case study of agoraphobia

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What Is a Case Study?

When you’re performing research as part of your job or for a school assignment, you’ll probably come across case studies that help you to learn more about the topic at hand. But what is a case study and why are they helpful? Read on to learn all about case studies.

Deep Dive into a Topic

At face value, a case study is a deep dive into a topic. Case studies can be found in many fields, particularly across the social sciences and medicine. When you conduct a case study, you create a body of research based on an inquiry and related data from analysis of a group, individual or controlled research environment.

As a researcher, you can benefit from the analysis of case studies similar to inquiries you’re currently studying. Researchers often rely on case studies to answer questions that basic information and standard diagnostics cannot address.

Study a Pattern

One of the main objectives of a case study is to find a pattern that answers whatever the initial inquiry seeks to find. This might be a question about why college students are prone to certain eating habits or what mental health problems afflict house fire survivors. The researcher then collects data, either through observation or data research, and starts connecting the dots to find underlying behaviors or impacts of the sample group’s behavior.

Gather Evidence

During the study period, the researcher gathers evidence to back the observed patterns and future claims that’ll be derived from the data. Since case studies are usually presented in the professional environment, it’s not enough to simply have a theory and observational notes to back up a claim. Instead, the researcher must provide evidence to support the body of study and the resulting conclusions.

Present Findings

As the study progresses, the researcher develops a solid case to present to peers or a governing body. Case study presentation is important because it legitimizes the body of research and opens the findings to a broader analysis that may end up drawing a conclusion that’s more true to the data than what one or two researchers might establish. The presentation might be formal or casual, depending on the case study itself.

Draw Conclusions

Once the body of research is established, it’s time to draw conclusions from the case study. As with all social sciences studies, conclusions from one researcher shouldn’t necessarily be taken as gospel, but they’re helpful for advancing the body of knowledge in a given field. For that purpose, they’re an invaluable way of gathering new material and presenting ideas that others in the field can learn from and expand upon.

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• v.64(Suppl 1); 2021 Apr

Depersonalization and a severe form of agoraphobia: A case report and review

C. pedro fernandes.

1 Psychiatry, Hospital de Braga, Braga, Portugal

2 Serviço De Psiquiatria, Hospital de Braga, Braga, Portugal

Introduction

Depersonalization during panic attacks may be a feature of a subgroup of Panic disorder. Several studies suggest that such subgroup corresponds to a more clinically severe form of Panic Disorder, with earlier onset and a higher rate of comorbidity with other psychiatric disorders, such as obsessive-compulsive disorder and generalized anxiety disorder. It is also hypothesized that depersonalization during panic attacks may lead Panic disorder to evolve into Agoraphobia.

To present the case report of a patient with severe Agoraphobia, whose only symptom of Panic disorder was depersonalization.

Description of a case report.

We describe the case of a 20-year-old woman who developed Agoraphobia after a single panic attack, during a physical education class, at the age of 13, with depersonalization symptoms only. After the attack, the patient stopped playing sports and engaging in any kind of activity in the absence of a trusted person. At the age of 20, the patient will only travel alone in the immediacies of her home, sometimes missing classes, because she cannot get a ride from trusted acquaintances. She justifies such avoidances with her fear of feeling depersonalized again. Over the course of her illness, she denied having experienced any other symptoms of a panic attack. She was treated with Paroxetine 40mg daily and cognitive behavioral therapy, having improved.

Conclusions

We believe this case provides good insight into depersonalization in panic attacks, supporting the view that Panic disorder with depersonalization may be a distinct and more severe subgroup of Panic Disorder.

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"Agoraphobia is a prison": Man confronts anxiety disorder that has restricted his life to one mile from his home

By David Begnaud

April 4, 2022 / 10:12 AM EDT / CBS News

Agoraphobia has gripped Cecil Jackson's life since he was 19 years old. He's one of an estimated 2 million adults in the United States who have the anxiety disorder that causes them to stay home to avoid situations that could cause a panic attack – like traveling or going too far away from home. 

"I have been colorfully living and silently suffering for years," Jackson said. 

Jackson has missed family weddings, birthdays and even funerals because of agoraphobia. He has restricted his life to one mile from his home — living across the street from his job and a grocery store.

"For me, agoraphobia is a prison," he said.

Recently, Jackson watched the "CBS Mornings" story about longtime anchor Karen Swensen stepping away from her TV career after overcoming a series of tragedies. Jackson said it was that story that caused him to take a clearer look at his own struggles and reach out to "CBS Mornings" lead national correspondent David Begnaud, asking Begnaud to be with him as he broke his boundaries.

"That was so powerful. I'm a 35-year-old Houstonian, and I suffer from agoraphobia. I seemingly lead a normal life as a local store manager, but no one knows that I haven't traveled beyond a one-mile radius from my home in over 10 years," Jackson told Begnaud. 

Jackson's late mother also suffered from agorophobia, but he never imagined it would happen to him, too. His symptoms first appeared when he was driving on the freeway, headed to school, on a sunny day. 

At first, he said, his heart began racing, his arms felt weak and he felt lightheaded. Jackson said he tried to ignore those symptoms, hoping it was something like hunger, but he was also having breathing issues and his vision became distorted. That's when he started experiencing depersonalization, in which things "don't appear to be real," Jackson said.

"Eventually, I went into a complete panic," he said.

"That morning, I thought I had the world at my feet," he said. "Hours later, the way that I viewed the world, the way that I viewed life had completely changed."

Jackson said the best way to describe agorophobia is feeling like he's living in a glass box — "like there are walls and boundaries that I cannot get past. And if I attempt to, or when I do, I literally feel as though I'm going to die."

In 2016, he found Dr. Karen Cassiday, the owner of the Anxiety Treatment Center of Greater Chicago. Throughout the years, Cassiday not only responded to him. She also arranged for a local therapist to treat him with a session held online.  

This past year, Jackson said he has accelerated steps to recover. He has lost 90 pounds in seven months by going meatless and giving up soda.  

CBS News arranged for Cassiday to fly to Houston to help guide Jackson as he confronted places and conditions. 

Jackson had a list of goals he wanted to get done during their meeting, including going to his therapist's office, going to the grocery store and riding an elevator — something he hasn't done in four years.  

"The last time I attempted to get on one, or got on one, I jumped off," he said. "So I kept trying to get on, but it got so overwhelming. I just said whatever's up there, I won't see today." 

The two embarked on the escalator together, Cassiday coaching Jackson every step of the way.  

"I want you to reframe the anxiety to say 'This means I'm doing something really good. This means I'm actually successful. I'm bringing it on,'" said Cassiday. 

He would ride up and down four times, relying on exercises to induce dizziness to make it through. It was not soon after that Jackson noticed that the exercises were working.

"The sweaty palms, the dizziness, the sensitivity to light, I think I stood there for like three minutes talking to her... and it just subsided," Jackson said. 

One of those exercises is a rapid breathing technique known as hyperventilation, in which Cassiday would intentionally provoke Jackson's anxiety. That is done to get him used to the sensation of panic and learn that he can handle it and teach his body to not respond with panic attacks, she said.

"I want to give you practice recovering from a panic attack so that you discover you can do it," Cassiday told him. "You don't have to be afraid of it. And even if the next time you go to your therapist's office it's the worst traffic jam ever, I want you to feel confident that you're going to get there."

For the first time in years, Jackson took an escalator by himself. He didn't just stop there: Together with Cassiday, he went to a grocery store for the first time in years.

"It's amazing to be here," Jackson said as he slowly walked through the aisles. 

He seemed quiet but not visibly nervous. But he managed to get through the cashier by himself and was all smiles as he walked out of the store moments later and high-fived Cassiday.

Jackson also ran outside his apartment complex for the first time ever and went to his therapist's office for a face-to-face appointment — a step toward his future treatments. 

He said he wanted to share his road to recovery to help others suffering from mental illness — but also to "be seen."

"Initially I thought that in telling my story that I needed to be in a place where I was recovered. You know, 'Let me be recovered so that everybody will see, you know, what it looks like at the end of the road,'" Jackson said. 

"I think that sometimes when you suffer, you feel like nobody sees you," he said. "And when you deal with agoraphobia, people write you off, and you're often hidden in the shadows. I hope that others feel seen by me sharing this message."

David Begnaud is the lead national correspondent for "CBS Mornings" based in New York City.

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Sue conquers panic and agoraphobia

Sue conquered her agoraphobia one step at a time, starting with a visit to her GP.

Time to read: 5 minutes

Sue, 30 years old, recently left the RAN after ten years of active service

I remember my first panic attack like it was yesterday. I guess I’d always been an anxious type, but this was like nothing I’d ever experienced. I was at a football game about six years ago. It was a big crowd, and St Kilda was getting hammered by the Pies.

I’ve never liked being hemmed in, feeling like I was stuck somewhere I couldn’t get out of easily, but suddenly this thing just took over me. I felt pains in my chest and I couldn’t breathe. I was sure I was having a heart attack and was going to die. I started thinking about my daughter – she was two at the time – and I kept saying to myself "it can’t end like this, I’ve got to see her again".

I was sweating, my heart was racing, I was trembling ... I had to get out of there.

Somehow, I managed to push my way through the crowd and find a St John’s ambo.

What a relief!

He helped me to the ambulance and they took me straight to hospital, wired me up to all sorts of machines and then ... they told me there was nothing wrong! Or as one of nurses put it, "it was all in my head".

All in my head?

Those pains were real. But all they said was that I’d had a panic attack. I was so happy to be alive, I didn’t ask them more about it. I just wanted to get home.

From that day, my life hasn't been the same. Especially my Navy career.

I've only been back to sea once. My skills are needed more on shore than at sea, thank God, but that last exercise was terrifying.

I spent the whole time worrying about whether I’d have an attack while we were far from land so I avoided being below decks whenever I could. In total, I’ve had about a dozen attacks and each one was terrifying.

I’ve stopped going anywhere that I can’t get out of easily in case I have another one. No shopping centres. No cinemas. No football games. No public transport. No crowded places.

I left the Navy because I couldn’t face going to sea again.

Help yourself

Everything came to a head when we were planning my daughter’s 8th birthday.

She wanted me to take her and a couple of friends into the city on the train to see a movie. But due to my panic attacks, I told her I couldn’t risk it ... then I got angry with her ... then I had a big fight with my husband about it.

It became obvious I couldn't go on like this any longer. I wasn't the only one suffering; it was now affecting my family.

The first step was seeing my GP, who told me I had panic disorder (which I guess I already knew) and something called 'agoraphobia'. That’s the part where I won’t go anywhere in case I have an attack.

He gave me a script for tablets to take if I felt a panic attack coming on, and referred me to a psychologist.

The psychologist explained everything about panic attacks and anxiety, emphasising that it was important to know I wasn't having a heart attack and I wouldn't die from it.

She explained there were different strategies to manage and prevent panic attacks, and the medication she prescribed was a last resort.

The more she explained what was happening, the more sense my panic attacks made. The tablets help to stop the attacks when they’re happening, but they don’t do anything to prevent another one. She says I can only learn how to control them if I let myself risk having one.

After a few months' treatment, I think we’re on the right track.

We’ve spent a lot of time talking about my breathing. She says I’m "hyperventilating", that my body is getting ready for fight or flight when there’s no danger there. I’ve been practising the exercises she gave me and I really do feel more in control.

The next step is to start getting back to do the things I’ve been avoiding. That’s scary, but she says I can do it in small steps. And she’s started to talk about how my thoughts play a part.

I’m a long way from 'cured', but I feel much more confident now and my husband says he can see it, too.

My daughter's 9th birthday doesn't feel so scary now.