WEBVTT - How Does Agoraphobia Work? 0:00:02.120 --> 0:00:07.600 Welcome to brain stuff from how stuff works. Hey, brain stuff, 0:00:07.600 --> 0:00:10.640 it's Christian Sager. Doesn't it seem like some people aren't 0:00:10.680 --> 0:00:13.840 afraid of anything? But you know what, those people their 0:00:13.920 --> 0:00:18.560 phonies because they're scared of chainsaw clowns just like everybody else. 0:00:18.600 --> 0:00:22.000 They're just better at hiding it. Everybody has fears, but 0:00:22.079 --> 0:00:26.680 not everybody has a phobia. Medically recognized phobias are different 0:00:26.760 --> 0:00:30.200 from normal fear in that they provoke a very intense reaction. 0:00:30.800 --> 0:00:34.920 They are unreasonable or unwarranted. For instance, being intensely afraid 0:00:34.920 --> 0:00:36.960 of a guy with a shotgun and a ski mask. 0:00:37.280 --> 0:00:40.160 While that kind of makes sense, but being intensely afraid 0:00:40.200 --> 0:00:44.520 of balloons doesn't so much. And finally, they can interfere 0:00:44.560 --> 0:00:47.680 with a person's ability to live their life. But there 0:00:47.720 --> 0:00:51.280 are other anxiety disorders that, while very real and potentially 0:00:51.400 --> 0:00:55.920 very disruptive of a person's life, are far more insidiously vague, 0:00:56.120 --> 0:00:59.520 and agoraphobia is one of them. According to the d 0:00:59.680 --> 0:01:03.680 s M five, every year one point seven percent of 0:01:03.760 --> 0:01:08.760 adolescence and adults will be diagnosed with agoraphobia. So what 0:01:09.120 --> 0:01:11.440 is it? Well, a lot of people have heard the 0:01:11.560 --> 0:01:13.920 term and have a vague idea of what it means, 0:01:14.200 --> 0:01:16.480 but a lot of these ideas are wrong, or at 0:01:16.560 --> 0:01:19.319 least they don't tell the whole story. So, for instance, 0:01:19.360 --> 0:01:23.839 some things that agoraphobia are not are a fear of crowds, 0:01:24.040 --> 0:01:26.680 a fear of wide open spaces, or a fear of 0:01:26.680 --> 0:01:30.479 being outside. Though all of these may be a manifestation 0:01:30.680 --> 0:01:35.920 of actual agoraphobia, agoraphobia is actually a broader complaint that 0:01:35.959 --> 0:01:40.480 will often include some or all of the fears previously listed. 0:01:40.959 --> 0:01:44.520 So for some general layperson definitions to help you get 0:01:44.560 --> 0:01:47.760 the gist of it, here we go. Agoraphobia is a 0:01:47.800 --> 0:01:51.320 type of anxiety disorder in which you fear and often 0:01:51.400 --> 0:01:55.600 avoid places or situations that might cause you to panic 0:01:55.680 --> 0:01:59.640 and make you feel trapped, helpless, or embarrassed. That's from 0:01:59.680 --> 0:02:03.560 the mayor O Clinic. Or Agreaphobia is an intense fear 0:02:03.640 --> 0:02:06.480 and anxiety of being in places where it is hard 0:02:06.520 --> 0:02:10.560 to escape or where help might not be available. Agoraphobia 0:02:10.720 --> 0:02:15.959 usually involves fear of crowds, bridges, or of being outside alone. 0:02:16.320 --> 0:02:19.240 That's from the National Library of Medicine at the National 0:02:19.280 --> 0:02:23.480 Institutes of Health. One more agreaphobia is a fear of 0:02:23.520 --> 0:02:28.000 being in situations where escape might be difficult or help 0:02:28.280 --> 0:02:31.519 wouldn't be available if things go wrong. That's from the 0:02:31.639 --> 0:02:35.960 National Health Service in the UK. So really, agoraphobia is 0:02:36.000 --> 0:02:39.919 more broadly the fear of being trapped in a vulnerable situation, 0:02:40.120 --> 0:02:45.519 especially when exacerbated by an existing predisposition to panic disorder. 0:02:46.120 --> 0:02:50.960 Very often, the person with agoraphobia specifically dreads experiencing a 0:02:51.000 --> 0:02:55.799 panic attack or other panic like symptoms in a situation 0:02:55.880 --> 0:03:00.280 where such an experience would be especially in opportune. According 0:03:00.360 --> 0:03:02.280 to the d s M five and this is the 0:03:02.360 --> 0:03:07.440 latest edition of the Professional Diagnostic Handbook for Mental Health professionals. 0:03:07.560 --> 0:03:11.720 According to that to meet the diagnostic criteria for agoraphobia, 0:03:12.040 --> 0:03:16.240 you must have quote market fear or anxiety about two 0:03:16.440 --> 0:03:19.920 or more of the following scenarios standing in line or 0:03:19.960 --> 0:03:22.919 being in a crowd, being outside of the home alone, 0:03:23.280 --> 0:03:27.720 using public transportation, being in open spaces, or being in 0:03:28.000 --> 0:03:31.280 enclosed spaces. So the d s M five reports that 0:03:31.320 --> 0:03:34.839 the person with a gorphobia fears or avoids these situations 0:03:34.880 --> 0:03:38.320 because of thoughts that escape and might be difficult or 0:03:38.440 --> 0:03:41.680 might not be available in the event of developing panic 0:03:41.760 --> 0:03:47.720 like symptoms or other incapacitating or embarrassing symptoms. What physically 0:03:47.800 --> 0:03:51.840 happens is the following. According to the U S National 0:03:51.880 --> 0:03:56.119 Library of Medicine, these symptoms show up when you're experiencing 0:03:56.160 --> 0:04:01.200 a gooraphobia, chest pain or discomfort, choking or shortness of breath, 0:04:01.600 --> 0:04:08.040 dizziness or fainting, nausea, rapid heartbeat, sweating, and trembling. Also, 0:04:08.080 --> 0:04:10.160 according to the d s M five, you can only 0:04:10.240 --> 0:04:14.240 meet the criteria for diagnosis if you always are almost 0:04:14.280 --> 0:04:18.000 always have the fear response to these situations, you actively 0:04:18.040 --> 0:04:21.120 avoid these situations or require the help of a companion. 0:04:21.520 --> 0:04:24.599 The level of fear you feel is disproportionate to the 0:04:24.640 --> 0:04:28.760 threat represented. This condition lasts for six months or more. 0:04:29.080 --> 0:04:34.200 The fear, anxiety, or avoidance causes quote clinically significant distress 0:04:34.360 --> 0:04:38.120 or prevents you from living a normally functional life, and 0:04:38.480 --> 0:04:42.080 the suite of symptoms you experience is not better grouped 0:04:42.160 --> 0:04:46.080 under another diagnosis. For example, if your fear only occurs 0:04:46.160 --> 0:04:49.240 because you fear people's reactions to perceive flaws in your 0:04:49.279 --> 0:04:53.680 physical appearance, this might be a body dysmorphic disorder instead 0:04:53.839 --> 0:04:59.320 of general agoraphobia. So if you have intense, persistent, debilitating 0:04:59.400 --> 0:05:02.000 fear that will begin to have a panic attack or 0:05:02.040 --> 0:05:06.080 another embarrassing or incapacitating episode. While you're stuck in a 0:05:06.160 --> 0:05:08.919 place or a situation you can't get out of or 0:05:08.960 --> 0:05:13.240 where you can't find help, you might have agoraphobia. That's 0:05:13.279 --> 0:05:17.480 a long one, and this can have some really serious consequences. 0:05:17.640 --> 0:05:20.920 For example, more than one in three people with agoraphobia 0:05:21.000 --> 0:05:25.800 are completely homebound and unable to work, and sometimes people 0:05:25.960 --> 0:05:29.760 inappropriately self medicate with the abuse of drugs and alcohol. 0:05:30.200 --> 0:05:34.680 Agoraphobia often develops out of an existing panic disorder. For example, 0:05:34.920 --> 0:05:38.120 if a person experiences a panic attack in a particular 0:05:38.160 --> 0:05:40.719 type of place, say, for example, like an airplane or 0:05:40.720 --> 0:05:44.239 an elevator, he or she might start to avoid ever 0:05:44.320 --> 0:05:48.039 being in that situation again. Over time, this can develop 0:05:48.120 --> 0:05:54.159 into full blown agoraphobia. Something like agoraphobia can sometimes be 0:05:54.279 --> 0:05:58.919 difficult to accurately diagnose, since it's associated with something like 0:05:59.040 --> 0:06:03.400 panic disorder, and also because the functional symptoms may resemble 0:06:03.480 --> 0:06:07.680 those of problems with different causes. For example, you may 0:06:07.839 --> 0:06:11.920 dread and avoid flying in airplanes because of agoraphobia, or 0:06:12.240 --> 0:06:15.919 maybe simply because you fear death by plane crash. The 0:06:16.000 --> 0:06:20.560 situational phobia is outwardly similar, but it happens for very 0:06:20.640 --> 0:06:23.880 different reasons. All right, So maybe you're wondering, if I've 0:06:23.920 --> 0:06:27.039 got agoraphobia, how do I treat it well? The most 0:06:27.120 --> 0:06:31.880 common treatment responses are a combination of cognitive behavioral therapy 0:06:32.279 --> 0:06:37.640 and antidepressant medication. Cognitive behavioral therapy is basically a common 0:06:37.680 --> 0:06:41.400 form of psychotherapy where the therapist helps the patient talk 0:06:41.600 --> 0:06:46.200 through thought processes and common behaviors, and then replaces those 0:06:46.240 --> 0:06:51.240 bad thoughts and behavior patterns with better ones. Antidepressant medication 0:06:51.360 --> 0:06:56.400 could also include drugs such as selective serotonin reuptake inhibitors 0:06:56.560 --> 0:07:02.400 or ss R eyes or serotonin nora epinephrin reuptake inhibitors. 0:07:02.800 --> 0:07:06.760 So if you or someone you know are suffering from agoraphobia, 0:07:07.120 --> 0:07:10.240 there's help out there. All you have to do is 0:07:10.280 --> 0:07:18.440 seek it out. Check out the brain stuff channel on YouTube, 0:07:18.520 --> 0:07:20.680 and for more on this and thousands of other topics, 0:07:20.840 --> 0:07:36.040 visit how stuff works dot com.