Agoraphobia is a very debilitating anxiety disorder (Morris & Maisto , 2005). It can be very complex in what it involves with a patient, and is diagnosed and treated in a specific manner.
Definition of Agoraphobia
The Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV), published by the American Psychiatric Association, describes agoraphobia as “Marked anxiety or distress of leaving home, being in public places, or feared situation(s). This anxiety or distress stems from the fear of being trapped, stranded without help, or from the anxiety these situation(s) cause (Agoraphobia).” This is further broken down into specific fears/ phobias, such a fear of bridges, crowds, or of being alone (Morris & Maisto , 2005).
Diagnosing Agoraphobia
Diagnosing agoraphobia is done by taking the patients symptoms and comparing them to the diagnostic criteria in the DSM-IV. This criterion is evidence of phobias, often occurring in clusters, which fit the defined outline of agoraphobia (i.e. fear of bridges, fear of crowds, etc.). There also may be a person that the patient has deemed necessary as they are a safety against these situations (Agoraphobia).
It is important to note, that agoraphobia is also seen with persons with a history of panic attacks, and is often a result of fear of panic attacks (Perugi, Frare, & Toni, 2007). It is controversial at this time as to whether agoraphobia occurs without the history of panic attacks or a panic disorder, as it is so very closely tied to panic conditions.
Many clinical studies show that it is nearly impossible for agoraphobia to exist without the history of panic disorders, but most epidemiological studies show that it is more common for agoraphobia to exist without a past history of a panic disorder (Perugi, Frare, & Toni, 2007). This brings to the front a question as to whether panic disorders are being correctly diagnosed before a patient appears with agoraphobia.
For the purpose of this article, Agoraphobia is being considered overall, which includes both patients with a history of panic disorders and patients without a history of panic disorders.
Treating Agoraphobia
There are various treatments of agoraphobia. The DSM-IV lists the following psychotherapy options for treatment of agoraphobia: desensitization, Adlerian therapy, behavior therapy, existential therapy, Gestalt therapy, person-centered therapy, psychoanalysis, rational-emotive therapy, reality therapy, and transactional analysis. Two drugs are also listed as acceptable treatment: Trazodone, which is marketed under Desyrel and Trialodine (Agoraphobia).
Adlerian therapy is helpful in promoting better life skills and helping the patient to achieve goals. Part of this goal setting could be the use of desensitization, which would be exposing the patient to the fear and working towards alleviating the cause of the fear (Psychotherapy). Behavioral therapy would also be beneficial, as this uses learning theory to modify behavior. This could be used to modify fearful behaviors into more useful behaviors to improve the quality of life (Psychotherapy). Reality therapy could also be used to achieve these types of results (Psychotherapy).
Existential therapy is a treatment choice as it could be used to show the patient how to come to living a life free from fear(s) and being able to make their own choices without the pressure from their fear(s). This therapy could be useful in helping a person be less dependent on others as well (Psychotherapy).
Gestalt therapy is viable for treating agoraphobia because it will help the patient to understand what has happened in their life to cause the development of their fears. They will be able to learn how to live in the present and let go of situations which are hindering them (Psychotherapy). Person-centered therapy would accomplish similar results, but it centers more on the patient being in control (Psychotherapy). Psychoanalytic therapy is also used to resolve issues in that a rooted in the past and this therapy requires an individual who is extensively trained. This therapy is not an option for patients that have been deemed self-centered, extremely psychotic or impulsive, as this therapy does not work well with patients that have these qualities.
Rational-emotion therapy is focused more on the patient’s morals cognitive abilities. This therapy is used to help the patient realize that they are capable and move them forward towards good behaviors (Psychotherapy). Transactional therapy could also be used to achieve these results.
Trazodone is a medication that is used to help treat agoraphobia. This drug is used to treat any type of depression, but good results have been seen with agoraphobia patients. This drug works by altering brain chemistry.
There are many treatment options available for patients with agoraphobia, and improvement to quality of life can be achieved through these treatments, both psychotherapeutic and psychopharmacological . Correct diagnosis is essential for patients exhibiting these symptoms, as they need to be professionally treated when they become severe. More research is in the works regarding agoraphobia and its relationship to panic disorders. Through this research, new understanding will be achieved and the progress of treatment expanded.
References:
- Agoraphobia. (n.d.). Retrieved August 08, 2010, from Psyweb.com: http://psyweb.com/Mdisor/AnxietyDis/agoraphobia.jsp
- Morris, C. G., & Maisto , A. A. (2005). Psychology: An Introduction, Twelfth Edition. Prentice- Hall.
- Perugi, G., Frare, F., & Toni, C. (2007). Diagnosis and treatment of agoraphobia with panic disorder. CNS Drugs, 21(9), 741-764. Retrieved from MEDLINE with Full Text database.
- Psychotherapy. (n.d.). Retrieved August 8, 2010, from Psyweb.com: http://psyweb.com/Mdisord/MdisordADV/AdvPsych.jsp
- Trazodone. (n.d.). Retrieved August 08, 2010, from Psyweb.com: http://psyweb.com/Drughtm/jsp/trazod.jsp
Lindsey Mason - I have been a freelance writer since April of 2006. I write because I have passion regarding the topics I choose. I am constantly ...
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