We often think of Agoraphobia only as of the inability to leave one’s house. But it may present in more subtle ways and still be very debilitating.
The DSM-5 gives Agoraphobia examples of marked fear or anxiety about:
· Using public transportation (cars, buses, trains, ships, planes)
· Being in open spaces (parking lots, marketplaces, bridges)
· Being in enclosed places (shops, theaters, cinemas)
· Standing in line or being in a crowd, and also maybe being outside of the home.
A person with agoraphobia fears or avoids these situations where escape may be difficult. They are afraid of having attacks of panic or embarrassment (like fearing falling, fainting, or incontinence). Often, the person needs someone to go with them to get through these.
Agoraphobia responds well to psychotherapy and medications for anxiety. Some old-school beliefs in the field about the care of someone with agoraphobia would purport that teletherapy or telepsychiatry further enables a person to stay in their comfort zone. They believe it prevents the therapeutic exposure process. While there is some truth to that, but what about the people not there yet? The ones who need a few more steps before walking into an office. The ones who cannot even make a phone call because of profound anxiety. I believe telehealth is a way to reach these struggling people. Exposure therapy is gradual.
At Your Service Psychiatry provides online care for people struggling with Agoraphobia.