Agoraphobia is an anxiety disorder. People who suffer from this condition fear being away from places where they feel safe, often this means that they fear leaving their home.
In less severe cases, agoraphobic fear can occur when the sufferer is faced with public spaces or places where they can’t easily escape. Examples of these types of places include: supermarkets, shopping centres, trains, planes, airports, parks, and office buildings.
Typically sufferers will either avoid these situations and places altogether, or only go to these places/events with someone else.
What causes agoraphobia?
Agoraphobia develops over time. It usually starts with a sufferer experiencing anxiety and fear around a particular place or situation.
The initial anxiety is usually generated by an aversion to the physical or mental effects of fear brought on by the place or situation.
For instance, if a person felt fearful in a shopping centre food court and they experienced shortness of breath and sweaty palms, they may develop a serious fear of a racing heart beat or excessive perspiration, because they associate these things with fear and discomfort. They may start to associate food courts with these negative feelings and may begin to avoid them altogether.
Gradually over time, these fears grow and expand beyond a particular situation, to several situations, and eventually to most public spaces, so that the sufferer only really feels safe in their own home.
What are the symptoms of agoraphobia?
Common symptoms of agoraphobia include a fear of:
- Being alone in public spaces
- Having a panic attack
- Crowded places
- Losing control in public
- Public embarrassment
- Getting stuck in a place that cannot be exited quickly, like a lift, train, bus or aircraft
- Being too far from immediate medical help
People who suffer agoraphobia may also be extremely co-dependent, feel helpless a lot of the time and may experience panic attack symptoms when they feel unsafe or when out in public. These panic symptoms include:
- Rapid heart rate
- Excessive perspiration
- Shallow breathing
- Shaking and/or trembling
- Chest pain or pressure
- Upset stomach
- A feeling of chocking or suffocating
- Detachment from surroundings
- Fear of losing mind and/or dying
- Hot or cold flushes
- Dry mouth
The very best thing you can do if you feel that you are developing the symptoms of agoraphobia is seek professional help immediately. The quicker that you get help, the easier it is to stop further symptoms developing, and the road to recovery can be much quicker.
Your first port of call should be a visit to your GP. Tell them what’s been going on and how you have been feeling. Also ask them for a referral to see a psychologist or a psychiatrist.
Once you have this referral, make sure you book regular appointments with your psychologist or psychiatrist.
You can also have a look at the Australian Psychological Society’s website to find a psychologist near you who specialises in agoraphobia and anxiety conditions.
One of the keys to managing agoraphobia is to understand it. The more you know about your condition, the more you can begin to unpick its hold on your life.
There are some great resources out there where you can learn more about the condition, including:
Address your core fears
Anxiety, panic and agoraphobia are caused by deep-rooted core fears. These usually revolve around:
Fear of loss of control
Panic is intense, and the physical and mental fear symptoms it brings on can make you feel like you are going to lose control of yourself.
Sometimes you believe you will say or do something that you can’t control, like opening a plane door mid-flight, or that you will scream on a crowded bus, lose the ability to speak, lose bladder control in a supermarket, run wild through the streets, or any other number of other ‘loss of control’ scenarios that you can imagine.
The truth is, there is no documented evidence anywhere on this blue planet, of someone losing control of themselves during a panic or anxiety attack. None. It simply does not happen.
You are in control of your actions no matter what your mind tells you.
Fear of insanity
Anxiety and panic will not make you “go crazy”. The feeling of dizziness, loss of control and disassociation with surroundings has nothing to do with a mental disorder and everything to do with the constriction of blood flow, a lack of oxygen and fear thoughts.
Combined, these things can make you feel detached from reality, dizzy and disoriented; like you’re not in full control. This is understandably frightening, and can make some people believe that they are mentally unstable.
But the truth is you are not “losing your mind”. It is just a temporary physical disturbance. There has never been a single documented case of a person “going crazy” from panic or anxiety.
In fact, severe mental disorders that are often associated with a break from reality develop over years, they do not suddenly occur out of panic.
Indeed, in cases of serious mental disturbances often associated with “going crazy”, the sufferer is unaware that there is anything wrong, and it is only after medical intervention that a condition is diagnosed and medicated. The fact that you fear “going crazy” is a clear indicator that you are not losing touch with reality.
Fear of death
You simply cannot die from a panic attack. Your heart may race and you may feel constriction in your chest, but this is temporary, it won’t last. You cannot suffocate from panic either. You may have shortness of breath and feel dizzy, but you will not stop breathing. It can’t happen. Even if you did faint (which again, is nearly impossible), your body would automatically breathe while you are unconscious.
The symptoms of panic are extreme and they can make you feel like you are dying. But that’s the key, they are feelings, not the reality. They are also temporary and non-life threatening, they will generally pass in around 10 minutes.
Fear of public humiliation
A big fear a lot of agoraphobics suffer is that of public humiliation, of doing or saying something in a public place that would shame them.
The fear of public humiliation is often worse than the event itself. Taking into account that during an anxiety attack you won’t lose control or “go crazy”, it follows that it’s unlikely you will do anything to embarrass yourself.
Secondly, even if you do something embarrassing in public, who cares? Will you ever see those people again? It’s not probable. Do they matter all that much to you? Is their opinion worth even an hour of your life? No! The answer is definitely no.
In fact, most people are to inwardly focused to even notice you in public. At best they will notice you for around a minute, then they’ll forget you just as quickly.
And anyway, any public humiliation can always be spun into a funny story for your friends over dinner one night. Change the way you view the situation, and you will change the situation itself in your mind.
Cognitive behavioural therapy (CBT) is often used for people with agoraphobia. CBT basically retrains you to recognise and overcome the distorted patterns of thinking which lead to fear and avoidance behaviours.
You can do CBT with a trained psychologist, or there are also some great CBT programs online that may help, including:
Acrophobia can be extremely isolating. Joining a support group with other people suffering similarly can be a huge help. It is a place not only to share your concerns, and compare notes and treatment strategies, but it is also a place to go where people truly understand what you’re going through.
To find a support group near you visit:
Learning a few relaxation techniques can help you calm down and manage your anxiety when you are in a feared situation or place.
The two techniques below are designed specifically to help you calm down when you feel anxious.
In the middle of anxiety it can be hard to think straight to correct your disordered thoughts. So in preparation for an anxiety attack, you may want to write up a few thought cards to give you clarity when panic strikes.
Basically, you create a thought card by writing a single “thought” onto a piece of cardboard or in the notes section of your phone, that you can carry around with you, and look at when your anxiety rises.
Thoughts you could write on your emergency cards could include:
- Panic is only temporary, it will pass soon
- My fast heartbeat and shallow breathing are just anxiety, I am not dying
- I cannot go crazy from a panic attack
- I am in control, what I am feeling is just the physical symptoms of anxiety and it will pass soon
- It’s time to do a breathing exercise
- Anxiety is a bully, but it cannot hurt me
Exposure therapy (graded, repeated, prolonged)
Exposure therapy is a must for people with agoraphobia, however it is best done under the supervision or guidance of a psychologist.
Basically, what exposure therapy is, is gradual exposure to the situations and places that you fear.
Exposure therapy involves three steps: graded, repeated and prolonged exposure.
Graded: this means that you start with something that you only fear a little, and gradually work your way up to the most feared situations and places.
Repeated: This means that you will repeatedly expose yourself to feared situations to de-sensitise you to the fear.
Prolonged: Here, you will work your way up to prolonged outings to feared places. You may start with only a minute or so there, and work up to spending hours in the location or situation.
Over time, with repeated exposure, the fear of the situation or place will lessen and eventually leave altogether.
There are medications that you can take to help you cope with the symptoms of agoraphobia when your working on eliminating the fear with a therapist.
Speak to your GP about your options, and remember that medicines work hand in hand with therapy, they should not be the sole source of treatment.
You don’t have to live with the tyranny of fear. Agoraphobia is a treatable condition, and with time, effort and a care plan, you can absolutely overcome its grip and go on to live a life free from fear.
Interested in mental health?
Open Colleges offers a number of mental health courses, including a Diploma of Counselling. Study online and learn the skills you need to help people through life’s struggles.