Fear of open spaces, but can reflect a fear of panic attacks.

Individuals are afraid of being in situations which may be difficult to escape from, or in which they feel if they had a panic attack no one would be able to help them.

Patients fear the embarrassment of having or being seen having a panic attack.

Includes avoidance of a specific situation, like enclosed spaces, being outside of the home alone, due to fear about the ability to escape, or the availability of help if panic attacks or related symptoms occur.

Patients avoid being at home alone, crowded places including stores, restaurants, malls, enclosed or confined areas like tunnels, bridges, trains, buses, subways and aircraft.

Fear traveling and want to be accompanied by others when leaving home.

Usually become homebound.

Refers to an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives their environment to be unsafe with no easy way to escape.

Sufferers of this condition become anxious in unfamiliar environments or where they perceive that they have little control.

1.7% of adults are affected.

Occurs about twice as commonly among women as it does in men.

Panic disorder with or without agoraphobia affects roughly 5.1% of Americans, and about 1/3 of this population with panic disorder have comorbid agoraphobia.

It is uncommon without panic attacks, with only 0.17% of people with agoraphobia not presenting panic disorders as well.

Believed to be due to a combination of genetic and environmental factors.

Condition often runs in families.

Women are affected about twice as often as men.

Often begins in early adulthood .

Les common in the elderly.

It is rare in children.

Stressful or traumatic events such as the death of a parent or being attacked may be a trigger.

Situations can include open spaces, public transit, crowds, shopping centers, traveling, or simply being outside their home: all may result in a panic attack.

It is often, but not always, compounded by a fear of social embarrassment.

Patients fear the onset of a panic attack and appearing distraught in public.

Classified as a phobia.

Symptoms may occur nearly every time the situation is encountered.

Symptoms can last for more than six months.

Patients attempt to avoid precipitating situations.

Severely affected individuals may become completely unable to leave their homes.

Complications may lead to depression, and substance use disorders.

Caused by genetic and environmental factors.

Risk factors: Family history, experience of a stressful event.

Differential diagnosis: Separation anxiety, posttraumatic stress disorder, major depressive disorder.

Treatment is with cognitive behavioral therapy, that leads to resolution in half the patients.

Agoraphobia is also defined as fear by those who have experienced one or more panic attacks, where the. patient is fearful of a particular place because they have experienced a panic attack at the same location at a previous time.

Any irrational fear syndromes, like obsessive compulsive disorder or post-traumatic stress disorder can also cause agoraphobia.

Temporary separation anxiety disorder may occur other members of the household depart from the residence temporarily.

Sometimes there is fear of waiting outside for long periods of time, called macrophobia.

Panic attacks are associated with epinephrine release in large amounts, triggering the fight-or-flight response.

Symptoms of a panic attack include palpitations, rapid heartbeat, sweating, trembling, nausea, vomiting, dizziness, tightness in the throat, shortness of breath, fear of dying or of losing control of emotions and/or behaviors.

There is a link between agoraphobia and difficulties with spatial orientation.

A disproportionate number of agoraphobics have weak vestibular function and consequently rely more on visual or tactile signals for their balance. so they may become disoriented when visual cues are sparse.

When visual clues are sparse as in wide-open spaces, or overwhelming as in the presence of crowds, disorientation may occur.

Patients with agorhophopia can be confused by irregular surfaces have impaired processing of A/V data.

Chronic use of tranquilizers and sleeping pills such as benzodiazepines has been linked to onset of agoraphobia.

Alcohol use disorders are associated with panic with or without agoraphobia due to the long-term distortion in brain chemistry.

Tobacco smoking is associated with the development and emergence of agoraphobia.

Most people who present with agoraphobia after the onset of panic disorder

It is an adverse behavioral outcome of repeated panic attacks.

It leads to anxiety and preoccupation with these attacks and avoidance of situations where a panic attack could occur.

Often the early treatment of panic disorder can prevent agoraphobia.

Agoraphobia is present when symptoms are worse than panic disorder, but also do not meet the criteria for other anxiety disorders such as depression.

In rare cases the formal diagnosis of agoraphobia without history of panic disorder is used, primary agoraphobia.

The process of desensitization can provide lasting relief to the majority of patients with panic disorder and agoraphobia.

Many can deal with situations easier if they are accompanied by a friend.

If situational anxiety is not abated prior to leaving the phobic response will not decrease and it may even rise.

Psychological interventions in combination with pharmaceutical treatments are more effective than either modality alone.

Cognitive restructuring is useful in treating agoraphobia, using discussion, with the intent of replacing irrational, counterproductive beliefs with more factual and beneficial ones.

Relaxation techniques are often useful skills for the agoraphobic to develop, as they can be used to stop or prevent symptoms of anxiety and panic.

The treatment of agoraphobia with antidepressant medications most commonly used to treat anxiety disorders are mainly selective serotonin reuptake inhibitors, although benzodiazepines, monoamine oxidase inhibitor, and tricyclic antidepressants are also sometimes prescribed.

Antidepressants have some antipanic effects.

Management includes antidepressants used in conjunction with exposure as a form of self-help or with cognitive behavior therapy.

A combination of medication and cognitive behaviour therapy is sometimes the most effective treatment for agoraphobia.

Benzodiazepines, and anti anxiety medications are used to treat and can control the symptoms of a panic attack.

Many patients with anxiety disorders benefit from joining a self-help or support group

Meditation practices and visualization techniques can help people with anxiety disorders to calm themselves.

Evidence suggests aerobic exercise may have a calming effect.

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