Agoraphobia impacts all aspects of a person’s life.
What is a Phobia?
Anxiety disorders cover a vast array of symptoms. One category of anxiety disorder (mood disorder) is a phobia. People suffering from phobias have a “persistent fear of an object or situation”, usually disproportional to the actual threat, and they will go to “great lengths in avoiding” this threat, or suffer with “marked distress and…interference in…activities”. Diagnosis of a phobia, according to the DSM-IV-TF (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), requires that the patient has proximity to the feared encounter in real life. If they fear something that they will likely never encounter, then the diagnoses cannot be made. For example, having a fear of snakes but living in a region where there are no snakes could not lead to a phobia diagnosis. The phobias have several subtypes, such as fear of spiders (arachnophobia), a specific phobia, or social phobias and generalized fears, such as agoraphobia (fear of leaving a familiar and safe area, such as the home) or a fear of contamination. Specific phobias have five subtypes: animal, situation, blood-injection-injury, natural environment, situational, and other.1
One of the most debilitating types of phobias is agoraphobia. Patients with this disorder avoid situations that could trigger a panic attack, or a feeling of being embarrassed, trapped, or helpless. The fear is of an “actual or anticipated situation”, such as being in an open spaces, being in a crowd, using public transportation, etc. Agoraphobia often develops as a result of a patient having had a prior panic attack. The patient then tends to avoid the location where the panic attack occurred. At first, the patient may utilize a support person to get through public places, but over time, the patient may ultimately no longer leave the home.2 Agoraphobia has a tendency to run in families, and it is more often found in females, starting around the teen to early adult years. Symptoms may include panic attacks, which involve having rapid heartbeat, dizziness, fearfulness, disorientation, or diarrhea. Patients could also have other disorders such as generalized anxiety disorder and social anxiety disorder.3
Some of the drug treatments for panic and phobias are benzodiazepines. While these medications are relaxing, they can lead to overdose and addiction, especially if alcohol is consumed. Valium, Xanax, Klonipin, and Ativan are some of the benzodiazepines.4 Agoraphobia does need to be treated, however. Overdependence on others, not leaving the home, trouble breathing, and the fear of dying are some of the serious symptoms that may occur.5 Besides benzodiazepines, patients may be prescribed antidepressants, such as SSRIs (Paxil, Prozac). These have fewer side effects than MAOIs or tricyclic antidepressants. Talk therapy or counseling is also important for patients. One of the most effective psychotherapies for phobias is cognitive behavioral therapy.6 There are some herbal and dietary supplements offered for agoraphobia and anxiety, but some, such as kava, carry risks. In the case of kava, liver damage is possible.7 Some alternative therapy options for agoraphobia include massage therapy, aromatherapy, Reiki, yoga, tai chi, and making lifestyle changes to reduce stress, eliminate caffeine, and increase exercise.8 In a case report, a middle-aged woman who had agoraphobia and panic attacks resulting from an automobile accident had reduced anxiety, “an end to the agoraphobia attacks”, and other physical and emotional symptom relief after two months of chiropractic care and counseling.9
Learn more about chiropractic and mood disorders.