Life doesn't have to be that way for the 6 million and more people who suffer from agoraphobia, says C. Alec Pollard, Ph.D., professor of community and family medicine at Saint Louis University School of Medicine and director of the Anxiety Disorders Center at Saint Louis Behavioral Medicine Institute.
Dr. Pollard is the co-author of a new book, "The Agoraphobia Workbook," which outlines a step-by-step plan to help people face their fears, overcome the disorder and return to normal life.
"We wrote this book because prior books on agoraphobia focused only on panic attacks and were not complete," Pollard says. "Some people with agoraphobia are irrationally afraid of other types of symptom attacks, such as vomiting, losing bladder or bowel control, developing a bad headache or fainting."
While panic attacks are the most common symptom feared by people with agoraphobia, all people with the anxiety disorder fear having a symptom attack -– a sudden, intense rush of one or more internal sensations or physical symptoms.
"They expect that being in certain situations could cause those symptoms to occur. They exaggerate the impact of what might happen into bringing terrible consequences. Most people with agoraphobia have not truly experienced the ultimate catastrophe they fear. They may have experienced distress or embarrassment, but no catastrophe has ever actually occurred."
"The Agoraphobia Workbook," which Pollard wrote with Elke Zuercher-White, Ph.D., a specialist in agoraphobia who works for Kaiser-Permanente in San Francisco, explains how and why different forms of agoraphobia develop and gives step-by-step directions for overcoming fears and phobias. The workbook includes exposure and desensitization exercises that help people return to a healthy, active lifestyle and offers strategies for coping with setbacks. "The Agoraphobia Workbook" is published by New Harbinger Publications.
Between 3 and 6 percent of adults -– the majority women –- develop agoraphobia at some point in their lives, usually in their 20s or 30s.
"Epidemiological studies only have examined the prevalence of panic attacks but haven't looked at other kinds of agoraphobic attacks. Estimates are based on what clinicians say and probably are low," Pollard says.
Pollard believes agoraphobia is more common because primary care physicians are more likely to see these patients than psychologists or psychiatrists.
"A person with a phobia about migraine headaches may go to the doctor to get rid of headaches but won't mention that she hasn't left the house for a year because she's afraid of getting a migraine," Pollard says.
Doctors then may treat only the symptom without examining the irrational "what if I get the problem" phobia.
"Patients may continue to suffer from the phobia even if they've gotten some relief from the symptom itself. They sometimes think that because they're avoiding social interactions, they're better. This just reinforces the pattern of agoraphobia and restricts their life," he says. "Without treatment, agoraphobia can get worse and cause people to become trapped in their own homes because they are too fearful to leave."
Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first M.D. degree west of the Mississippi River. Saint Louis University School of Medicine is a pioneer in geriatric medicine, organ transplantation, chronic disease prevention, cardiovascular disease, neurosciences and vaccine research, among others. The School of Medicine trains physicians and biomedical scientists, conducts medical research, and provides health services on a local, national and international level.