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General Medical Questions
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Question : What is agoraphobia?
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The Trusted Source
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Howard LeWine, M.D.

Michael Craig Miller, M.D., is Senior Editor of Mental Health Publishing at Harvard Health Publications. He is an assistant professor of psychiatry at Harvard Medical School. Dr. Miller is in clinical practice at Beth Israel Deaconess Medical Center, where he has been on staff for more than 25 years.

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March 24, 2014
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Agoraphobia means “fear of open places.” In this disorder, severe anxiety may begin as soon as you step out the front door.

People with this disorder worry about becoming anxious in places that scare them. For example, crowded, public places may be a trigger.

One source of dread is developing panic symptoms. These symptoms include a racing heart, difficulty breathing, sweaty palms, and shakiness.

Another worry is the fear of losing control in public. Feelings of helplessness may come on. Or a person may feel detached from others. He or she may feel unreal or worked up.

Avoiding scary situations becomes a part of life. This can be very restricting. At its worst, agoraphobia makes someone stay home all the time.

We don’t know why agoraphobia develops. Some people are genetically predisposed to developing it.

But like all anxiety, agoraphobia is partly learned. A person may become anxious or panicked in a particular place. The person may then avoid that place or places like it.

Treatment usually involves a combination of talk therapy and medication.

One goal of therapy is to recognize distorted thoughts about particular situations. A therapist may teach techniques to correct the thoughts or counter the stress and fear.

Two common approaches are exposure therapy and the teaching of relaxation techniques. They are often used together.

A therapist might begin with visualization exercises. You will imagine a fear-provoking situation, then use relaxation techniques to control the fear.

In some cases a therapist might actually accompany you as you venture into scary situations. The goal is to desensitize you to the situation so that it is no longer so scary.

Some patients need medication too. Medications can curb the fear and make the therapy easier. Options include antidepressants and anti-anxiety medications.

With support of friends and family and the guidance of professionals, treatment is usually very effective.

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