Here’s something you might not know. Everyone has at least one activity that feels impossible – even though it’s a breeze for others. For most people, it’s frustrating but has little impact on their lives.
However, for people with agoraphobia, the consequences are a lot more serious. Many people think agoraphobia is just a fear of open spaces, but it goes far beyond that. Rather, it is an anxiety disorder which limits the spaces in which the person feels safe.
Someone with agoraphobia experiences intense fear when faced with the prospect of a situation where leaving might be difficult or help unavailable. Thoughts about what might happen if something goes wrong become overwhelming.
This makes certain ordinary environments daunting, including places like shopping malls, public transportation, and even large open fields. For some, even leaving the house is difficult. The person limits their activities, leading to struggles in relationships, work, and overall well-being.
Fortunately, with help from professionals, people with agoraphobia can heal and live a life in which possibility is welcome.
What to Know About Agoraphobia
Let’s get into the details of what exactly agoraphobia is, including its symptoms and its causes.
What is Agoraphobia?
Agoraphobia is an anxiety disorder. It develops after one or more panic attacks, during which the person feels an intense lack of control. This leads to avoidance of many situations, causing severe dysfunction in the person’s life.
What are the Symptoms of Agoraphobia?
Agoraphobia leads to emotional, physical, cognitive, and behavioral symptoms.
Emotional Symptoms
The primary emotional symptom is an intense fear of:
- Open spaces (such as parking lots, bridges)
- Enclosed spaces (like shops, theaters, cinemas)
- Public transportation (buses, trains, planes)
- Crowds or standing in line
- Being outside of the home alone
- Losing control
Physical Symptoms
The physical symptoms include:
- Rapid heartbeat or palpitations
- Sweating
- Trembling or shaking
- Shortness of breath or smothering sensations
- Feelings of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Dizziness, light-headedness, or feeling faint
- Chills or hot flashes
- Numbness or tingling sensations
- Feelings of unreality or detachment from oneself (derealization)
Cognitive Symptoms
Agoraphobia affects the person’s thoughts as well. This leads to:
- Persistent worry about having further panic attacks
- A fixation on places where previous panic attacks have occurred
- Negative self-talk and catastrophic predictions about situations perceived as unsafe
Behavioral Symptoms
It is the above factors which lead to the most recognized symptoms of agoraphobia – the person’s behavior. This includes:
- Avoidance of situations that might trigger panic attacks, often leading to isolation
- Seeking out a companion when outside of the home
- Leaving or ‘escaping’ a situation at the onset of anxiety
Examples of Agoraphobia
Agoraphobia presents differently in each individual, often depending on their personal circumstances and past experiences. Here are some stories of people who have experienced the effects of agoraphobia.
Sarah’s Bridge Fixation
Sarah, a 32-year-old graphic designer, had a panic attack on a bridge while walking to a conference. After this experience, she started feeling overwhelming anxiety about crossing bridges.
“If I approached a bridge, my heart started pounding out of my chest and I felt like I couldn’t breathe,” she recalls. She fixated on catastrophic possibilities, and had to take roundabout routes to work, leading to her arriving late and covered in sweat.
When a family member expressed their concern, Sarah sought help and slowly started exposure therapy, taking small steps towards facing her fears under guided supervision.
Michael’s Avoidance of Crowds
Michael’s agoraphobia developed following a series of panic attacks in crowded places. He describes being in a busy supermarket:
“Suddenly, I felt like the aisles were closing in on me. Getting out seemed impossible, like I was in a hole with no way of finding the exit.”
Michael quit his teaching job, as he could not avoid crowds in a high school. After a few weeks during which he barely left the house, he saw a therapist, who helped him with techniques like mindfulness and exposure therapy, among others.
How is Agoraphobia Treated?
Agoraphobia can have a severe impact on a person’s life, but there are multiple ways to treat it. Many people benefit from a combination of the following treatments.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is one of the most effective treatments for anxiety disorders, and this applies to agoraphobia as well. CBT works by utilizing the link between thoughts, feelings, and behaviors. By shifting one, you shift the other two as well.
Exposure Therapy
Exposure therapy focuses on the behaviors of the person. It involves exposure to the stressful situation, with measures in place to ensure the person knows they are safe. With prolonged exposure, even as the person’s instinct is to leave, they gradually become accustomed to the reality of the situation as opposed to their thoughts and feelings around it.
Cognitive Restructuring
This technique focuses on the irrational thoughts and beliefs that underlie the fear. The therapist helps the individual to first identify and name these thoughts, and then to challenge them. By repeatedly subjecting the thoughts to logical processes, the person begins to think differently, leading to a change in how they feel about the situation and how they act.
Mindfulness
Mindfulness was once seen as ‘alternative’ medicine, but it is now recognized as one of the most effective first-line treatments for mental health. Mindfulness can help a person with agoraphobia to feel their emotions in the moment. By doing so without judgment, the feeling no longer seems so overwhelming. The person recognizes it for what it is – a feeling rather than a fact – and it goes away on its own.
Medication
Medication can help with the symptoms of agoraphobia but should be used in conjunction with other treatments. Antidepressants can help reduce anxiety. Anti-anxiety medication, such as benzodiazepines, can provide temporary relief, but should be treated with care due to the potential for dependency.
Conclusion
Agoraphobia is an anxiety disorder that can have a severe impact on a person’s life. Some people with this illness struggle even to leave the house. Fortunately, it is highly treatable, with multiple routes towards healing.
Relief is not as far away as it may seem. If you or a loved one are suffering from agoraphobia, seek help from a professional now.
