Agoraphobia

Today’s post will touch on the DSM 5 criteria for Agoraphobia as well as the suggested treatment involved. If you’ve seen my last post, I briefly discussed what phobias are and the typical treatment used. Over the next couple of months I will write various posts on specific phobias, starting with this one.

Agoraphobia is an anxiety type disorder. According to the dictionary this disorder is “extreme or irrational fear of entering open or crowded places, of leaving one’s own home, or of being in places from which escape is difficult”. Based on this definition alone a person diagnosed with agoraphobia begins exhibiting stress like responses when they are at concerts, sports games or any unfamiliar crowded space. However we are going to look at how someone would be diagnosed with agoraphobia. For this disorder there are nine criterion that needs to be met prior to being diagnosed and they are as follows;

Criterion A

There is a recognizable fear or anxiety in at least two out five possible situations:

-       Using public transportation

o   Any transportation available to the public, not only “subways” and “buses”

-       Being in open spaces

o   Think parking lot or a field

-       Being in enclosed spaces

o   Think movie theater or store

-       Standing in line or being in a crowd

-       Being outside of home alone

Criterion B

In reference to the possible situations listed in Criterion A, the fear or avoidance of these situations are due to a belief that escape would be difficult or help would not be available whenever the panic-like or embarrassing symptoms occur.

Criterion C

The situations from Criterion A almost always invoke fear or anxiety

Criterion D

The situations from Criterion A are either

-       Actively avoided

-       Requires the presence of a companion to assist in dealing with the situation

-       Or endured with immense fear/anxiety

Criterion E

The fear or anxiety is not in proportion to the actual danger that the situations may hold

Criterion F

The fear, anxiety or avoidance is persistent and has been lasting for at least 6 months

Criterion G

The fear, anxiety or avoidance causes significant distress in important area of functioning (social, occupational, etc.)

Criterion H

If another medical condition is present, the fear, anxiety or avoidance is excessive

-       For example, with medical conditions such as inflammatory bowel disease (as listed in the DSM-5) the symptoms of this specific disease would leave an individual with similar anxiety like responses. When paired with agoraphobic situations (Criterion A) then the responses become excessive

Criterion I

The fear, anxiety or avoidance can not be better explained by the symptoms of any other mental disorder

Once all criterion is met, someone could be diagnosed with Agoraphobia.

Treatment

According to the Mayo Clinic’s website, a combination of both psychotherapy and medication is best to address agoraphobia. They list Cognitive Behavioral Therapy (CBT) as the treatment of choice to assist in the treatment of this disorder. I plan to create a post in the future on the specifics of this therapeutic style, but I’ll give a quick overview. CBT aims to identify the negative patterns in a person’s thought process and work to provide coping strategies to address the negative patterns. For example, say a person’s agoraphobia stems from a fear of using public transportation such as the subway. CBT could be used to help the individual realize why they’ve been avoidant of public transportation and then work on a plan to mitigate the negative symptoms.

All information was found using the DSM-5 and the Mayo Clinic’s Website