Panic Attacks in Open Spaces (Agoraphobia)

Panic attacks are strongly associated with agoraphobia, which is an anxiety disorder involving the fear of not being able to escape a difficult or embarrassing situation.

As a result of this fear, many people who suffer from this condition avoid public and open spaces and often confine themselves to places in which they feel safe, such as their home. It is not uncommon for people to have difficulty moving away from these places into open spaces.

Definition

Although agoraphobia is commonly thought of as a fear of open spaces, this is not clinically accurate when the nature of the condition is properly considered.

The mostly likely reason for this misconception can be explained by the derivation of the work from ancient Greek. Agora is a term that refers to the meeting place of a town or city where people would discuss various issues and includes a number of public places, also described as open. Thus, agoraphobia is a fear of these open places, particularly as the victim feels like they are unable to escape.

Causes

Any condition that has the potential to inhibit an individual from going outside into the public due to an irrational fear may be responsible for causing agoraphobia. These conditions may include:

• Obsessive compulsive disorder
• Post traumatic stress disorder
• Social anxiety disorder
• Social phobia or anxiety
• Fear of having a panic attack

When these fears amount to the level of anxiety to stop an individual from leaving their safe haven, the condition may be described as panic disorder with agoraphobia.

Diagnosis

It is important to distinguish agoraphobia when diagnosing panic attack disorder and it is common practice for medical professionals to check for signs of agoraphobia when making a diagnosis of panic attack disorder.

The defining characteristic of agoraphobia is the staying within safe territories and avoiding public and open spaces at great lengths.

This can, in fact, make it difficult to diagnose the condition, as often people who suffer from the condition do not feel comfortable to leave the house and seek help for the condition.

Management

In the treatment of agoraphobia, it is important that the aim of therapy involves integration into public spaces as normal, in addition to the disappearance of panic attacks.

Exposure treatment and systemic desensitization are often used to help individuals feel more at ease in situations that usually result in fear and panic attacks. This is often more successful if they are accompanied by a trusted friend that can help them if the need arises.

In the case that a panic attack does occur in a public space, it is important the individual remain in the area until the anxiety has improved. This is because distancing themselves from the situation can lead to worsening of the phobic response in the future.

Adequate counseling and helping the individual to relax can be very helpful for improving the condition and prevent anxiety and panic in these situations. Medications also have a role to play in the treatment of agoraphobia. Benzodiazepines can aid individuals to help them regain control over physical symptoms when they are experiencing a panic attack.

To aid in the prevention of attacks, some anti-depressants such as SSRIs may be used. These are able to alter the way in which individuals respond to situations as they have effects that tend to decrease symptoms of panic.

References

• http://www.nlm.nih.gov/medlineplus/ency/article/000923.htm
• http://www.anxietycare.org.uk/docs/agoraphobia.asp
• http://www.patient.co.uk/health/agoraphobia-leaflet
• http://www.nhs.uk/conditions/Agoraphobia/Pages/Introduction.aspx