Dr. Sidawi is an Orlando based, UF trained physician who is happy to be serving the community he grew up in by offering a combination of psychiatric medication management and psychodynamic psychotherapy.
Agoraphobia is an anxiety disorder characterized by an intense fear of situations where escape may be difficult or help might not be available. Individuals with agoraphobia often avoid public places, crowds, or even leaving their homes due to fear of experiencing distressing symptoms. This blog post will explore the signs and symptoms of agoraphobia, its DSM-5 diagnostic criteria, epidemiology, prognosis, comorbid conditions, and how it can be differentiated from similar disorders.
Fear and Avoidance: Individuals with agoraphobia experience intense fear or anxiety about being in situations where they might have a panic attack or feel trapped. Commonly feared situations include public transportation, open spaces, enclosed places, standing in line, or being in a crowd.
Panic-like Symptoms: Symptoms may include rapid heartbeat, dizziness, nausea, difficulty breathing, sweating, and feelings of impending doom when in feared situations.
Significant Distress or Impairment: The avoidance behavior significantly disrupts daily activities, work, and social relationships.
Persistent Symptoms: Symptoms typically persist for six months or longer.
According to the DSM-5, the diagnostic criteria for agoraphobia include meeting the following conditions:
A. Marked fear or anxiety about two (or more) of the following situations:
Using public transportation
Being in open spaces
Being in enclosed places
Standing in line or being in a crowd
Being outside of the home alone
B. The individual fears or avoids these situations due to thoughts that escape might be difficult OR help might not be available if they experience panic-like or embarrassing symptoms.
C. The situations almost always provoke fear or anxiety.
D. The situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety.
E. The fear or anxiety is disproportionate to the actual danger posed by the situations.
F. The symptoms are persistent, typically lasting six months or longer.
G. The avoidance, fear, or anxiety causes significant distress or impairment in social, occupational, or other areas of functioning.
H. If another medical condition is present, the fear or avoidance is excessive.
I. The symptoms are not better explained by another mental disorder (e.g., social anxiety disorder, specific phobia, PTSD, separation anxiety disorder, or panic disorder).
The annual prevalence of agoraphobia is about 1.7%.
The incidence peaks in late adolescence and early adulthood.
Females are twice as likely as males to experience agoraphobia.
The course of agoraphobia is usually persistent and chronic.
If untreated, the remission rate is around 10%.
More than 33% of individuals with agoraphobia are homebound and unable to have gainful employment.
Other anxiety disorders such as specific phobias, panic disorder, and social anxiety disorder are common. These may precede the onset of agoraphobia.
Major depressive disorder, PTSD, and alcohol use disorder are also common, typically as a secondary result of agoraphobia.
Separation Anxiety Disorder: In separation anxiety disorder, the fear is about being away from significant others and the home environment (e.g., parents or attachment figures). In contrast, agoraphobia focuses on panic-like symptoms or other incapacitating or embarrassing symptoms in two or more feared situations.
Social Anxiety Disorder (Social Phobia): In social anxiety disorder, the primary fear is being negatively evaluated by others.
Panic Disorder: Agoraphobia should not be diagnosed if the avoidance behaviors associated with panic attacks do not extend to two or more agoraphobic situations. Panic disorder’s hallmark is a fear of having future panic attacks.
Acute Stress Disorder and PTSD: These can be differentiated from agoraphobia by determining whether the fear, anxiety, or avoidance is related only to situations that remind the individual of a traumatic event. If avoidance behavior does not extend to two or more agoraphobic situations, agoraphobia should not be diagnosed.
Agoraphobia is typically treated with a combination of therapy and medication:
Cognitive-Behavioral Therapy (CBT): CBT helps individuals gradually face feared situations while modifying irrational thoughts and anxiety patterns.
Exposure Therapy: Gradual exposure to feared situations in a controlled manner can help reduce avoidance behaviors.
Medications: Selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines or other as needed medications may be prescribed to manage symptoms.
Support Groups and Mindfulness Practices: Engaging in support groups or mindfulness techniques can provide additional coping mechanisms.
We are happy to be a part of your journey towards mental health, or at least point you in the right direction. Please either fill out the contact form below, call or email and we will get back to you as soon as possible. We are now scheduling adults age 18 and up residing in Florida for initial appointments. Unfortunately due to laws around cash pay we cannot currently see patients who have Medicare or Medicaid.
Email: Info@AnalyzePsych.com
Phone: 407-900-9656
Dr. Phillips:
7450 Dr Phillips Blvd Suite 314
Orlando, FL 32819
Winter Garden:
310 S Dillard St Suite 135
Winter Garden, FL 34787
Copyright © 2024 Analyze Psych LLC. All rights reserved.