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What Agoraphobia is and How Therapy Can Help Manage It

What is agoraphobia
Written by:

Rabia Khaliq

MSc in Applied Psychology
Reviewer:

Umar Javed

Dr. MBBS

Content

Medical Disclaimer
The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient’s unique health circumstances and needs.Read more

According to agoraphobia definition, it is the excessive and unreasonable fear of crowded spaces where one thinks escape would be difficult. It may occur in places that can potentially make you feel trapped, helpless, or extremely embarrassed when you have a panic attack.

In the 11th version of the ICD [1*] (International Statistical Classification of Diseases and Related Health Problems), agoraphobia falls under anxiety or phobic disorders. In this article, let’s learn more about the major symptoms of this condition and treatment options, focusing on the benefits of psychotherapy.

Phobias often prevent people from living the lives they want. Don’t let it control your well-being.

Agoraphobia Meaning

Whenever a person with agoraphobia [2*] is in crowded or enclosed places, they feel trapped, and their anxiety levels rise. Their thoughts spiral as they focus on how hard it would be to escape if something bad happened. As they visualize the helplessness of their situation, they begin to panic. They exhibit panic attack symptoms, such as difficulty breathing, excessive sweating, or increased heartbeat. Consequently, the more thoughts of fear of being trapped accumulate, the more they stimulate the development of agoraphobia.

Since people with agoraphobia fear going outside or being in crowded places, they prefer staying in environments where they feel safe. In most cases, that’s their home. Sometimes, they may rely on someone they trust to accompany them outside their homes. However, severe cases of agoraphobia can leave patients housebound for years. It also affects their social life since they may fail to attend their jobs, visit friends or meet up anywhere outside their homes.

Agoraphobia Symptoms

Common symptoms of agoraphobia are:

  • Fear of enclosed places such as elevators or movie theaters.
  • Fear of crowded places such as the mall or standing in line.
  • Fear of leaving home without a companion.
  • Fear of using public transport like trains, buses, and airplanes.

When placed in a situation where they must be in the above-mentioned situations, agoraphobic patients experience panic attacks.

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 [3*] ), diagnostic criteria of agoraphobia note that a diagnosis should establish that the patient has:

  • Marked and irrational fear for more than six months when presented with any two of the situations (crowded places, public transportation, etc.) they fear.
  • Avoidance behavior since they are scared to come outside.
  • Fear that is disproportionate to the actual situation.
  • Anxiety or panic attacks upon exposure to the phobic stimulus.
  • Social or occupational dysfunction due to their fear and anxiety.
  • No underlying medical illnesses that may trigger similar symptoms.
  • Another mental health condition does not better explain symptoms.

Phobias can be treated successfully with the help of a medical professional.

Agoraphobia Treatment

After diagnostics, doctors use medication and therapy to treat agoraphobia.

Medication

Medicine [4*] can include antidepressants like selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines to lower anxiety. The physician can also prescribe beta-blockers like propranolol to stabilize the patient’s heartbeat during panic attacks.

Agoraphobia symptoms

Cognitive-Behavioral Therapy

The best treatment for agoraphobia is cognitive-behavioral therapy (CBT). It teaches patients to adopt a positive thinking process to break a cycle of negative behavior and thoughts. The therapist studies the patient’s psychology to understand the cause of fear and trains the patient to overcome their fear when exposed to phobic stimuli.

Since therapists understand the patients’ fear of going outside their homes, the initial sessions can take place online or on call. As treatment continues, the patient may become comfortable with physical sessions.

Ask a mental health professional about suitable treatment options for phobia treatment.

Dialectical Behavior Therapy

Doctors can also use dialectical behavior therapy (DBT) for agoraphobia treatment. The difference between DBT and cognitive-behavioral therapy is that DBT trains patients to accept and change their conditions. Dialectical behavior therapy works well for individuals who feel fear, depression, or anxiety intensely.

Treating agoraphobia through DBT requires active involvement from the patient as they go through four stages:

Stage 1: Distress tolerance. The patient deals with destructive behaviors caused by intense emotions. For example, the patient leaves the house to face their fears.

Stage 2: Emotional Regulation. The patient learns to recognize the onset of fear and label it fear or anxiety. After this, the patient starts to work on adjusting their emotions. A good example is learning to replace negative thoughts with positive ones to ease the disproportionate fear of feeling trapped.

Stage 3: Mindfulness. Patients learn to live in the present, being aware of themselves and others. The therapist will help patients improve their self-esteem and their social life.

Stage 4: Interpersonal effectiveness. The patient learns to face conflict and interact with people without fear. The patient is no longer afraid of being around people in crowded or enclosed places. They can now handle their emotions and thoughts.

The therapist would administer DBT in four parts [5*] that would benefit an agoraphobic person:

  • Individual sessions between the patient and the therapist.
  • Group meetings with other patients and the therapist.
  • Inter-session contact between the patient and physician when necessary.
  • Peer consultation meetings for all physicians involved in the patient’s treatment process. This way, they can offer treatment specific to the patient’s needs.

In Conclusion

Fortunately, agoraphobia is a curable condition. Once your doctor has diagnosed agoraphobia, they will prescribe a suitable treatment. Medications, cognitive-behavioral therapy, or dialectical behavior therapy can be the best treatment solutions. Psychotherapy encourages active participation and interaction between the doctor and patient toward recovery, while medicines help reduce the symptoms. If you have fears that prevent you from living a fulfilling life, contact MEDvidi doctors to go through a symptoms check.

Sources

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+5 sources
  1. ICD-11 for Mortality and Morbidity Statistics
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  2. Agoraphobia: Phenomenological aspects, associated characteristics, and theoretical considerations. (1984)
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  3. Agoraphobia. (2022)
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  4. Diagnosis and treatment of agoraphobia with panic disorder. (2007)
    Source link
  5. The Structure of Standard DBT: The Four Skill Modules
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Written by:

Rabia Khaliq

MSc in Applied Psychology
Reviewer:

Umar Javed

Dr. MBBS
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in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.