Agoraphobia – An overview

Agoraphobia is a state of having an intrinsic fright of attending crowded areas, civic places, or open spaces, and at times comes with anxiety assaults. However, the terminology is extensively misinterpreted. Its wordy meaning implies an apprehension of "open spaces". Notwithstanding, it is not an appropriate way and rather ambiguous mode of looking at it.

Agoraphobics are not generally and frequently afraid of open spaces. They are rather fearful of undergoing panic-stricken emotions, whatever place or wherever time such fearful feelings may possibly engender. For many, this takes place at home, in community gathering or worship places, or in jam-packed supermarkets, places that are certainly not "open".

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In reality, agoraphobia is a state which takes over when an individual shuns spaces or state of affairs that induce anxiety. typical "phobic situations" might contain circumstances like driving, shopping, crowded places, traveling, standing in line, being alone, meetings and social gatherings. (Nayman 2010)

Experts say that agoraphobia occurs due to inner nervousness conditions which later develop so extreme that the sufferer turns paranoid of going in places where panic feelings or anxiety arise. Once the panic attacks begin, these occurrences turn into an ongoing strain.

This normally directs an increase in the numbers of panic attacks and, for some individuals, a surge in such situations or events can produce panicky feelings. A handful might experience apprehensive feelings constantly, more emotions of overall distress, instead of panic.

Therefore, agoraphobia is both – an intense form and a phobia, besides being a prototype of a shunning behavior. (Nayman 2010) Some agoraphobics may suffer from this phobia so ruthlessly that they totally housebound themselves, due to which they rarely go outside.

Many people consider agoraphobia as contradictory to claustrophobia (fear of being locked in closed spaces, e.g. elevators) – however, it is not merely a fright of open spaces.

Agoraphobia may cause due to the fear of leaving outdoors, a sort of open space - but it is NOT an anxiety of being in vast openness and without walls, a roof or other peripheries, etc. This trepidation of going outdoors offshoots from an anxiety of being humiliated, cornered and vulnerable someplace while having a panic attack that is never thought to occur within one’s own home. (Gournay 1989)

According to the estimates of National Institute of Mental Health (NIMH), in America around 3.2 million Americans suffer from agoraphobia. The normal age of the beginning of agoraphobia is 20 years.

The Causes:

Professionals are not as confident and certain as to what are the exact causes of agoraphobia. Many assume that it might be a product of physical (excessive anxiety) and/or psychological factors how it is connected to an anxiety disorder.

Many people suffering from panic disorder will ultimately develop a state of agoraphobia, because normally agoraphobics undergo a panic attack or disorder which with the passage of time turns into an intense phase of anxiety. The condition might become a traumatic health and social phase that anxiety ridden individuals end up find them trapped in. (Gournay 1989)

History of Agoraphobia:

In the mid 1960's Agoraphobia was termed as a ‘Phobic Anxiety Disorder’ A prominent German neurologist Westphal was the first to coin the word in 1871. Westphal emphasized on the significance of anxiety interconnected with the condition.

Later researches prove that mostly women as compared to men go through this kind of phobia. (depressionguiude.com) phobia.depression-guide.com/agoraphobia.html Physical symptoms of agoraphobia: Sufferers happen to undergo the symptoms when they experience such situations or surroundings that induce anxiety in them.

Physical indications may be uncommon since a number of agoraphobic individuals evade situations which they perceive will activate panic. However, if symptoms do appear, they might include: Increased heart beat and an increased breathing rate (hyperventilating).

Feeling hot, going red, Stomach upset, Diarrhea, trouble swallowing, breaking out in a sweat, nausea, shivering, trembling, dizziness, feeling light headed, if about to faint, & ringing in the ears. (medicalnewstoday.com)

Psychological Symptoms:

The Psychological symptoms are sometimes related to the physical symptoms of the phobia which might include:

Anxiety that people will take in observation a panic attack, which results in disgrace and discomfiture.

Fear that they would be unable to breathe throughout a terror assault, their heart my stop working, or, resulting in their death.

Fright that the sufferer himself/herself is going wild and out of control.
Other exclusive possible psychological symptoms may include: decrease in morale and self-esteem, out of control sensation, stress, general feeling of dread and anxiety. Thinking that without the help of others the sufferer himself/herself would never be able to function or survive.  Dread of being left alone. (medicalnewstoday.com)

Behavioral symptoms:

Behavioral symptoms of agoraphobia may be:

Dodging - Escaping from surroundings and situations that may prompt anxiety. In some instances this may be moderate, in which the patent shuns all crowded and public places.

In extreme episodes, he/she totally house bounds him/herself, or ties at the hip of a close friend or loved one. Avoids going in a crowded train. In some very intense occurrences the person can't leave the house or considers it impossible to do so.

Encouragement - the sufferer direly needs encouragement or reassurance from someone very close. He/she might go out to shops or marketplaces provided a trustworthy friend comes along too. On the contrary, in acute instances the sufferer can't bear or stand being alone at all.

Safety measures - needing to take along some items in order to confront or face boldly the environment or places triggering anxiety. For instance, some of such individuals need to have an alcoholic drink before stepping into a crowded place, while others may not go outside until they are sure to keep their tablets along.

 Run away – escaping or running away from nerve-racking places or situations straight away and going back home. (medicalnewstoday.com)

How To Identify Agoraphobic Students And Assist Them To Learning Better:

A handful of American students in their final years leave their studies due to agoraphobia, & of course no individual or student in a class room student can stand being tagged as an "agoraphobic patient" or a "sufferer".

Fortunately, we have school psychologists working with great concerns on such matters, even though the process of identifying such agoraphobic students is not a herculean task, because the indications or symptoms are conspicuous enough to pin point such individuals.

The course teachers can be of great help for the psychologists seeking agoraphobic students in academia. Once identified, the process of helping them do better in their educational lives is discussed below.

Case Study And Treatment Of The Disorder:

Consider the instance of scottfin, a high school student about how she overcame this disorder.

"I am not a teen anymore, but I remember having terrible panic attacks in class. I didn't know what they were. Now don't laugh or maybe you should, but I thought I was being possessed by the devil. Don’t know why I thought that, but I didn't have anything to base what I was going through on. I finally got help from a doctor, and he put me on medication.

It made them disappear. It was a huge relief. I later learned that it is very common. I hope you will be able to get some help, and get on with your life. I want you to know it does get better. Hang in there. The teen years are hard enough, but then to have this on top of it is intolerable. I wish you the best!"

This shows that this phobia can be treated if the sufferer is ready to coordinate. And as stated earlier school therapists can do a lot to treat agoraphobics via helping them develop coping skills to curb their fright and anxiety. Systematic desensitization, a sort of cognitive behavioral therapy (CBT), is a viable behavioral method used to cure agoraphobics.

It is based on the foundation of getting the person relaxed, asking him/her to then ponder over the gears of the phobia, operating from the slightest fearful to the most fearful. Ongoing and Steady introduction to real life phobias is also a method deployed which has practically aided patients to conquer the fears.

(Eisenstadt 2003) According to some findings at National Institute of Mental Health, approx 75% agoraphobics having specific phobias shed their fears through this method of cognitive-behavioral therapy. (psychologistanywhereanytime.com)

Anti-apprehension and anti- trauma remedies are often prescribed to help reduce the indicators’ toll on this disorder. Some drugs which facilitate in controlling the operation of serotonin (brain’s secretion controlling transmissions relating mood changes) are often prescribed. Nonetheless, these prescriptions do not crack the phobia wholly; it can decrease unease so that the sufferer can handle the phobia.

Hypnotherapy or Hypnosis is another method in which patients are made to speak about their intrinsic frights being in a subconscious state. It can prove an effective therapeutic technique used by clinical psychologists. (Eisenstadt 2003)

Another famous technique to heal the disorder is called Emotional Freedom Techniques, which is assumed to be one of the most viable forms of psychological treatments. It is a method widely accepted by doctors all over the world.

However, this must be taken into account that during the handling of agoraphobia, the counselor or psychiatrist might have to travel with the sufferer or spend time with him/her personally maintain a therapeutic distance.

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