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Panic disorder with agoraphobia
Panic disorder with agoraphobia

Agoraphobia
Definition:
An incapacitating fear of open spaces.

Causes, incidence, and risk factors:

Agoraphobia is a disorder characterized by avoidance of crowds, and open and public places, particularly if escape or assistance is not immediately available. It may occur alone, or may accompany panic disorder.

If it occurs with panic disorder, the onset is usually during the 20's, and women are affected more often than men. People with this disorder may become house bound for years, with resulting impairment of social and interpersonal relationships.
Symptoms:
  • Fear of being alone
  • Fear of losing control in a public place
  • Fear of being in places where escape might be difficult
  • Becoming house bound for prolonged periods
  • Feelings of detachment or estrangement from others
  • Feelings of helplessness
  • Dependence upon 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
Additional symptoms that may occur:
Signs and tests:

There may be a history of phobias, or the health care provider may receive a description of typical behaviors from family, friends, or the affected person. The pulse (heart rate) is often rapid, sweating is present, and the patient may have high blood pressure.
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 behavioral technique used to treat phobias. It is based upon having the person relax, then imagine the components of the phobia, 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.
Expectations (prognosis):

Phobias tend to be chronic but respond well to treatment.
Complications:

Some phobias may have consequences that affect job performance or social functioning.
Calling your health care provider:

Call for an appointment with your health care provider if symptoms suggestive of agoraphobia develop.
Prevention:

As with other panic disorders, prevention may not be possible. Early intervention may reduce the severity of the condition.
Review Date: 5/18/2001
Reviewed By: Christos Ballas, M.D., Department of Psychiatry, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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