This is extreme fear or anxiety associated with certain situations and places and these situations are actively avoided. This means that the person deliberately plans to avoid agoraphobia places, such as not using public transport, avoiding certain stores or shopping centres. Typically, anxiety in agoraphobic situations will take the form of a panic attack.
Signs & symptoms
To have a diagnosis of agoraphobia a person must experience significant fear or anxiety about 2 or more of the following situations:
- Using public transport (e.g. buses, trains, trams, ferry, plane)
- Being in open spaces (e.g. in the country, in a parking lot, bridges, markets)
- Being in enclosed places (e.g. shops, cinemas, theatres)
- Being in crowded situations, or standing in a queue
- Being outside of the home alone
Around about 1.7% of adults and adolescents are diagnosed annually. Females have twice the rate of agoraphobia in comparison to males. Onset occurs most frequently in adolescence and early adulthood.
Treatment for agoraphobia is very similar as for panic disorder (see below).
- The psychological approach most frequently used is Cognitive Behavioural Therapy. Relaxation and thinking strategies, to get some control over anxious feelings and thoughts (including realising that fears are likely not to come true) are used in the initial approach, along with education to understand the body’s anxiety response to feared situations. Graduated exposure is used to gradually overcome the feared situation. For example, in overcoming a fear of using buses, exposure might begin with just standing at a bus stop, then getting on a bus (at the depot) but not going anywhere, to eventually taking increasingly longer bus routes. This is done in conjunction with relaxation and cognitive (thinking) strategies.
- Medication may also be used if symptoms are severe, in particular some types of antidepressants are also useful in treating anxiety. This type of medication is preferred over the short acting and addictive drugs such as benzodiazepines. These types of medications are only used for brief periods of time.