Agoraphobia

What is Agoraphobia?

Agoraphobia is a psychiatric condition that causes a great deal of distress for the individual. If untreated, it can greatly reduce the individual’s personal and occupational functioning, and significantly affect their relationships. Agoraphobia can cause individuals to greatly limit their activity; if severe some individuals completely stop leaving their homes due to their symptoms.

The definition of Agoraphobia according to the DSM-V includes, but is not limited to:

• Marked fear or Anxiety regarding two (or more) of the following situations:
  • Using public transportation
  • Being in open spaces (parking lots, market places, bridges)
  • Being in enclosed spaces (such as movie theaters, shops)
  • Standing in line, or being in a crowd
  • Being outside of one’s home alone
• The individual fears or avoids these situations due to concerns that escape from these situations may be difficult, or that they may develop panic symptoms (or other embarrassing symptoms, like falling, vomiting or incontinence), while in the situations.
• The fear is out of proportion to the actual danger posed by the situation.
• The fear (or level of fear) is not fully explained by another psychiatric condition or a person’s medical illness.
• The patient will often avoid the situations that they are anxious about, insist on having a companion accompany them, or experience the situation (but with a great deal of distress).

Agoraphobia is often intertwined with Panic Attack Disorder. Individuals fear certain situations, due to worry that they’ll have a panic attack in those situations, and have an inability to escape.

How Common is Agoraphobia?

Approximately 1-2% of individuals in the US have symptoms consist with a diagnosis of Agoraphobia.

Women are Twice as likely as men to suffer from Agoraphobia.

What Symptoms may a person Experience with Agoraphobia?

Individuals with agoraphobia may notice an avoidance of certain situations, due to a fear that they may either have a panic attack (or panic symptoms) or that they will experience something embarrassing (such as falling, vomiting, incontinence). The situations are often situations where it may be difficult to quickly escape (such as standing in a line, being on a bridge, or being in an open market).

Symptoms of panic that may occur in triggering situations may include:

• Racing heart
• Shortness of breath
• Dizziness or lightheadedness
• A feeling as if one is going to pass out
• Subjective feelings of anxiety
• Tremor
• “Tunnel Vision”
• Upset stomach
• Sweating/ feelings of warmth / Chills

When Should I get an Evaluation for Treatment of Agoraphobia?

We recommend that individuals schedule a psychiatric evaluation for Agoraphobia if they experience:

• Avoidance of situations due to symptoms
• Symptoms interfering with social or occupational life
• Symptoms interfering with relationships
• Symptoms reducing one’s ability to leave the house
• Anxiety related to fears affecting sleep, energy, focus, or appetite.
• Feelings of hopelessness
• High levels of anxiety or stress
• Crying episodes
• Difficulty being present with friends or loved ones
• If one is utilizing poor coping mechanisms (alcohol or substance use, gambling, sexually acting out, self-harm) to manage distress
• Suicidal thoughts

What Types of Treatment are Available for Agoraphobia?

Treatment for an Agoraphobia should be tailored to the individual. There is no one-size-fits-all treatment in psychiatry. Your treatment for Agoraphobia may include:

• Psychotherapy, such as Cognitive Behavioral Therapy (CBT) and Exposure Therapy, to increase functioning and desensitize from triggers.
• Medication Management. Medication management may be part of your Agoraphobia treatment. Specific medication utilized for an individual’s agoraphobia may include SSRI’s/ SNRI’s or others. At times, as needed medications such as beta blockers (which decrease the sympathetic nervous system’s tone (fight or flight) or other as needed medications may be appropriate.
• Behavioral modification: Recommendations regarding sleep hygiene, exercise, diet, social outlets and others, may be part of a patient’s treatment.

Do You Offer Both In-office and Virtual Online Psychiatric Appointments for Agoraphobia Treatment?

Yes, we offer both in-office and virtual online psychiatric appointments for the treatment of Agoraphobia.

Why Choose Rittenhouse Psychiatric Associates for my Agoraphobia Treatment?

The providers at Rittenhouse Psychiatric Associates are academically oriented providers, most of whom teach, or have taught, at academic institutions. Our providers are Board Certified Psychiatrists and Psychiatric Nurse Practitioners and we have several licensed and doctoral level therapists and psychologists. We are experienced in working with individuals who struggle with various psychiatric conditions, including Agoraphobia and Panic.

• Licensed Therapists and Doctoral Level Psychologists
• Board Certified Psychiatrists and Psychiatric Nurse Practitioners
• Academically Oriented providers, most of whom teach, or have taught, at local Academic Institutions, such as Johns Hopkins Hospital & The University of Pennsylvania.
• Appointments generally available within 2 weeks.
• In-office and online Virtual Appointments for the treatment of Agoraphobia and Panic.
• Providers experienced in treating co-occurring psychiatric conditions.
• Providers who are welcoming to all individuals.