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 defined as 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 is largely
underreported, 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 percent to almost 7 percent 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.
with other mental disorders, agoraphobia is usually caused by a number of
factors, tends to run in families, and for some people, may have 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
The panic attacks associated with agoraphobia, like all panic
attacks, may involve intense fear, disorientation, rapid heart beat, dizziness,
The situations that are often avoided by people with agoraphobia
and the environments which 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
Symptoms of agoraphobia should be treated when the
signs and symptoms of the associated anxiety are not easily, quickly, and
Agoraphobia is often diagnosed and treated 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 used to treat agoraphobia.
Medications like SSRIs, beta
blockers, and benzodiazepines are most commonly used to treat agoraphobia. The
risk of overdose, addiction, or need for increasingly higher doses make
benzodiazepines a less desirable treatment for 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.
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