1 00:00:02,120 --> 00:00:07,600 Speaker 1: Welcome to brain stuff from how stuff works. Hey, brain stuff, 2 00:00:07,600 --> 00:00:10,640 Speaker 1: it's Christian Sager. Doesn't it seem like some people aren't 3 00:00:10,680 --> 00:00:13,840 Speaker 1: afraid of anything? But you know what, those people their 4 00:00:13,920 --> 00:00:18,560 Speaker 1: phonies because they're scared of chainsaw clowns just like everybody else. 5 00:00:18,600 --> 00:00:22,000 Speaker 1: They're just better at hiding it. Everybody has fears, but 6 00:00:22,079 --> 00:00:26,680 Speaker 1: not everybody has a phobia. Medically recognized phobias are different 7 00:00:26,760 --> 00:00:30,200 Speaker 1: from normal fear in that they provoke a very intense reaction. 8 00:00:30,800 --> 00:00:34,920 Speaker 1: They are unreasonable or unwarranted. For instance, being intensely afraid 9 00:00:34,920 --> 00:00:36,960 Speaker 1: of a guy with a shotgun and a ski mask. 10 00:00:37,280 --> 00:00:40,160 Speaker 1: While that kind of makes sense, but being intensely afraid 11 00:00:40,200 --> 00:00:44,520 Speaker 1: of balloons doesn't so much. And finally, they can interfere 12 00:00:44,560 --> 00:00:47,680 Speaker 1: with a person's ability to live their life. But there 13 00:00:47,720 --> 00:00:51,280 Speaker 1: are other anxiety disorders that, while very real and potentially 14 00:00:51,400 --> 00:00:55,920 Speaker 1: very disruptive of a person's life, are far more insidiously vague, 15 00:00:56,120 --> 00:00:59,520 Speaker 1: and agoraphobia is one of them. According to the d 16 00:00:59,680 --> 00:01:03,680 Speaker 1: s M five, every year one point seven percent of 17 00:01:03,760 --> 00:01:08,760 Speaker 1: adolescence and adults will be diagnosed with agoraphobia. So what 18 00:01:09,120 --> 00:01:11,440 Speaker 1: is it? Well, a lot of people have heard the 19 00:01:11,560 --> 00:01:13,920 Speaker 1: term and have a vague idea of what it means, 20 00:01:14,200 --> 00:01:16,480 Speaker 1: but a lot of these ideas are wrong, or at 21 00:01:16,560 --> 00:01:19,319 Speaker 1: least they don't tell the whole story. So, for instance, 22 00:01:19,360 --> 00:01:23,839 Speaker 1: some things that agoraphobia are not are a fear of crowds, 23 00:01:24,040 --> 00:01:26,680 Speaker 1: a fear of wide open spaces, or a fear of 24 00:01:26,680 --> 00:01:30,479 Speaker 1: being outside. Though all of these may be a manifestation 25 00:01:30,680 --> 00:01:35,920 Speaker 1: of actual agoraphobia, agoraphobia is actually a broader complaint that 26 00:01:35,959 --> 00:01:40,480 Speaker 1: will often include some or all of the fears previously listed. 27 00:01:40,959 --> 00:01:44,520 Speaker 1: So for some general layperson definitions to help you get 28 00:01:44,560 --> 00:01:47,760 Speaker 1: the gist of it, here we go. Agoraphobia is a 29 00:01:47,800 --> 00:01:51,320 Speaker 1: type of anxiety disorder in which you fear and often 30 00:01:51,400 --> 00:01:55,600 Speaker 1: avoid places or situations that might cause you to panic 31 00:01:55,680 --> 00:01:59,640 Speaker 1: and make you feel trapped, helpless, or embarrassed. That's from 32 00:01:59,680 --> 00:02:03,560 Speaker 1: the mayor O Clinic. Or Agreaphobia is an intense fear 33 00:02:03,640 --> 00:02:06,480 Speaker 1: and anxiety of being in places where it is hard 34 00:02:06,520 --> 00:02:10,560 Speaker 1: to escape or where help might not be available. Agoraphobia 35 00:02:10,720 --> 00:02:15,959 Speaker 1: usually involves fear of crowds, bridges, or of being outside alone. 36 00:02:16,320 --> 00:02:19,240 Speaker 1: That's from the National Library of Medicine at the National 37 00:02:19,280 --> 00:02:23,480 Speaker 1: Institutes of Health. One more agreaphobia is a fear of 38 00:02:23,520 --> 00:02:28,000 Speaker 1: being in situations where escape might be difficult or help 39 00:02:28,280 --> 00:02:31,519 Speaker 1: wouldn't be available if things go wrong. That's from the 40 00:02:31,639 --> 00:02:35,960 Speaker 1: National Health Service in the UK. So really, agoraphobia is 41 00:02:36,000 --> 00:02:39,919 Speaker 1: more broadly the fear of being trapped in a vulnerable situation, 42 00:02:40,120 --> 00:02:45,519 Speaker 1: especially when exacerbated by an existing predisposition to panic disorder. 43 00:02:46,120 --> 00:02:50,960 Speaker 1: Very often, the person with agoraphobia specifically dreads experiencing a 44 00:02:51,000 --> 00:02:55,799 Speaker 1: panic attack or other panic like symptoms in a situation 45 00:02:55,880 --> 00:03:00,280 Speaker 1: where such an experience would be especially in opportune. According 46 00:03:00,360 --> 00:03:02,280 Speaker 1: to the d s M five and this is the 47 00:03:02,360 --> 00:03:07,440 Speaker 1: latest edition of the Professional Diagnostic Handbook for Mental Health professionals. 48 00:03:07,560 --> 00:03:11,720 Speaker 1: According to that to meet the diagnostic criteria for agoraphobia, 49 00:03:12,040 --> 00:03:16,240 Speaker 1: you must have quote market fear or anxiety about two 50 00:03:16,440 --> 00:03:19,920 Speaker 1: or more of the following scenarios standing in line or 51 00:03:19,960 --> 00:03:22,919 Speaker 1: being in a crowd, being outside of the home alone, 52 00:03:23,280 --> 00:03:27,720 Speaker 1: using public transportation, being in open spaces, or being in 53 00:03:28,000 --> 00:03:31,280 Speaker 1: enclosed spaces. So the d s M five reports that 54 00:03:31,320 --> 00:03:34,839 Speaker 1: the person with a gorphobia fears or avoids these situations 55 00:03:34,880 --> 00:03:38,320 Speaker 1: because of thoughts that escape and might be difficult or 56 00:03:38,440 --> 00:03:41,680 Speaker 1: might not be available in the event of developing panic 57 00:03:41,760 --> 00:03:47,720 Speaker 1: like symptoms or other incapacitating or embarrassing symptoms. What physically 58 00:03:47,800 --> 00:03:51,840 Speaker 1: happens is the following. According to the U S National 59 00:03:51,880 --> 00:03:56,119 Speaker 1: Library of Medicine, these symptoms show up when you're experiencing 60 00:03:56,160 --> 00:04:01,200 Speaker 1: a gooraphobia, chest pain or discomfort, choking or shortness of breath, 61 00:04:01,600 --> 00:04:08,040 Speaker 1: dizziness or fainting, nausea, rapid heartbeat, sweating, and trembling. Also, 62 00:04:08,080 --> 00:04:10,160 Speaker 1: according to the d s M five, you can only 63 00:04:10,240 --> 00:04:14,240 Speaker 1: meet the criteria for diagnosis if you always are almost 64 00:04:14,280 --> 00:04:18,000 Speaker 1: always have the fear response to these situations, you actively 65 00:04:18,040 --> 00:04:21,120 Speaker 1: avoid these situations or require the help of a companion. 66 00:04:21,520 --> 00:04:24,599 Speaker 1: The level of fear you feel is disproportionate to the 67 00:04:24,640 --> 00:04:28,760 Speaker 1: threat represented. This condition lasts for six months or more. 68 00:04:29,080 --> 00:04:34,200 Speaker 1: The fear, anxiety, or avoidance causes quote clinically significant distress 69 00:04:34,360 --> 00:04:38,120 Speaker 1: or prevents you from living a normally functional life, and 70 00:04:38,480 --> 00:04:42,080 Speaker 1: the suite of symptoms you experience is not better grouped 71 00:04:42,160 --> 00:04:46,080 Speaker 1: under another diagnosis. For example, if your fear only occurs 72 00:04:46,160 --> 00:04:49,240 Speaker 1: because you fear people's reactions to perceive flaws in your 73 00:04:49,279 --> 00:04:53,680 Speaker 1: physical appearance, this might be a body dysmorphic disorder instead 74 00:04:53,839 --> 00:04:59,320 Speaker 1: of general agoraphobia. So if you have intense, persistent, debilitating 75 00:04:59,400 --> 00:05:02,000 Speaker 1: fear that will begin to have a panic attack or 76 00:05:02,040 --> 00:05:06,080 Speaker 1: another embarrassing or incapacitating episode. While you're stuck in a 77 00:05:06,160 --> 00:05:08,919 Speaker 1: place or a situation you can't get out of or 78 00:05:08,960 --> 00:05:13,240 Speaker 1: where you can't find help, you might have agoraphobia. That's 79 00:05:13,279 --> 00:05:17,480 Speaker 1: a long one, and this can have some really serious consequences. 80 00:05:17,640 --> 00:05:20,920 Speaker 1: For example, more than one in three people with agoraphobia 81 00:05:21,000 --> 00:05:25,800 Speaker 1: are completely homebound and unable to work, and sometimes people 82 00:05:25,960 --> 00:05:29,760 Speaker 1: inappropriately self medicate with the abuse of drugs and alcohol. 83 00:05:30,200 --> 00:05:34,680 Speaker 1: Agoraphobia often develops out of an existing panic disorder. For example, 84 00:05:34,920 --> 00:05:38,120 Speaker 1: if a person experiences a panic attack in a particular 85 00:05:38,160 --> 00:05:40,719 Speaker 1: type of place, say, for example, like an airplane or 86 00:05:40,720 --> 00:05:44,239 Speaker 1: an elevator, he or she might start to avoid ever 87 00:05:44,320 --> 00:05:48,039 Speaker 1: being in that situation again. Over time, this can develop 88 00:05:48,120 --> 00:05:54,159 Speaker 1: into full blown agoraphobia. Something like agoraphobia can sometimes be 89 00:05:54,279 --> 00:05:58,919 Speaker 1: difficult to accurately diagnose, since it's associated with something like 90 00:05:59,040 --> 00:06:03,400 Speaker 1: panic disorder, and also because the functional symptoms may resemble 91 00:06:03,480 --> 00:06:07,680 Speaker 1: those of problems with different causes. For example, you may 92 00:06:07,839 --> 00:06:11,920 Speaker 1: dread and avoid flying in airplanes because of agoraphobia, or 93 00:06:12,240 --> 00:06:15,919 Speaker 1: maybe simply because you fear death by plane crash. The 94 00:06:16,000 --> 00:06:20,560 Speaker 1: situational phobia is outwardly similar, but it happens for very 95 00:06:20,640 --> 00:06:23,880 Speaker 1: different reasons. All right, So maybe you're wondering, if I've 96 00:06:23,920 --> 00:06:27,039 Speaker 1: got agoraphobia, how do I treat it well? The most 97 00:06:27,120 --> 00:06:31,880 Speaker 1: common treatment responses are a combination of cognitive behavioral therapy 98 00:06:32,279 --> 00:06:37,640 Speaker 1: and antidepressant medication. Cognitive behavioral therapy is basically a common 99 00:06:37,680 --> 00:06:41,400 Speaker 1: form of psychotherapy where the therapist helps the patient talk 100 00:06:41,600 --> 00:06:46,200 Speaker 1: through thought processes and common behaviors, and then replaces those 101 00:06:46,240 --> 00:06:51,240 Speaker 1: bad thoughts and behavior patterns with better ones. Antidepressant medication 102 00:06:51,360 --> 00:06:56,400 Speaker 1: could also include drugs such as selective serotonin reuptake inhibitors 103 00:06:56,560 --> 00:07:02,400 Speaker 1: or ss R eyes or serotonin nora epinephrin reuptake inhibitors. 104 00:07:02,800 --> 00:07:06,760 Speaker 1: So if you or someone you know are suffering from agoraphobia, 105 00:07:07,120 --> 00:07:10,240 Speaker 1: there's help out there. All you have to do is 106 00:07:10,280 --> 00:07:18,440 Speaker 1: seek it out. Check out the brain stuff channel on YouTube, 107 00:07:18,520 --> 00:07:20,680 Speaker 1: and for more on this and thousands of other topics, 108 00:07:20,840 --> 00:07:36,040 Speaker 1: visit how stuff works dot com.