Agoraphobia

Agoraphobia is a form of anxiety disorder. The word is an English adoption of the Greek words agora (αγορά) and phobos (φόβος). Literally translated in modern Greek as "a fear of the marketplace". A common misconception is that agoraphobia is a fear of open spaces. This is most often not the case since people suffering from agoraphobia usually are not afraid of the open spaces themselves, but of public spaces or of situations often associated with these spaces. more...

The Greek word agora should be interpreted using the Ancient Greek meaning of the word agora (αγορά) which translates as "where the people gather" (later "forum" in Latin), which gives the idea of a crowded marketplace rather than just an open space -- this makes the common combination of agoraphobia and claustrophobia less conflicting. Some people who suffer from agoraphobia fear social gatherings where help in an emergency might not be readily available. Others are comfortable seeing visitors, but only in a defined space they feel in control of. Such a person may live for years without leaving his or her home, while happily seeing visitors and working, as long as they can stay within their safety zone.

An agoraphobic may experience severe panic attacks during situations where they feel trapped, insecure, out of control, or too far from their personal comfort zone. During severe bouts of anxiety, the agoraphobic is confined not only to their home, but to one or two rooms and they may even become bedbound until their over-stimulated nervous system can quiet down, and their adrenaline levels return to a more normal level.

Agoraphobics are often extremely sensitised to their own bodily sensations, sub-consciously over-reacting to perfectly normal events. To take one example, the exertion involved in climbing a flight of stairs may be the cause for a fullblown panic attack, because it increases the heartbeat and breathing rate, which the agoraphobic interprets as the start of a panic attack instead of a normal fluctuation.

Agoraphobia can be successfully treated in many cases through a very gradual process of graduated exposure therapy combined with cognitive therapy and sometimes anti-anxiety or antidepressant medications.

Examples of agoraphobia mentioned in modern literature include the character of Boo Radley from Harper Lee's To Kill a Mockingbird, and in Ian Fleming's Goldfinger. In Goldfinger, the character of Auric Goldfinger pretends to suffer from agoraphobia to cheat opponents in Canasta. The British sitcom Game On also centered around an agoraphobic character.

Diagnostic criteria (DSM-IV-TR)

The DSM-IV-TR, a widely used manual for diagnosing mental disorders (see also:DSM cautionary statement), defines Agoraphobia as:

A. Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed Panic Attack or panic-like symptoms. Agoraphobic fears typically involved 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.

B. The situations are avoided (e.g., travel is restricted) or else are endured with marked distress or anxiety about having a Panic Attack or panic-like symptoms, or require the presence of a companion.

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

Agoraphobia is the chief complaint in two separate disorders: Panic Disorder With Agoraphobia and Agoraphobia Without History of Panic Disorder.

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