Agoraphobia – causes, symptoms and treatment

Agoraphobia – also known as claustrophobia – is the exaggerated fear of public places. It refers to situations in which escape or help from the outside seem impossible. Anxiety disorder often occurs in combination with panic disorder. This is associated with symptoms that have a strong threatening effect. Sufferers avoid corresponding situations, in some cases hardly ever leave their own four walls. Immense suffering and social isolation are the unattractive consequence. Agoraphobia is easily treatable, provided it is treated appropriately.

What is agoraphobia?

Agoraphobia – also known as claustrophobia – is one of the Anxiety disorders. The name is a combination of the ancient Greek words for "marketplace" and "fear" and gives an idea of the problem behind the psychological disorder.

This is how sufferers feel great fear of public places. Panic refers to situations from which escape seems supposedly hopeless. People who suffer from agoraphobia fear that they will not receive any help in such situations, that they will be at the mercy of others. Connected to this is Fear of losing control, what is perceived as embarrassing or – in the worst case – life-threatening. Even if sufferers are aware that their fears are exaggerated or unrealistic, this does not change how they feel. Anxiety mechanisms have become entrenched – this often happens insidiously.

The agoraphobia is always associated with a very individual aspect at. Thus, places and situations that trigger anxiety may well vary. Very often crowds perceived as extremely threatening, public places such as marketplaces, parks, department stores, cinemas or special events are consequently avoided. The anxiety disorder also occurs often associated with waiting in lines or various forms of transportation (subway, airplane, cab, …) on.

In appropriate situations, unpleasant, threatening symptoms occur. Combined with agoraphobia, panic disorder often occurs (in about 35-55 percent of all cases). Such Anxiety attacks can last for several minutes and are accompanied by severe psychological and physical discomfort associated. The experience of panic in public places often leads to the avoidance of such situations – a vicious circle begins. This is also referred to as "Fear of fear" (phobophobia). In the worst case agoraphobia can lead to depression social isolation can lead to anxiety, because the affected person can hardly leave their own four walls.

On the difference between agoraphobia and claustrophobia

Agoraphobia (claustrophobia) and claustrophobia (fear of space) are called often confused with each other. This is due in no small part to its colloquial names. It may well be Overlaps The two anxiety disorders can be very different from each other, however.
While agoraphobia – the colloquial fear of place – refers to public places, claustrophobia – also known as claustrophobia – refers to a fear of confined and/or enclosed spaces. Unlike claustrophobia, the problem with agoraphobia is not the confinement or enclosed nature of a space, but the idea of not being able to escape if in doubt, of not being able to get help.

Agoraphobia: definition

Agoraphobia can therefore be excessive fear of public places are defined. It is a common form of anxiety disorder and refers to situations in which escape or help from the outside seem impossible. Associated with this are Feelings of loss of control and shame. Most of the time, threatening symptoms accompany the claustrophobia.

Agoraphobia is more widespread than is generally assumed. About four to five percent of the population suffer from it at least once in their life. The onset may be sudden or gradual often occur first symptoms already in late adolescence at. Women are affected significantly more often than men. Moreover, claustrophobia rarely occurs in isolation. Common are other anxiety disorders (z.B.: panic disorder), Depression or Personality disorders associated with agoraphobia. Also the combination with substance abuse is not uncommon.

Agoraphobia: symptoms and behaviors at a glance

Claustrophobia has a significant impact on the perception, behavior and lifestyle of those affected. the suffering is often immense. The following is an overview of common symptoms and signs of agoraphobia:

  • Fear of / avoidance of: Crowds, public places, (traveling alone)
  • severe anxiety (fear of losing control; fear of going crazy; sometimes fear of death)
  • avoidance behavior up to social isolation
  • increased heart rate (palpitations, heart flutter, palpitations)
  • trembling, dizziness, sweating
  • dizziness, feeling of fainting
  • Feeling of anxiety, pain in the chest
  • Shortness of breath
  • nausea, stomach pain
  • headaches, weakness

How does agoraphobia develop??

The exact origin of agoraphobia – as with many other mental illnesses – is not fully understood. Currently, one can speak of a combination of genetic and genetic factors biological and psychosocial factors go out.

Thus familial accumulations clear evidence for a genetic component. A certain imitation behavior must also not be disregarded in this context. Also Dysfunctions related to the release of certain neurotransmitters (serotonin, noradrenalin) are suspected of triggering such anxiety disorders.

Likewise severe strokes of fate as the death of a close person, illnesses or accidents lead to the occurrence of corresponding symptoms. Positive experiences associated with exertion are also considered triggers (birth, change of location,…). In addition permanent strain and stress promote the occurrence of agoraphobia. In addition, traumatic experiences in childhood and afterwards (abuse, experience of violence, etc.) are triggering factors. Last but not least, the individual character a role. Anxious, avoidant individuals have a higher risk of developing an anxiety disorder.

Agoraphobia: Causes and risk factors at a glance:

  • genetic disposition
  • neurotransmitter imbalance
  • Strokes of fate (death, illness, accident,…)
  • positive challenging experiences (birth, move, job change, …)
  • Strain and stress
  • Traumatic experiences
  • individual character traits

Agoraphobia: Diagnosis

In the case of physical and psychological symptoms, the general practitioner is the first point of contact. If necessary, the latter refers the patient to the specialist (psychiatrist). In order to diagnose agoraphobia with certainty, other causes for the existing symptoms be excluded. Such can be mental or physical nature be. For example, other anxiety disorders, depression, or personality disorders are associated with similar symptoms. Combinations are also possible.
Likewise diseases of the heart or lungs, vestibular disorders or thyroid disorders cause a corresponding symptomatology. All this is carefully clarified. So in addition to a detailed anamnesis interview, at least a blood count and an ECG are usually indicated to rule out other causes. In addition, defined criteria regarding avoidance behavior as well as symptomatology must be met in order to diagnose agoraphobia.

How to treat agoraphobia?

The aim of therapy for agoraphobia is always to, reduce avoidance behavior as well as feelings of anxiety respectively, to break through completely. This not only reduces the suffering pressure, it also enables a everyday life without massive restrictions.

Predominantly a psychotherapeutic treatment – in particular behavioral therapy approaches – to the application. In particularly severe cases, a simultaneous drug treatment useful. In addition, there are a number of things that affected persons can do to support the success of the therapy. The therapy of a claustrophobia is always individually adapted to the respective situation of the patient.

Agoraphobia: Therapy

Patients with anxiety disorders respond to behavioral therapy approaches good response. Excellent results can be achieved with cognitive behavioral therapy are achieved. It is a matter of specific confrontation with existing fears and avoidance strategies within the framework of the therapeutic setting. Patients deal intensively with their fears as well as underlying thought patterns. Step by step, these are now dissolved. The aim is to get to consciously face fears.

One method for doing this, which is commonly used in behavioral therapy, is the exposure (confrontation). After appropriate preparation, the patient seeks anxiety-provoking situation usually directly to. This happens under therapeutic accompaniment, with the aim, Reduce avoidance behavior. Exposure does not necessarily have to be direct, there are also possibilities of mental confrontation.

Coming less often depth psychological methods are considered in the treatment of agoraphobia. This can be useful, for example, when dealing with past traumatic experiences.

In severe cases of claustrophobia, an additional Drug therapy be necessary. The contact person is the psychiatrist. As a rule selective serotonin reuptake inhibitors (SSRIs) to use. In justified exceptional cases, the specialist can also prescribe benzodiazepines for a short time.

What else can be done for claustrophobia?

In addition to the therapeutic approaches described above, there are a number of things that patients can do to support the success of their treatment. Have proven about special relaxation techniques like progressive muscle relaxation According to Jacobson, autogenic training or meditation. Physical activity – such as light endurance sports – also has a positive effect on anxiety disorders.
Some sufferers rely on the power of nature and apply calming herbs such as valerian, lavender, St. John’s wort or lemon balm to. Here, however, should always be Consultation with the treating physician are held. In addition, many patients find the exchange with other affected persons helpful. The visit of a self-help group is a possibility for it.

What is the prognosis for agoraphobia??

Described therapy concepts significantly improve the prognosis of agoraphobia. The earlier treatment begins, the better. In many cases, with appropriate therapy, the Quality of life immensely improved for sufferers become. The suffering pressure decreases, a normal everyday life is possible again. Without treatment, however, claustrophobia often takes a chronic course, whereby better and worse phases can alternate.

However, the therapy of an anxiety disorder is not usually about healing in the narrower sense. After all, fears are part of our lives and do have their uses. It is rather a matter of dealing with them and reducing existing suffering to a minimum.

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