Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Agoraphobia is a fear of being outside or otherwise being in a situation from which one either cannot escape or from which escaping would be difficult or humiliating.
Like other phobias, agoraphobia often goes unreported, probably because many phobia sufferers find ways to avoid the situations to which they are phobic.
Agoraphobia often occurs in combination with panic disorder.
Agoraphobia occurs alone in less than 1% to almost 7% of the population.
There are a number of theories about what can cause agoraphobia, including a response to repeated exposure to anxiety-provoking events or a reaction to internal emotional conflicts.
As with other mental disorders, a number of factors usually cause
agoraphobia, it tends to run in families, and for some people, there may be a clear genetic factor involved in its development.
Symptoms of agoraphobia include anxiety and subsequent avoidance of being in a situation in which one will have a panic attack, when in a situation from which escape is not possible, or is difficult or embarrassing.
The panic attacks associated with agoraphobia, like all panic attacks, may involve intense fear, disorientation, rapid heartbeat, dizziness, or diarrhea.
The situations that people with agoraphobia avoid and the environments that cause people with balance disorders to feel disoriented are sometimes quite similar, leading some cases of agoraphobia to be classified as vestibular function agoraphobia.
Agoraphobia tends to begin by adolescence or early adulthood.
Girls and women, Native Americans, middle-aged individuals, low-income populations, and individuals who are either widowed, separated, or divorced are at increased risk of developing agoraphobia.
Suffering from virtually any other anxiety disorder increases the risk of developing agoraphobia.
Symptoms of agoraphobia should be treated when the signs and symptoms of the associated anxiety are not easily, quickly, and clearly relieved.
Physicians often diagnose and treat agoraphobia when patients seek treatment for other medical or emotional problems rather than as the primary reason that care is sought.
To diagnose agoraphobia, the treating psychiatrist or other physician will usually take a careful history, perform or refer to another doctor for a physical examination, and order laboratory tests as needed. Any medical condition or other emotional problem will be considered.
Cognitive behavioral therapy and exposure therapy are the most effective psychotherapies
that treat agoraphobia.
Medications like SSRIs, beta-blockers, and benzodiazepines most commonly treat agoraphobia. The risk of overdose, addiction, or need for increasingly higher doses make benzodiazepines a less desirable treatment for agoraphobia.
Agoraphobia increases the likelihood that the person will also suffer from another anxiety disorder and that both conditions will be more severe and difficult to treat.
Agoraphobia tends to occur more often in individuals who have a number of different physical conditions.
If left untreated, agoraphobia may worsen to the point where the person's life is seriously affected by the disease itself and/or by attempts to avoid or conceal it.