What is agoraphobia?

Agoraphobia is an anxiety disorder. People with agoraphobia avoid being in certain places or situations because they are afraid they will have no way to escape or will be overwhelmed with panic and have no help. For example, you might develop an intense fear of driving, crossing bridges, or being in shopping malls. You might become afraid of the reactions you will have in these situations. The fears can disable you. At their most extreme, they can prevent you from ever leaving your home.

People who have agoraphobia often have panic disorder. This means they have a number of severe panic attacks marked by a sense of impending doom. They may become agoraphobic because they want to avoid situations or places that might trigger a panic attack.

About 5% of people in the U.S. have had agoraphobia sometime during their lives. Women have it two to four times more often than men. When it occurs with panic disorder, the condition tends to run in families.

How does it occur?

The cause of this disorder is unknown. As with many types of mental illness, doctors think that both genetics and factors in the environment play a role.

What are the symptoms?

You may have agoraphobia if you often avoid going places or doing things because you are afraid you will have no way to escape or that you will have the following symptoms of panic:

• a suddenly fast heartbeat

• a lot of sweating

• trembling or shaking

• shortness of breath

• a feeling that you are choking

• chest pain

• stomach problems such as nausea

• dizziness

• a feeling of being detached

• fear of going crazy or losing control

• fear of dying

• numbness

• chills or hot flashes.

How is it diagnosed?

Your doctor or therapist will ask about your symptoms. He or she will make sure you do not have a medical illness or drug or alcohol problem that could cause the symptoms.

How is it treated?

Several types of therapy can help treat agoraphobia:

• behavior therapy

• relaxation therapy

• cognitive therapy

• visual imagery techniques.

The treatment your doctor or therapist uses may depend on how much the disorder interferes with your day-to-day life.

Medications, such as antidepressants and antianxiety drugs, can help prevent panic attacks. Over time, you will learn that you really do not have to avoid certain situations.

How long will the effects last?

Without treatment, agoraphobia can last many years. Sometimes it lasts a lifetime. Researchers are continuing to try to learn more about this disorder.

What can I do for myself?

• Make sure you discuss any of your concerns with your doctor or therapist.

• Tell your doctor about any medicine you are taking.

• Realize you are not alone and that your anxiety can be overcome.

• Do not use alcohol or other drugs not prescribed by your doctor to overcome your anxiety.

• Avoid the kind of shallow or rapid breathing that can be caused by anxiety. Exhale slowly and completely and breathe regularly.

You may find it helpful to contact the National Mental Health Association. NMHA's toll-free Information Center number is 1-800-969-NMHA. NMHA's website address is http://www.NMHA.org.