Agoraphobia Disorder Diagnosis

Case number four illustrates that P’s constant avoidance from places has interfered with her integration in society. Introduced by the German physician Carl Friedrich Westphal in 1871, the Greek term agoraphobia is used to represent fear of spaces (Pollard & White, 2003, p. 20). The manifestation of her anxiety has overcome her ability to function as a productive social being, which can be seen in her job absence. According to the DSM IV, “agoraphobia is anxiety about, or avoidance of, places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having a panic attack or panic-like symptoms” (Staff, 1995, p. 429). While agoraphobia and panic disorders are commonly associated, this essay will support agoraphobia as P’s disorder.

P believes that being confined to her home will keep her safe from danger and hopelessness, especially places where she might experience similar situations, such as state or carnival fairs. Furthermore, the fact that P did not want to visit the doctor’s office provides another sign of her avoiding public places. Additionally, the elongated time of rescue was detrimental and imperative to the level of her current agoraphobic disorder. All of these instances are examples of what has caused and triggered this type of disorder. P’s disorder is not associated with “panic disorder with agoraphobia,” as she denied feelings of shortness of breath, choking sensations, nausea, chest pain, and fear of going crazy (Staff, 1995, 429). Being cognisant of this information, this analysis will disregard the panic disorder.

According to Pollard and White, agoraphobia is defined as a “maladaptive fear of and desire to avoid situations in which the individual believes symptoms of attack may occur and result in incapacitation, humiliation, or some other catastrophe” (2003, p. 20). P’s life-threatening experience while hanging on the Ferris wheel ride for an hour triggered desperation, which led to fear and desire to withdraw from public places where she might experience an emotional or deadly situation and be humiliated while being susceptible and exposed to someone else’s mercy. Moreover, P had confessed she was afraid of carnival rides prior to her experience on the Ferris wheel, which is probably why she closed her eyes while reaching the top of the ride. This event negatively reinforced her previously established fear about fair rides. The change in P’s sad and plaintive response to the possibility of engaging in carnival rides to an emphatic and assertive tone is another indication of her fear of engaging in similar activities in the future. It is also important to note that P’s sadness, hopelessness, irritability, and disinterest in sexual pleasure might be conducive to the theoretical perspective of a major depressive episode; however, she has not lost interest in everything that gave her personal pleasure, such as knitting and working on crossword puzzles. Another applicable disorder is one of the most common anxiety disorders, Generalized Anxiety Disorder, due to the duration of P’s symptoms, which have lasted over six months, one year to be exact.

References

Pollard, C. A., & White, E. (2003). Understanding agoraphobia. The agoraphobia workbook: A comprehensive program to end your fear of symptom attacks. (p. 20). Oakland: New Harbinger Publications.

Staff, A. P. (1995). Anxiety disorders. Diagnostic and statistical manual of mental disorders, fourth edition: primary care version (DSM-IV-PC) (pp. 429-430, 349). Washington, DC: American Psychiatric Association.