Agoraphobia

By Joyce Willis, MC, CPC

Agoraphobia can occur with Panic Disorder or without a history of Panic Disorder. The criteria for Agoraphobia, according to the DSM-IV-TR, (the manual used by Psychiatrists and Psychologists), are as follows:

1. Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situational Panic Attack (or panic-like) symptoms. Agoraphobic fears typically involve characteristic clusters of situations that include being outside the home alone, being in a crowd or standing in a line; being on a bridge; and traveling in a bus, train or automobile.
2. The situations are avoided (for example, travel is restricted) or else are endured with marked distress or with anxiety about having a Panic Attack or panic-like symptoms, or require the presence of a companion.
3. The anxiety or phobic avoidance is not accounted for by another disorder such as Social Phobia (for example, avoidance limited to social situations because of fear of embarrassment), Specific Phobia (for example, avoidance limited to a single situation like elevators), Obsessive-Compulsive Disorder (for example, avoidance of dirt in someone with an obsession about cleanliness or contamination), Post-Traumatic Stress Disorder (for example, avoidance of an event, place, person or such associated with a sever stressor), or Separation Anxiety Disorder (for example avoidance of leaving home or relatives).

In Layman's terms, Agoraphobia is fear of being outside of the home, or in a crowd and the inability to leave the home even to do something basic like grocery shopping without experiencing panic. Agorophobic people can, sometimes, leave the house or go shopping only with a trusted companion.Almost all Agorophobic individuals also have a history of Panic Disorder. Also, the Agorophobic condition may in actuality be a Specific Phobia – which is characterized by significant anxiety due to exposure to a specific feared object or situation, often leading to avoidance behavior.The goal of treatment for an Agoraphobic individual, Specific Phobia or a Panic Disorder is to reduce fear so the person can independently and freely leave home and be comfortable in public environments. It is important to reduce fear of the specific stimulus object or situation that provokes immediate anxiety. It is also important to remove panic symptoms and the fear that they will recur without an ability to cope with and control them.

Joyce Willis, MC, CPC © 2004 AskTheInternetTherapist.com

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