had, I would never share my feelings with anybody because I was afraid that they thought I was crazy and I had never met a fellow agoraphobic because here’s the deal about that y’all, you’re not going to meet agoraphobics out on the street … they’re hiding behind the safety of their doors at home.”
What Causes Agoraphobia?
There are several theories about the causes of agoraphobia, ranging from biological and genetic to psychological and social factors. Most likely, it is a combination of all these factors. Some studies have indicated a problem with the autonomic nervous system, the system that produces and regulates you “fight or flight” reactions. An overreaction to stimulus (such as a crowd, etc.) can affect the production and reabsorption of norepinephrine, serotonin and GABA neurotransmitters in your brain, which can result in intense anxiety and/or agoraphobia.
There is also evidence that both agoraphobia and panic disorder are hereditary. In addition, some experts believe it is a learned behavior. For example: As a child, you may witness you mother panic in a crowded mall. You, as an adult, may react in a similar manner when you are faced with crowds. Psychoanalysts believe that the separation anxiety experienced during childhood can resurface when, as adults, you find yourself alone in an unfamiliar place.
What Treatments Are Available For Agoraphobia?
When treated, the prognosis for agoraphobia is very positive. Behavior therapy has shown to be the most effective form of treatment for agoraphobia. During treatment, a therapist may use techniques such as exposure therapy, in which you are gradually introduced to the fear in a controlled environment. For example, you may first look at videos focusing on your fear. Then, you may be required to leave your comfort zone (such as home) for a short period of time. The goal is for you to eventually overcome your irrational fear so that you can live an unimpeded life.
In severe cases, agoraphobia can be treated with medications such as antidepressants. Sedatives and beta blockers can be used for dealing with the physical symptoms of agoraphobia or panic disorder. Antidepressants can also be helpful in treating agoraphobia, but it takes several weeks before their benefits become evident.
Flooding is a type of behavior therapy which is less commonly used. It follows the same idea as exposure therapy, but occurs much more rapidly. The benefit of flooding is that it is much faster than exposure therapy. However, there is a risk of worsening the agoraphobia from flooding rather than alleviating it. You may be given mild sedatives or beta blockers to deal with panic symptoms before flooding treatment occurs.
Cognitive therapy is also used for treating agoraphobia, often in conjunction with behavior therapy. It can help you recognize that your fears are irrational and that your overreaction to those fears is both unrealistic and unnecessary.
Where Can I Find More Information On Agoraphobia?
The Anxiety Disorders Association of America (ADAA) offers information about identifying, understanding and living with agoraphobia as well as other anxiety disorders. You can also find treatment in your local area just by entering your zip code. The website can be found www.adaa.org/finding-help/treatment.
Comer, R. J. (1996). Fundamentals of abnormal psychology. New York: W.H. Freeman and Company.
Kaplan, H. I., & Sadoc, B. J. (1996). Concise textbook of clinical psychiatry. Baltimore, MD: Williams & Wilkins.
Walsh, D. (2009). Q&A with Paula Deen and husband Michael Groover. FitCeleb.com. Retrieved from http://fitceleb.com/qa-with-paula-deen-and-husband-michael-groover/