Causes and risk factors
There are various theories about the causes of agoraphobia. It is found that agoraphobia develops as a response to repeated exposure to anxiety-provoking events, feeling of emptiness. It tends to run in families and may have a genetic factor contributing to its development. Agoraphobia often accompanies another anxiety disorder, such as panic disorder or a specific phobia.
Clinical presentation
Patient fears to go in places, from where escape seems difficult. Commonly feared places and situations are elevators, bridges, public transportation, shopping malls, airplanes, other crowded places like market etc. Patient shows symptoms like anxiety or panic attack [Acute severe anxiety], overdependence on others, sense of helplessness, being housebound [Inability to leave your house for long periods], fear of being alone, disorientation. Physical symptoms like light headedness, difficulty in breathing, dizziness, excessive sweating, rapid heart rate, flushing are seen. Patient suffers from nausea and vomiting, upset stomach or diarrhoea, chest pain, feeling of loss of control, trouble swallowing, numbness and tingling in extremities due to the anxiety.
Investigation
Medical history by the patient and psychological evaluation by the psychiatrist or psychotherapist helps in diagnosis. Anxiety should be ruled out from that out of post traumatic stress disorder. Diagnosis is confirmed if the patient avoids situations that cause anxiety, such as going out of the house and being in open spaces; the symptoms are caused by anxiety and anxiety is not related to some other condition such as depression; patient feels anxious in crowds, public places, travelling alone, or away from home and shows any other above mentioned mental or physical signs and symptoms.
Treatment
Treatment involves psychotherapy and counselling which involves cognitive and behavioural therapy , relaxation techniques to combat the problem. Individual and family therapy, public interaction techniques, social involvement, spending quality time with your family will also help in managing the condition. Medications such as antidepressants, anti anxiety or antipsychotic drugs may be required. Systematic desensitization is a technique used to treat phobias. In this technique, the therapists will make you relax completely and you have to imagine the things which make you anxious.
Other Modes of treatment
The other modes of treatment can also be effective in treating agoraphobia. Bach flower therapy is an effective treatment against psychological diseases. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating agoraphobia.
