Until recently agoraphobia was defined as
a fear of open spaces. It now also includes
several other related fears such as a fear
of entering shops, fear of crowds and public
places, or of travelling alone on trains,
buses or aeroplanes. It also includes the
anxiety associated with being unable to reach
a place of safety (eg home) quickly.Panic
attacks are a common feature of agoraphobia.
A panic attack is an unpredictable attack
of intense fear and anxiety. Because panic
attacks can be unpredictable, people often
worry about them happening when they have
to go into a public place. This can cause
the person to start avoiding any situation
where a panic attack might happen.
In extreme cases,
people with agoraphobia may be unable to
leave their home unless accompanied by another
trusted person.
Agoraphobia usually
begins in the late 20s and is more common
in women than men, (although that may be
because fewer men seek help).
Approximately 5% of
adults develop agoraphobia. Agoraphobia
sometimes starts suddenly and sometimes
it develops slowly. Often there is no obvious
cause. Without treatment, agoraphobia can
continue for years and may become more severe
with time.
Many agoraphobics
have other phobias too (see article on phobias).
This is described as a complex phobia.
Causes
The root cause of
agoraphobia is not known. Research studies
have found that agoraphobia tends to run
in families, but it is not clear if this
is because of a genetic link or for some
other reason.
Agoraphobia can be
treated using drugs or by using ‘talking
treatments’ like cognitive-behavioural
therapy (CBT), psychotherapy and group therapy.
Drug treatments
Two types of drug
treatments have been shown to be effective
in treating panic attacks;
Antidepressants (especially
the type known as Selective Serotonin Reuptake
Inhibitors - SSRI). SSRIs are the most commonly
prescribed drugs for panic attacks. They
usually result in an improvement in about
6-8 weeks.
Benzodiazepines are
only used for the short-term relief of more
extreme cases as they can be addictive.
Courses of the drugs are usually less than
four weeks and the drug should be withdrawn
gradually to avoid a ‘rebound’
effect.
Non-drug treatments
There is evidence
to support the use of Cognitive behaviour
therapy (CBT) in treating agoraphobia and
panic attacks. Cognitive behaviour therapy
combines two types of psychotherapy: cognitive
therapy and behaviour therapy. It is based
on the theory that most emotional and behavioural
responses are learned and the goal is to
unlearn unwanted responses and learn new
ways of reacting to situations.
Talking and sharing
experiences in individual and group psychotherapy
can help understanding and recovery from
agoraphobia.
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Agoraphobia
