Agoraphobia often represents more the avoidant pattern that emerges when the fear of impending panic is tied to specific events or potential events. The person creates for themselves, based often upon minimal past experiences, a series of anticipatory states in which they contemplate, obsess over potential outcome and, often, thereby, assure that outcome. Desensitization procedures and psychotherapy with and without medication if often very helpful to these patients who need to amass a series of successful experiences to offset the fears that they are developing while isolating themselves. The Disorder can be characterized by a sense of detachment, feeling as though things are unreal, forgetting parts of the event, and reduced awareness of daily activities. The patient can have recurrent thoughts, dreams and sense of reliving the event.
Many patients begin to avoid settings similar to that in which the traumatic even occurred.
They concentrate poorly, are restless and may startle easily. If the symptoms persist longer than four weeks, it may be posttraumatic stress disorder which we can discuss next week. The symptoms can be distressing, may persist, and the prudent thing to do would be to seek consultation to determine if care is needed.