What is agoraphobia?
The terms agoraphobia literally mean the fear of open spaces. However this can be a little misleading. Someone who experiences agoraphobia tends to have a number of fears of various places and situations both busy and quiet for example entering shops, public places, a lift, cinema, church or anywhere away from home. The underlying fear that causes this feeling of panic is the fear of being in a place where help will not be available or where you feel it may be difficult to escape to a safe place.

• Some individuals with agoraphobia may also suffer panic attacks (an unpredictable attack of intense fear and anxiety).
• Agoraphobia is the commonest type of phobia and is estimated to affect approximately 5% -10% of people within their lifetime.
• It usually begins between the ages of 15 and 35.
• It is twice as common in women as in men.
• Agoraphobia may start suddenly or come on gradually. Without treatment, it can continue for years and may become more severe and disabling with time.
• People with agoraphobia may also suffer from other phobias, depression and other anxiety disorders

Symptoms of agoraphobia may include:

• Anxiety in response to being away from an environment that is seen as safe.
• Symptoms of significant anxiety and sometime symptoms of a panic attack such as breathlessness, sweating, dizziness, fast heart rate, sensation of choking, nausea and feelings of extreme fear or dread.
• Anticipation of anxiety if the person is required to leave their safe place.
• Low self esteem and loss of self confidence.
• Reluctance to leave the house or familiar surrounds.

Common complications:
Untreated agoraphobia can severely reduce a person's quality of life. For example

• Activities outside of the home such as work, school, socialising, hobbies and many forms of exercise can be considered unachievable by the person experiencing agoraphobia.
• The person experiencing agoraphobia may realise that their fear is irrational but feel powerless to do anything about it. Feelings of angry and frustration may be common. These negative feelings affect self confidence and self perception.

What causes agoraphobia?
The exact cause of agoraphobia is not known. Agoraphobia and other phobias are thought to be the result of a number of physical and environmental factors. For example:

• Biochemical imbalances in brain neurotransmitters (chemical nerve messengers)
• Some individuals develop an irrational fear about a certain situation and experience a panic attack. Their brain then associates the panic with that situation and learns to avoid it.
• Genetic factors. Research studies have found that agoraphobia tends to run in families (especially when it occurs with panic disorder), but it is not clear if this is because of a genetic link or for some other reason.
• Unresolved emotional conflicts or past experiences may play a role
  All of these factors may play a role in the development of agoraphobia.

Diagnosis:
Diagnosis of agoraphobia is usually based on the individuals reported symptoms. However a series of tests may be run to rule out any physical cause of the listed symptoms.

Agoraphobia responds well to treatment. The treatment options available to someone experiencing agoraphobia will depend on their situation but could include the following:

• Medication such as antidepressants or anti anxiety medications.
• Cognitive behaviour therapy
• Psychotherapy including individual and group psychotherapy.
• Relaxation therapy
• Support group involvement.

Where to get help:
If you feel you are experiencing the symptoms of agoraphobia, contact your doctor. For details of your nearest GP please see the Outside Help section.

Support Group:
Out and About Association
140 St. Lawrence's Road,
Clontarf, Dublin 3.
Tel: (01) 833 8252/833 8253
Fax: (01) 833 4243