Tuesday, September 26, 2017 7:26

Agoraphobia

Posted by on Wednesday, September 30, 2009, 12:35
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The term Agoraphobia was coined in ancient Greece to describe “fear of the marketplace” In current usage.

Agoraphobia is more broadly defined as the avoidance of many different places and situations that on surface seem unrelated.

Different people have different rosters of situations to avoid and these may expand, contract or shift over time.

According to the diagnostic manual, you have Agoraphobia if:

  • You are afraid of going places or doing things from which you might not be able to escape if you have a panic attack.
  • Because of these fears, you avoid these situations or enter them only with great discomfort or with a trusted companion.

You may be afraid to crowded places like:

  • a supermarket, department store, or movie theater
  • of driving on a bridge or a busy highway
  • of talking public transportation
  • of traveling farther than a specified distance from home
  • of being home alone
  • or all of these

The seemingly haphazard pattern of fears makes sense once you understand how agoraphobia typically develops. Agoraphobia is the end result of your desperate attempt to control panic attacks by avoiding the situations that seem to trigger them.

Unfortunately, this fails to contain the problem because panic attacks arise more from within than from without and are likely to keep popping up in different situations. For example, if your first panic attack occurs while driving on a crowded interstate highway, you might begin by avoiding rush hours. As more attacks occur, the universe of dreaded situations widens and your life constricts. The next panic attack begins while you are driving on a bridge, so that bridges are added to you inventory of forbidden places.

The level of impairment and suffering caused by Agoraphobia varies widely from person to person. Some people with this problem are among the most disabled of the patients we ever see in psychiatry and can become visual prisoners in their own homes. Others can move around freely only within prisoners in their own homes.

For example someone who must avoid both bridges and busy interstates has to travel twenty circuitous miles in slow moving traffic on local roads to get to work. In very mild version, getting around poses no particular problem so long as the person can avoid relatively few feared situations like crowed stores or restaurants.

Some people will venture into feared situations if certain precautions are taken. Ensuring an escape route may allow you to do things that would otherwise be impossible choosing an aisle seat in a movie theater, or a table near the bathroom in a restaurant, or taking the local as opposed to the express train because in has more frequent stops.

Certain situations may be especially difficult because they afford not easy way out. Bringing along a companion a trusted friend or family member often works wonders but can also become a crutch that is hard to give up unless you also start venturing forth on your own. Sometimes, the phobic companion can be inanimate object or a pet.

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