Agoraphobia

Agoraphobia

Agoraphobia or agoraphobia is the excessive fear or anxiety of places or situations that make the sufferer feel panicked, trapped, helpless, or embarrassed. Generally, agoraphobia occurs when the sufferer travels or is in public places, especially crowded ones.

A phobia is a condition when a person experiences an excessive fear reaction to something. This fear can be caused by various things, for example there are those who feel afraid of a condition or situation, such as crowds, and there are also those who 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, the environment outside the home, and public transportation. As a result, the lives of people with agoraphobia risk becoming very limited and isolated.

Causes of Agoraphobia

The exact cause of agoraphobia is not known . However, this condition 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.

Agoraphobia can be experienced by someone since childhood, but this condition is more common in teenagers or young adults (less than 35 years). In addition, agoraphobia is also more common in women than men.

Agoraphobia risk factors

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

  • Feeling afraid of being the victim of a crime, having an accident, or contracting a certain disease
  • Having trauma from events that have been experienced, such as losing a family member or experiencing torture
  • Having an unhappy relationship with your partner, for example because your partner is too restrictive
  • 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
  • Suffering  from other types of phobias
  • Has an easily anxious and nervous nature
  • Have a family member who suffers from agoraphobia

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

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

  • Chest pain
  • Heart beat
  • Rapid breathing (hyperventilation)
  • Trembling, numbness, or tingling
  • Body feels hot and sweaty
  • Lightheadedness or dizziness
  • Tinnitus
  • Stomach pain, nausea, or diarrhea
  • Difficulty swallowing or choking
  • Feeling unwell or like going to faint

Cognitive symptoms

In addition to physical symptoms, people with agoraphobia may also experience cognitive symptoms, including:

  • Feeling embarrassed or looking stupid in front of others
  • Feeling nervous and shaking when being stared at by other people
  • Feeling unable to escape from a place or situation during a panic attack
  • Can't think clearly when in public
  • Having a panic attack that can make you short of breath or your heart stop beating

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
  • Avoid going outside for a long time
  • Need a friend to go outside the house
  • Feeling afraid to leave the house

When to go to the doctor

Check with your doctor  if you experience any of the above symptoms, especially when these symptoms occur frequently and interfere with your socializing, work, or other daily activities. An examination to a doctor should also be carried out immediately if there is a desire to injure oneself or commit suicide.

Diagnosis of 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.

Based on the criteria in the DSM-5 ( The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition ) , a person can be diagnosed with agoraphobia if he has experienced fear or anxiety for at least 6 months in two or more of the following situations:

  • Being in an open space, such as a parking lot or a shopping center
  • Being in an enclosed space, such as a movie theater or elevator
  • Standing in line or being in a crowd
  • Using public transportation
  • Alone when outside

Agoraphobia Treatment

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. The following are some methods of treatment that can be done:

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  (   CBT), to make the patient more confident, courageous, and think positively about the feared situation or place
  • Exposure therapy (desensitization), to reduce the fear experienced and assume something feared is normal
  • Relaxation therapy, to relax 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 experiences 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

Keep in mind, always follow the instructions for using drugs that have been prescribed by a doctor. Do not stop taking or change the dose of the drug without consulting your doctor first.

Self-help program

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

  • Living a healthy lifestyle, such as  getting enough sleep , eating nutritious foods, and reducing the consumption of caffeinated or alcoholic foods and drinks
  • Practice relaxation , such as breathing techniques to help the patient relax more when dealing with agoraphobia triggers
  • Exercise regularly, in order to increase the chemicals in the brain that play a role in regulating mood
  • Distracts the mind from the feared thing or situation, for example by watching the clock move or imagining positive things until the panic disappears
  • Try to stay still and not run to a safe place during 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 left untreated can cause the sufferer to feel afraid, anxious, and panicked when thinking about, experiencing, or being in the dreaded places and situations.

This of course can affect the quality of life. Patients may not want to leave the house for normal activities, such as going to school or working in the office. As a result, sufferers are at risk for decreased achievement and financial difficulties, and become dependent on others.

In addition, agoraphobia can make sufferers more susceptible to:

  • Depression
  • Mental disorders, such as anxiety disorders
  • Alcohol dependence
  • Drug abuse
  • Self isolation
  • Suicide attempt

Agoraphobia Prevention

To date, there has been no definitive way to prevent agoraphobia . However, there are several ways that can be done 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.
  • Train yourself slowly to go to feared places.
  • Talk to and ask family or close friends for help to help you deal with your anxiety.
  • Consult a doctor so that your agoraphobia does not get worse and more difficult to treat.
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