Agoraphobia and Panic Disorder
Updated: Jul 15, 2022
You can get help with agoraphobia and treatment for mental health at Arise Counseling Services in York, PA.
Agoraphobia is a condition that is closely associated with panic attacks and panic disorder. If you would like to learn more about these topics, feel free to read my post about panic disorder.
A panic attack is sudden and terrifying experience of physical reactions when there is no actual apparent harm present. People report that panic attacks sometimes make them feel as though they are dying, unable to breathe, having a heart attack, etc. When a person begins to engage in avoidance behaviors of some situations that they believe will cause them to experience panic attacks, they can be diagnosed with agoraphobia.
Fear of at least two of the following: using public transportation systems, being in open spaces, being in enclosed spaces, standing in line or being in a crowd, being outside of the home alone.
A person avoids the above situations because they think that it may be difficult for them to escape or help might not be available if they were to experience a panic attack or other embarassing episode when in these settings.
These situations always almost always cause fear or anxiety
These situations are avoided or require that someone be present with them to help them through these situations, or they endure them with intense fear or anxiety.
The fear or anxiety is out of proportion to the actual threat present in the situation.
This pattern of fear and avoidance is present for at least six months.
The fear or anxiety causes significant impairment for the client in important areas of functioning.
I have conceptualized agoraphobia as a situation that has occurred where a person has been pushed further and further away from the public due to having panic attacks. In this conceptualization, a person would have a panic attack at some public place, for example while driving across a bridge, for a reason that is not obvious to them. After this point, they will avoid crossing bridges and avoid anything that reminds them of bridges. Then, they might have a panic attack one day while on a highway, and then they avoid highways. After this, they might have one at a store while waiting in line, and then they avoid stores, and so on until they have few options other than just spending most of their time at home.
I have worked with a lot of clients who have panic disorder with agoraphobia and in my clinical experience, they are not usually entirely unhappy about their status. Though they also could have other mental health illnesses such as depression, they do not always. Many clients have been perfectly content and happy to live at home and spend most of their time there engaged in hobbies and activities that they enjoy. They do, however, acknowledge that there are limitations in their lives due to agoraphobia, and that they would benefit from trying to increase their ability to engage in activities outside of the home, and I have seen many of them confront their fears and be successful at overcoming agoraphobia.
Prevalence of Agoraphobia
According to the DSM 5, 1.7 % of adults and adolescents have a diagnosis of agoraphobia and females are twice as likely as males to experience agoraphobia. Like with Panic disorder, the prevalence for people over the age of 65 and under the age of 14 is very low and it seems to be a disorder that mostly impacts people who are adolescents and adults.
Causes of Agoraphobia
Agoraphobia is similar to a lot of other mental health disorders in that they seem to be caused by both biological and environmental factors. It is clear that there is a genetic component and an environmental component to agoraphobia individuals who have a family history of anxiety disorders are more prone to developing agoraphobia. Traumatic experiences are also linked to agoraphobia. Thought I have talked a lot about panic attacks and their relatiosnhips to agoraphobia in this article, a person might also experience something like a sexual assault or mugging which leads to them having anxiety about the situations described above, or a history of physical or sexual abuse may be the cause of this fear. A person's temperament is also a predictive factor in that people who are more neurotic and anxiety sensitive are have a greater chance of developing this disorder.
At Arise Counseling Services, I provide treatment for agoraphobia. I help people to explore the underlying causes of their symptoms such as unhelpful patterns of thinking, trauma, or other problems with life. There are many different ways that I can help once these causes are identified, and I will list some of them below.
Treatment of Agoraphobia
Cognitive Behavioral Therapy (CBT): We will work together to analyze your thoughts, feelings, and behaviors to examine how these impact one another and cause your symptoms to be worse. Then we will work to change how you think about issues in your life and what you believe about yourself and the world.
Treating trauma: When you feel safe and comfortable, we will examine any traumatic experiences that you have had related to loss of attachment relationships or changes to how you view yourself so that you can stop having the effects of trauma intrude upon your daily life.
Exposure: First, you will learn and practice coping skills and grounding techniques so that you develop some ability to control your body's ability to regulate itself when it is confronted with anxiety provoking situations. Then, we will move at a pace that you select and confront some of the situations that make you feel anxious/panic in a safe way so that you can learn that you are capable of facing these fears.
Narrative therapy: I encourage clients to examine their personal characteristics and life journey and to rewrite their story so that they can change the way that they look at themselves and the trajectory of their lives.
For more information
If you would like to learn more about any of the treatments above, please contact me and I would be happy to help. If you would like some professional help dealing with your mental health concerns, feel free to schedule an appointment with me today or reach out to discuss your options. You should also subscribe to my blog and continue to follow because I intend to write more specific posts about the treatments that I use in the future.