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Agoraphobia Introduction and Overview
Agoraphobia is an anxiety disorder characterized by an intense fear "...about being in places or situations from which a possible escape might be difficult or embarrassing, or in which help may not be available in case of a panic attack or panic-like symptoms" (DSM). The term agoraphobia is often misunderstood and confused with its literal definition (fear of "open spaces"). However, agoraphobia is not limited to a fear of open spaces, but rather fear of situations, locations, or activities associated with anxiety and/or panic-like symptoms. Panic-like symptoms include at least one of the panic attack symptoms (palpitations, pounding heart, accelerated heart rate, sweating, chills or hot flashes, trembling or shaking, sensation of shortness of breath, sensation of choking, chest pain or discomfort, nausea or abdominal discomfort, dizziness or lightheadedness, tingling sensations) or symptoms that can be embarrassing or incapacitating (such as a sudden attack of dizziness, a sudden attack of diarrhea, loss of bladder control, vomiting in public).
Agoraphobia has an insidious evolution. It usually begins after a first seemingly "out of the blue" panic attack. This first episode is usually followed by a visit to the emergency room with the concern a heart attack has occurred. If the medical investigation reveals no health related causes, the person starts associating the panic attack with the initial situation it occurred in, which might be avoided in the future. The avoidance behavior increases when the panic attacks repeat in similar or different situations. The fear and worry of experiencing similar episodes troubles the person which they will eventually avoid or fear to face alone other situations where possible panic attacks can occur. In time and without a proper treatment, the avoidance behavior will expend over a wide range of situations, locations, and activities.
It is estimated that approximately 5 to 12 percent of Americans are affected by agoraphobia at some point within their life. About 3.2 million Americans age 18 to 54 are living with agoraphobia. Agoraphobia is twice as common among women than men, and its average onset age is between 15 and 35.
Article by Alina Morrow
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