Agoraphobia by Emily Burdett

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Patient must have fear/anxiety lasting at least 6 months in at least two of the following situations:

1 – using public transportation

2 – being in open spaces

3 – being in enclosed places

4 – standing in line or being in a crowd

5 – being outside of the home alone

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Fear must involve thoughts that escape from the situation might be difficult or that patients would receive no help if they became incapacitated by fear or a panic attack. In addition, all of the following should be present:

The same situations nearly always trigger fear or anxiety.
Patients actively avoid the situation and/or require the presence of a companion.
The fear or anxiety is out of proportion to the actual threat (taking into account sociocultural norms).
The fear, anxiety, and/or avoidance cause significant distress or significantly impair social or occupational functioning.
If another medical condition (eg, inflammatory bowel disease, Parkinson disease) is present, the fear, anxiety, and/or avoidance are clearly excessive.

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Significantly higher prevalence of agoraphobia in women vs men (Bekker, 1996)

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Constant fear of leaving a safe situation (e.g home) because something might happen

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They may avoid leaving their home for weeks, months or years if it feels that unsafe

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begins around age 10 or 11, youngest around 9 and oldest average around 18 years old

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1.5 % without other phobia (Whitten et al. 2008)

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Epidemiological findings from 13 studies across 14 countries suggest it has a prevalence of 1.3%. However, it continues to be underdiagnosed and undertreated in primary care settings (Goodwin et al., 2006).

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Individuals will experience extreme isolation and avoidance. This is likely a very exhausting and lonely reality.

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be afraid of that a panic attack would make him or her lose control such as unable to breathe; or escape from that situation without friends/families by side

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An estimated 0.9% of U.S. adults had agoraphobia in the past year.
Past year prevalence of agoraphobia among adults was similar for females (0.9%) and males (0.8%).

An estimated 1.3% of U.S. adults experience agoraphobia at some time in their lives. (Harvard Medical School, 2007)

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When going out they need to be accompanied by people they trust

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struggles with being alone outside of home without an accessible escape, e.g. in a car, bus or airplane, or being in a crowded area (NIMH)

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having fear about specific events when being in public space (e.g. having diahrrea while unable to find toilets), which lead to a fear of going outside from home and need companion to ease the fear.

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Evidence suggests that agoraphobia commonly emerges in the mid- to late- twenties (Tearnan et al., 1984).

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Agoraphobia can begin in childhood, but usually starts in the late teen or early adult years — usually before age 35. But older adults also can develop it.

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Stress has been found to accelerate the development of agoraphobia (Franklin and Andrews, 2007).

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Extreme and catastrophic cognitive disturbances - e.g. fears of death, harm and war

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Reliance upon the presence of other people in order to complete daily tasks and errands

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The agoraphobic situation/place are actively avoided