Agoraphobia is an irrational fear of being trapped in places or situations where escape could be difficult or impossible. People with agoraphobia often will not leave the house. It often occurs in association with panic disorder . In this case, the affected people may fear that help will not be available in certain places in case a panic attack occurs.
The exact cause is unknown. Most people develop agoraphobia after having panic attacks. Afraid of having another attack, an agoraphobic avoids places and situations that have triggered an attack. Factors that may contribute to the development of this phobia include:
These factors increase your chance of developing agoraphobia. Tell your doctor if you have any of these risk factors:
Symptoms include:
Agoraphobia is commonly associated with the following:
Feared situations may trigger a panic attack. Attacks start quickly and peak in about 10 minutes. A panic attack usually includes four or more of the following:
The doctor will ask about your symptoms and medical history, and perform a physical exam. The doctor may also look for a medical condition, drug, or other substance that may be causing your symptoms.
You may be asked questions about your:
There are no tests for agoraphobia or panic disorder. However, you may have heart or blood tests done to look for an underlying cause.
Treatment aims to help you overcome irrational fears and live more independently. Goals include:
Treatments may include:
This therapy combines:
This therapy helps you learn to:
Commonly used drugs include:
RESOURCES:
American Psychiatric Association
http://www.psych.org/
Anxiety Disorders Association of America
http://www.adaa.org/
Mental Health America
http://www.nmha.org/
CANADIAN RESOURCES:
Canadian Mental Health Association
http://www.ontario.cmha.ca/index.asp/
Mental Health Canada
http://www.mentalhealthcanada.com/
References:
Beers MH, Fletcher AJ. The Merck Manual of Medical Information—Home Edition . 2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003.
Bernstein CA, et al. Psychiatry . Philadelphia, PA: WB Saunders Company; 1997.
Braunwald E. Harrison's Principles of Internal Medicine . 14th ed. New York, NY: McGraw-Hill; 2000.
Conn HF, Rakel RE. Conn's Current Therapy . 53rd ed. Philadelphia, PA: WB Saunders Company; 2001.
Fact sheet: phobias. Mental Health America website. Available at: http://www.mentalhealthamerica.net/go/phobias . Updated May 2008. Accessed February 13, 2009.
Ferri FF. Ferri's Clinical Advisor: Instant Diagnosis and Treatment . 8th ed. St. Louis, MO: Mosby; 2006.
Goldman L. Cecil Textbook of Medicine . 22nd ed. Philadelphia, PA: Saunders; 2004.
Goroll AH, Mulley AG. Primary Care Medicine . 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2000.
Griffith's 5-Minute Clinical Consult . Philadelphia, PA: Lippincott Williams & Wilkins; 2001.
Lenders JW, Eisenhofer G, Mannelli M, et al. Phaeochromocytoma. Lancet . 2005;20-26;366:665-675.
Last reviewed January 2009 by Theodor B. Rais MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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