What is agoraphobia?
Agoraphobia is a mental disorder which is seen in the DSM-IV, as part of various anxiety disorders.
Generally speaking agoraphobia is the fear of leaving a familiar and safe environment. This may take the form of fear of open spaces, squares, streets, situations where many people come together in embarrassment or fear to be, or not be able to return. "Also traveling (eg train, bus or car) can cause anxiety.
The condition can occur in varying degrees. In mild cases the person feels or unrest, but is able to move in public places. His social contacts were more normal. In severe cases, the person retreats to a place he considers as reliable or secure as much as possible and avoid contact with others. This can sometimes take years and lead to severe social isolation. Of course also all kinds of intermediate forms.
If there is a panic attacks, agoraphobia can also have a different picture. The disorder is seen as an anticipatory anxiety, a fear of fear as it were. These are in this case is not so much the open spaces or groups of people who the person instill anxiety, but it is expected to have a panic attack. This fear leads in turn to avoid situations in which the person thinks will panic.
Agoraphobia is often seen as the opposite of claustrophobia (fear of enclosed spaces), but this is perhaps a bit oversimplified. In a train can agoraphobia and claustrophobia example cause the same anxiety or anxiety symptoms, at least in the perception of the bystanders. In the first case, however, the fear of leaving the familiar environment, in the second case, the fear of being trapped in the train.
The DSM-IV sees agoraphobia alone as an independent disorder if there is no strong panic attacks (agoraphobia without history of panic disorder), but shares in the panic disorder with agoraphobia if this is the case. In this context, the manual suggests the following criteria for the independent disorder:
- A. The presence of Agoraphobia related to fear of developing panic-like symptoms (eg, dizziness or diarrhea).
- B. There are no criteria for panic disorder present.
- C. The disturbance is not a direct consequence of the ingestion of a substance (e.g., drugs, medication) or a general medical condition.
- D. In the case of a general medical condition is anxiety, as described in criterion A clearly more severe than normal in the general medical condition.
If there is indeed panic, the following criteria:
- A. Fear of places or situations from which escape is difficult or embarrassing or where no help is available if you experience a panic attack or panic-like symptoms. Until the agoraphobic fears among typical situations including just left home, are in a crowd, standing in a queue, standing on a bridge or traveling in a bus, train or car. Note: if the avoidant behavior is limited to one or only a few situations, the diagnosis of a specific phobia should be considered. If the avoidant behavior is limited to social situations, there may be a social phobia.
- B. The person avoids situations (for example, travel is restricted), there is obvious stress or fear of a panic attack or panic-like symptoms, or the person wants to have a companion.
- C. The anxiety or phobic behavior can not be explained as a manifestation of another mental disorder, such as Social Phobia (eg, avoidance of social contact for fear of embarrassment), Specific Phobia (eg, avoidance of specific situations such as an elevator ), obsessive-compulsive disorder (for example, the avoidance of dirt by someone with fears of contamination), post-traumatic stress disorder (for example, avoidance of stimuli that are associated with a strong stress factor) or separation anxiety (e.g., avoidance to leave home or family).