What is agoraphobia?

Coming from Greek, the word literally means “fear of the public square”, and is often said to refer to a fear of open spaces. However, this is somewhat misleading. Agoraphobia is actually an anxiety disorder in which you may perceive an environment as unsafe, with no escape, and the associated fear of such places or situations that could cause you to panic or feel helpless and embarrassed. This usually means that it is difficult for agoraphobics to feel comfortable in any public situation.

Agoraphobia can often cause sufferers to go out of their way to avoid the places and situations they fear, and in extreme cases, this can mean the patients become unable to leave their homes.

What are the symptoms of agoraphobia?

Agoraphobia usually goes hand-in-hand with panic attacks. While the fear of having another panic attack can be an important cause of the agoraphobia in the first place, it can also be the result of entering an environment or situation that the patient fears. Panic attack symptoms include:

  • Accelerated heart rate
  • Hyperventilation
  • Sweating
  • Nausea
  • Chest pain
  • Feeling faint

On a cognitive level, agoraphobics may experience:

  • Fear of looking stupid/embarrassing themselves (perhaps due to a public panic attack)
  • Fear of their heart stopping during a panic attack, or another fatal consequence
  • Fear of being unable to escape such a situation
  • Fear of losing control in public
  • Fear of losing their sanity
  • The sensation that people are staring at them
  • Fear of being left alone in the house
  • General anxiety or dread

Behavioural symptoms (usually a consequence of the cognitive symptoms) include:

  • Avoiding situations associated with panic attacks, e.g. crowded places, public transport, open spaces, etc.
  • Avoiding travelling far from home
  • Needing someone with them wherever they go
  • Not being able to leave the house (extreme cases)

What causes agoraphobia?

Agoraphobia usually begins after the patient experiences one or more panic attacks, and starts to fear having more. When this fear begins to affect behaviour, such as avoiding places the patient associates with the attack, agoraphobia can be diagnosed. In this way, it can be said to be a complication of panic disorder.

In some cases, it is triggered by other events, such as traumatic experiences, stressful events, such as bereavement, or drug abuse. Other mental illnesses, such as depression, or irrational fears of being attacked or catching illnesses from other people can also cause agoraphobia.

How can it be prevented?

There is no guaranteed way of preventing agoraphobia, but it is true that fear breeds fear. If you notice that you are starting to feel afraid of going to places that are logically safe, it is best to face that fear before it grows into a full-blown phobia by practising visiting the place again and again, perhaps with a trusted friend or family member.

What is the treatment?

If you are experiencing anxiety or panic attacks, it is important to seek help from your doctor or a specialist. Cognitive behavioural therapy (CBT) or other psychotherapy techniques, such as applied relaxation may be recommended. In some cases, medication may be prescribed.

There are also a number of support groups available, which many people with anxiety disorders find beneficial to contact.

A number of self-help techniques exist, which may form part of your therapy, or may be recommended by your doctor. These include breathing exercises, grounding techniques, controlling your thoughts and challenging your fear. As each case varies depending on the patient, it is always best to consult a doctor first.

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