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Agoraphobia and Other Phobias

Agoraphobia

Agarophobia occurs almost always (95%) in patients who have panic disorder. In the remainder, the fears that force people to restrict their lives drastically are usually fears of panic-like symptoms. Treatment requires treatment of the agoraphobia.

Untreated or inadequately treated agarophobia presents a major challenge to primary care physicians. People with agoraphobia are often unable to leave their homes cannot go to a physician's office.

Specific Phobias

Specific phobias (formerly called simple phobias) are persistent, and recognized by the patient as unreasonable, fears of specific objects or situations. These include certain animals or classes of animals, environmental events (thunder, lightning), blood or injections, or situations such as flying.

Therapy

Treatment of specific phobias remains essentially psychotherapy in some form. Medications may be extremely helpful in preventing or alleviating the symptoms from predictable situations such as flying.

Social Phobia

Social phobia is persistent and disproportionate fear in a performance or a social setting. It may include intense anticipatory anxiety. Often, it is associated with hypersensitivity to criticism and low self esteem, at times including the indirect criticism.

Social phobia is a very common disorder, with estimates of incidence varying with the criteria for diagnosis.

Therapy

Monamine oxidase inhibitors (MAOs) are known to be effective in the management of social phobia. The necessary dietary restrictions (low tyramine diet) and potential side-effects (hypertensive crisis, orthostatic hypotension, sexual).

Various forms of psychotherapy may also be useful, especially CBT. These forms are designed to meet the particular needs of each patient.

As with other anxiety disorders, a combination of pharmacotherapy and psychotherapy proves most efficacious.

TOC