Agoraphobia

Agoraphobia literally means “fear of the marketplace.” It is a type of anxiety disorder that causes a person to avoid situations that he or she fears, such as being in public or being in crowded spaces.

The term agoraphobia was first coined by Westphal (1871) in his description of three males who experienced intense anxiety when walking across open spaces. Westphal also noted the physiological symptoms of anxiety (i.e., palpitations, blushing, trembling, and sensations of heat) and the intense subjective anxiety that is elicited upon anticipating entering a feared situation.

These situations can include even the most wide-open spaces such as shopping malls, airports, parking lots, public transportation, restaurants, theaters, additional situations involving crowds or waiting in line, travel far from home, and being alone.

Agoraphobia is common with 1-3% of the population suffering from it. It is twice as common in women as it is men.

In the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III; American Psychiatric Association [APA], 1980), agoraphobia was characterized as a “marked fear and avoidance of being alone, or in public places from which escape might be difficult, or help not available in case of sudden incapacitation”.

Agoraphobia was then considered a primary diagnosis, which may or may not be accompanied by recurrent panic attacks.

A variety of factors such as fear of sensations and emotions in anxiety (anxiety sensitivity), family history of anxiety (genetics), and stressful events may contribute to this condition.
Agoraphobia

Panic attack

Panic attacks occur unexpectedly, sometimes even during sleep. People who experience such attacks and are preoccupied with the fear of another or alter their behavior to avoid places or situations may have panic disorder, a serious but highly treatable condition.

A panic attack is not a mental disorder. In fact, more than one in five people experience one or more panic attacks in their lifetime, but few go on to develop panic disorder or agoraphobia.

Most panic attacks last for between 5 and 20 minutes. They can come on very quickly, and the symptoms will usually peak within 10 minutes. Sometimes the patient might experience symptoms of a panic attack which last for up to an hour. If this happens he probably experiencing one attack after another, or a high level of anxiety after the initial panic attack.

A panic attack is the abrupt onset of intense fear or discomfort and includes at least four of the following symptoms:
▶Palpitations, pounding heartbeat, or accelerated heart rate
▶Sweating
▶Trembling or shaking
▶Feeling unable to breath or smothering
▶Feelings of choking
▶Chest pain or discomfort
▶Nausea (feeling sick) or abdominal distress
▶Dizziness, light-headedness, feeling faint or unsteady
▶Chills or hot flushes
▶Paresthesia (numbness or tingling sensations)
▶Derealization (feelings of unreality) or depersonalization (being detached from oneself)
▶Fear of losing control or “going crazy”
▶Fear of dying

The heart is pounding out of the chest, and the patient feels sweaty and lightheaded. He sure he will pass out, lose his mind, or even die. Then just as quickly, the symptoms disappear, but he then become preoccupied with the fear of another attack.
Panic attack