AGORAPHOBIA
DEFINITION
Agoraphobia (ag-uh-ruh-FO-be-uh) is an anxiety disorder in which individuals have feeling of afraid to panic and embarrass themselves in front of many people. As result, the trying to avoid themselves from public situation. Individuals who suffer from agoraphobia are afraid of being in situation in which escape would be difficult or embarrassing of panic-like symptoms occurred.
Because of their fear of embarrassing themselves, people with agoraphobia may confine themselves to their homes and venture out as little as possible, and when they do go out, they may only do so with someone they believe will able to be help them or becoming their shield when they become anxious. Note that individuals with agoraphobia do not avoid people because of any fear of people; instead they avoid people because “something” might happen that they cannot control and then they will embarrass themselves.
Diagnosed that have been carried out noted that amongst female and males, the female have higher percentage of agoraphobia which was 7% whereas the male only 3.5%.

THEORIES
The available theories suggest that agoraphobia have psychological and physiological components, but it is unclear whether physiological factors cause physiological changes, or vice versa. In considering biological contributors to the development of panic disorder, researchers have been struck by the fact that biological relatives of individuals with panic disorder are 8 times more likely to develop this condition; furthermore, people who develop panic disorder before the age of 20 are 20 times more likely than others to have first-degree relatives with the condition (American Psychiatric Association, 2000)
System in the brain plays an important role in triggering the individual to become agoraphobia. The brain send signals when there is insufficient air available for breathe. According to anxiety sensitivity theory, people with panic disorder tend to interpret cognitive and somatic manifestations of stress and anxiety in a catastrophic manner. They are thought to have a hypersensitive “suffocation” mechanism, so they feel as though they cannot breathe, even though others would feel nothing unusual in that situation. As the level of carbon dioxide in their blood accumulates, this false alarm mechanism is triggered, causing the individual to hyperventilate. If this increase in the rate of breathing fails to lower blood levels of carbon dioxide, the individual is thrown into a panic state.

SYMPTOMES
Physical signs that shown in agoraphobias are they tends to have difficulty in breathing, their heart racing and pounding hard, feeling some chest pain, their body become trembling and shaking, the dizziness, a churning stomach, sweating, and also the felt flashes of hot or cold by themselves.
Emotional signs that shown by them are feeling of overwhelming anxiety or panic, intense the need of escaping, feeling “unreal” or detached from yourself, fear of losing control or going crazy, feeling of going to die or pass out, and the agoraphobias knows that they are overreacting but could do nothing for their anxiety.

TREATMENTS

Conditioned fear reactions
The individual associates certain bodily sensations with memory of the last panic attack, causing a full-blown panic attack to develop even before measurable biological changes have occurred (Gorman & Liebowitz, 1986). Over time, the individual begins to anticipate the panic attack before it happens, leading to the avoidance behavior seen in agoraphobia (Klein, 1981).

Medications
Given that biological factors play at least some role in causing panic disorder, many clinicians recommend treatment with medications. The most effective antianxiety medications are benzodiazepines. This medication stimulate GABA neurons become active, leading the inhibition of the brain sites involved in panic attacks. Some commonly prescribed benzodiazepines are chlordiazepoxide (Librium), diazepam (valium), chlorazepate (Tranxene), and alprazolam (Xanax). The medication must be taken at least 6 months, and possibly as long as a year to be effective in treating panic disorder.

Relaxation Training
Relaxation Training is one behavioral technique used in the treatment of panic disorder and agoraphobia. In this approach, the client learns to systematically alternate tensing and relaxing muscles all over the body, usually starting at the forehead and working downward to the feet. After training, the client should be able to relax the entire body when confronting a feared situation.

Counterconditioning
In this approach, the client hyperventilates intentionally and then begin slow breathing, a respond that is incompatible with hyperventilation. Following this training, the client can begin the slow breathing at the first signs of hyperventilation. Thus, the client learns that it is possible to exert voluntary control over hyperventilation.

Panic Control Therapy (PCT)
Panic Control Therapy (PCT) consists of cognitive restructuring, , the development of an awareness of bodily cues associated with panic attacks, and breathing retraining (Barlow, Craske, Cerny, & Klosko, 1989). Clients treat with PCT show marked improvement , at levels comparable to the improvement shown by clients treated with antianxiety medications. Interestingly, however, later assessments of these clients showed that a greater percentage of those treated with PCT remained symptom free (Klosko, Barlow, Tassinari, & Cerny, 1990). In another comparison of cognitive therapy with other forms of treatment (relaxation and antidepressant medication) and control conditions, cognitive therapy was reported to be particularly beneficial for clients suffering from panic, anxiety, and associated avoidance, both at the end of the treatment and at follow-up (Street & Barlow, 1994).