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Agraphobia
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Intense anxiety about being in places or situations from which escape might be difficult or embarrassing.  These situations are avoided or else are endured with marked distress combined with anxiety about having a 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.

The patient has anxiety about being in a place or situation from which either or both, escape was difficult or embarrassing or If a panic attack occurred, help might not be available.

The patient:

Avoids these situations or places (restricting travel )
or;
Endures them, but with material distress (a panic attack might occur)
or;
Requires a companion when in the situation

Criteria have never been met for Panic Disorder 

The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

The symptoms do not represent Bereavement.

The anxiety or phobic avoidance is not better accounted for by another mental disorder, such as Social Phobia (avoidance limited to social situations because of fear of embarrassment), Specific Phobia (avoidance limited to a single situation like elevators), Obsessive-Compulsive Disorder  (avoidance of dirt in someone with an obsession about contamination),  Posttraumatic Stress Disorder  (avoidance of stimuli associated with a severe stressor), or  Separation Anxiety Disorder  (avoidance of leaving home or relatives).

If an associated general medical condition is present, the fear described is clearly in excess of that usually associated with the condition.

Associated Features:

Depressed Mood
Somatic/Sexual Dysfunction

Addiction

Anxious or Fearful or Dependent Personality

Differential Diagnosis:

Some disorders display similar or sometimes even the same symptom. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which one needs to be ruled out to establish a precise diagnosis

Panic Disorder with Agoraphobia;
Social Phobia;
Specific Phobia;
Major Depressive Disorder;
Delusional Disorder;
Obsessive-Compulsive Disorder;
Separation Anxiety Disorder;

Cause:

Many agoraphobics develop the disorder after first suffering a series of panic attacks usually in public places.  The attacks seem to occur randomly and without warning, making it impossible for a person to predict what situation will trigger such a reaction. The unpredictability of panic attacks, "trains" the victims to anticipate future panic attacks and, therefore, to fear any situation in which an attack may occur. As a result, they avoid going out in public. Agoraphobia victims also are likely to develop depression, fatigue, tension, spontaneous panic and obsessive disorders

Treatment:

Counseling and Psychotherapy [ See Therapy Section ]:

Treatment usually involves desensitization or exposure therapy through which the sufferer is exposed to the source of the phobia and gradually learns to overcome the fear. Exposure therapy can significantly reduce or end phobic reactions for at least seven years.  It is based upon having the person relax, then imagine the components of the phobia, working from the least fearful to the most fearful. Graded real-life exposure has also been used with success to help people overcome their fears.

Pharmacotherapy [ See Psychopharmacology Section ] :

Therapy is often combined with medication, such antianxiety and antidepressive medications are sometimes used to help relieve the symptoms associated with phobias. Dependency on the medication is a possible side effect of this treatment.

SSRIs;
TCAs;
Benzodiazepines;
MAOIs
    


DSM Code

300.22 Agoraphobia Without History of Panic Disorder.

F40.0 Agoraphobia.

Disorder Sheets

Anxiety UK
Zion Community Resource Centre
339 Stretford Road,
Hulme,
Manchester, M15 4ZY
Helpline: +448444775774
E-mail: info@anxietyuk.org.uk
Web: http://www.anxietyuk.org.uk/

  

agoraphobia-support.co.uk
Tele: +441206364636
Email: diane@agoraphobia-support.co.uk
Website: http://www.agoraphobia-support.co.uk/

Recommended Book

Constructing Panic: The Discourse of Agoraphobia - Click Here to View

 

Agraphobia

Agrapohobia


Misc Information

None

Phobic Disorder's