Definition :
Definition The word "agoraphobia" is an English adaptation of the Greek words agora and phobos and literally translates to "a fear of the marketplace."
Agoraphobia is a condition where the sufferer becomes anxious in environments that are unfamiliar or where he or she perceives that they have little control. Triggers for this anxiety may include crowds, wide open spaces, or traveling (even short distances). This anxiety is often compounded by a fear of social embarrassment, as the agoraphobic fears the onset of a panic attack and appearing distraught in public.
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The term agoraphobia has been widely misunderstood. Its literal definition suggests a fear of "open spaces". However, this is an incomplete and misleading view. Agoraphobics are not necessarily afraid of open spaces. Rather, they are afraid of having panicky feelings, wherever. these fearful feelings may occur. For many, they happen at home, in houses of worship, or in crowded supermarkets, places that are certainly not "open".
In fact, agoraphobia is a condition which develops when a person begins to avoid spaces or situations associated with anxiety. Typical "phobic situations" might include driving, shopping, crowded places, traveling, standing in line, being alone, meetings and social gatherings.
Agoraphobia arises; from an internal anxiety condition that has become so intense that the suffering individual fears going anywhere or doing anything where these feelings of panic have repeatedly occurred before. Once the panic attacks have started, these episodes become the ongoing stress, even when other more obvious pressures have diminished. This sets up a "feedback condition" which generally leads to increased numbers of panic attacks and, for some people, an increase in the situations or events which can produce panicky feelings. Others experience fearful feelings continuously, more a feeling of overall. discomfort, rather than panic.
A person may fear having anxiety attacks, "losing control", or embarrassing him/herself in such situations. Many people remain in a painful state of anxious anticipation because of these fears. Some become restricted or "housebound" while others function "normally" but with great difficulty, often attempting to hide their discomfort.
Causes and contributing factors :
Causes and contributing factors The causes of agorphobia are currently unknown. It is linked however to the presence of other anxiety disorders, a stressful environment or substance abuse. More women than men are affected.
Research has uncovered a linkage between agoraphobia and difficulties with spatial orientation. Normal individuals are able to maintain balance by combining information from their vestibular system, their visual system and their proprioceptive sense. A disproportionate number of agoraphobics have weak vestibular function and consequently rely more on visual or tactile signals. They may become disoriented when visual cues are sparse as in wide open spaces or overwhelming as in crowds. Likewise, they may be confused by sloping or irregular surfaces.Compared to controls, in virtual reality studies, agoraphobics on average show impaired processing of changing audiovisual data.
Symptoms :
Symptoms Fear of being alone
Fear of losing control in a public place
Fear of being in places where escape might be difficult
Becoming housebound for prolonged periods of time
Feelings of detachment or estrangement from others
Feelings of helplessness
Dependence on others
Feeling that the body is unreal
Feeling that the environment is unreal
Anxiety or panic attack (acute severe anxiety)
Unusual temper or agitation with trembling or twitching
Treatment :
Treatment The goal of treatment is to help the phobic person function effectively. The success of treatment usually depends upon the severity of the phobia.
Systematic desensitization is a technique used to treat phobias. The person is asked to relax, then imagine the things that cause the anxiety, working from the least fearful to the most fearful. Graded real-life exposure has also been used with success to help people overcome their fears.
Antianxiety and antidepressive medications are often used to help relieve the symptoms associated with phobias.
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Behavior Therapy
This is where the patient gets exposed to situations that would make them panic gradually to harden them against those things. This is problematic as it is very scary for the agoraphobic and if someone else is setting these situations up there is a lack of trust and control over the entire treatment. It may work but it is long and painful and many sufferers quit before they learn to cope.
Cognitive Therapy
This is the classic 'lie on a couch and talk about your problems' approach which poses many problems for agoraphobics. It is often very hard for them to make appointments to meet therapists, it is long and costly and the presence of the therapist is an uncontrollable factor for a long time until a large amount of trust is gained. The reliance on the therapist can also just transfer the sense of control to the therapist's room not curing the root causes.
Relaxation Techniques
While not harmful and sometimes helpful no amount of breathing techniques can cure the root cause of agoraphobia, it is often used in conjunction with other treatments and helps against the symptoms but is not a cure in its own right.
Hypnotherapy
This method allows the therapist to "reprogram" the sufferers thought patterns to a degree and has been shown to work with some phobias however agoraphobics fear of handing over control of themselves are usually horrified of the thought of someone else tinkering with their brains!