Agoraphobia is an irrational fear that a person has of open places, whether they are squares, avenues or any place where many people attend or that are too open. The first psychiatrist to use this concept was Karl Friedrich Otto Westphal, a German specialized in the study of mental illness. According to data collected by Karl, he showed that three of his patients had certain fears when entering a public area, squares, or bridges.
What is agoraphobia
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In the etymology of agoraphobia or the origin of the word agoraphobia, it is concluded that it comes from the Greek, which is broken down as follows "agora" plaza and "phobos" fear. In clinical terms, agoraphobia is the appearance of some symptoms of anxiety that a person suffers when they find themselves in situations or places in which it would be difficult for them to escape.
In general, this disorder is caused by a negative experience on the part of the person, either due to mental problems, biological factors, drug intake or stressful situations.
Psychiatric agoraphobia is nothing more than the fear of not being able to escape from a public place or not getting help when you have a panic attack. Crowds tend to activate this type of disorder and it is related to a panic attack, however, it is important to mention that, in addition to this disorder, many others can be activated that trigger physical and mental problems in the future, for example, anxiety with agoraphobia.
Among the consequences that the patient may have or experience, fainting occurs, losing body control or suffering a heart attack.
According to agoraphobia dsm, the disorders that concur with agoraphobia are the following: Agoraphobia without a history of panic disorders or episodes, panic disorders with agoraphobia, and panic disorders without agoraphobia. It is also important to mention that the age at which this disorder usually appears is between 25 and 30 years old, however, there are some exceptional cases in which agoraphobia develops between 5 and 58 years of age.
People with the highest risk factor for this disorder are those between 45 and 64 years of age.
The disorder is really based on experiencing panic attacks, but an attack of anxiety can also occur with agoraphobia, which grows exponentially according to the experiences or the exposure that the patient has to crowds or public places.
Generally, when symptoms begin to appear, the patient goes directly to health centers, they speak with specialists and doctors in general to find anomalies, but the first diagnosis is negative, which is why it is recommended to go to a psychiatrist. Patients can become stable for a time, but they also tend to relapse.
The improvement of the patient lies in his emotional state, the company of an animal or person, the empathy of society, the hormonal changes that he may present, if he has taken alcohol regularly, drugs or any contraindicated drug. That is why it is necessary to go to therapy for agoraphobia and try to cope with the situation.
Features of agoraphobia
Among the common characteristics of agoraphobic people, is to avoid situations that generate anxiety, for example, leaving their homes, making use of public transport, going to the movies, doing some kind of sport, going to restaurants, centers commercial, travel (no matter the destination), go to public places such as a library, educational institutes, work areas, etc. Being exposed to this type of situation generates problems for the patient, which is why they prefer to stay at home at all costs.
In general, women tend to be more likely to have agoraphobia, in fact, it is estimated that between 1 and 5% of women in different territories of the world have this disorder. Patients tend to experience different emotions as a consequence or response of anxiety, but they only appear in specific situations, that is, stimuli, including a panic attack due to agoraphobic experiences (caused by being in a public place), panic attack even if it is in a safe place (it has to do with the mood, because the person may be sad, happy, stressed, worried or angry and the episode begins.
It may also be the case that the panic attack is generated unpredictably in safe situations, for example, when the same person ensures that he is in a safe place, but receives internal stimuli that generate the attack, the body performs abnormal functions, the mind begins to generate catastrophic thoughts and the person loses control of himself. Finally, there is the anticipated panic attack, which happens when the patient maintains that they will soon have an anxiety attack even if there is no reason for it to happen.
Symptoms of agoraphobia
The symptoms experienced by an agoraphobic can vary depending on the severity in which it is, among them they can be dizziness, chest pain, tachycardia, fatigue or tiredness, tremors, blurred vision and a feeling of unreality among others. Those who experience this disorder conceive a wrong idea of death or that they are losing their mind, therefore they should refer to a specialist doctor to help them treat this disease before it causes irreversible damage. In addition to this, the chances of experiencing cold sweat, extreme heat, feeling like you are suffocating, excessive body shaking, a feeling of suffocation, vertigo, losing the reality of the environment you are in and chest pains are quite high.
But, it is important to note that other symptoms to suffer range from nausea and fatigue to swallowing conflicts, having the sensation of something in the stomach, such as butterflies, blindness or seeing strange lights when blinking, cramps, body tension, numbness, paleness, loss of facial or body sensation, weakness in the lower limbs and the urge to go to the bathroom.
Each patient experiences different symptoms, some may have all the aforementioned symptoms or simply have one or another symptom, however, the only thing that all agoraphobics have in common is that they ask for help right at the moment in which they have the attacks to feel safe again and put aside the feeling of danger. Another common symptom is negative thoughts, which creates an imminent emotional chaos and difficult to calm. For the agoraphobic, he is in danger, the place where he is may fall, a natural disaster, robbery or murder may occur.
Agoraphobia diagnosis
To diagnose this disorder, it is necessary to carry out a study of all the symptoms that the patient has, a prior and in-depth interview is carried out by a mental health professional so that he can determine the strategies to overcome panic and agoraphobia, to physically study the patient to be able to be clear if he suffers from other diseases or if he is healthy with the exception of the disorder, all the criteria of the world health organization or the manual of mental disorders are evaluated and the places that generate the attacks.
It is important to note that this diagnosis is made solely and exclusively by a professional at the mental level, that is, a psychologist or psychiatrist, if another person does, the diagnosis is not taken into account.
Causes of agoraphobia
This disorder is born from traumatic experiences, so the patient tries to prevent the situation from happening again and develops a defense mechanism, but this mechanism activates agoraphobia, which is why some professionals say that it is a post-traumatic stress disorder. Mental health professionals, that is, psychiatrists and psychologists, maintain that some of the situations that this type of disorder can generate are linked to sexual abuse, physical aggression, car accidents or experiences of natural disasters when I was a child or adolescent, although it can also happen in adulthood.
In addition, agarphobia is usually generated (very commonly in fact), by other types of phobias, for example, anuptaphobia (fear of being alone), claustrophobia (panic to be in closed places), acrophobia (fear of staying in the heights) hydrophobia (fear of being in water, be it the open sea or a swimming pool), enoclophobia (fear of being in crowds), hypochondria (panic of any type of disease), nyctophobia (fear of the night), chronophobia (fear of climate) and, finally, erotophobia (fear of having sex). Currently there are some agoraphobia movies that explain very well what it is like to have this disorder, for example, citadel or big sky.
Treatments for agoraphobia
In the treatment of agoraphobia, cognitive therapy is implemented through a psychologist who, in this case, will first have to observe the detailed reality of the patient, then the data is collected, analyzed and the diagnosis obtained, once this process is concluded, the The psychologist and the patient have about 10 to 20 consultations in which they will try to confront the patient face to face with the problem. In other cases agoraphobia is treated with medications such as selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors or other anxiolytic medications may also be prescribed.
It is imperative to emphasize that agoraphobia is exactly that, a phobia and must be treated with cognitive and behavioral therapies. How do you do this? The therapy for agoraphobia is nothing more than exposing the patient to anxiety-generating situations, of course, gradually so that there is no room for a severe panic attack or anxiety. The treating doctor explains to the patient everything related to the disorder they have, what causes it, what activates it and how to try to overcome it.
Therapy is really a kind of experiment in which information is collected, studied, applied and experimented on, and then gradual results are seen. If the patient knows how anxiety really acts, how it affects his life, what are the reactions it generates and why his mind feels in danger and protects himself, then he will have knowledge bases to realize that all the sensations of The danger you experience is actually false alarms.
When the treatment sessions are finished, the patient finally knows that everything is under control, that there are risk factors when being in crowded places but that the chances of having an accident or dangerous situation are really low and that if he can face real situations of danger or challenge. If there is something good that should be mentioned about this treatment, it is that the agoraphobic obtains knowledge to end all the tension in the body that he may have had or that he may have in the future, this is achieved through relaxation and breathing exercises.
Examples of agoraphobia
This disorder can make an appearance regardless of time, place or situation, in fact, some mental health professionals argue that it is not imperative that the patient is in a place surrounded by many people, it simply needs that person exposed to or away from home for the panic or anxiety attack to begin. A classic example of this disorder is that the person is in the cinema, a relatively closed place, with many people and that can trigger both this and other disorders. It can also happen in a theater, concert, in a park or in a school.
Over time, patients become very introverted and stop living as they did before, they stop going out, have a social life and begin to think that everything could end for them, they could be attacked on the street, an earthquake happens, a civil conflict, etc.
