So what is agoraphobia? Do you feel overwhelmed with fear of getting out of an embarrassing situation or being alone in public? Well, you may have it. Agoraphobia refers to being terrified of being alone in open areas.

What is agoraphobia?

Over 90% of the patients are women in their thirties and forties. People suffering from this disorder may have anxiety, depression, dizziness, strangeness, and irrational thoughts. Traumatic experiences can trigger it. 

As a result of the disorder’s anxiety, patients avoid circumstances where they may feel confined, helpless, or embarrassed. Some patients refuse to leave their homes for months at a time.

It is common for people who are afraid of panic attacks to avoid certain places and situations. agoraphobics, for example, fear driving, leaving the house, shopping in a mall or traveling by airline, or simply entering a crowded environment [1].

Since these situations that are avoided are so common, those who have agoraphobia can become extremely limited and lonely, with negative consequences on both their personal and professional lives.

People with agoraphobia may have difficulty traveling for work or seeing family and friends because of their increased worries and avoidance behaviors. The most straightforward tasks can become difficult, such as going to the supermarket.

A person with agoraphobia may become so scared and apprehensive that they cannot leave their house. Because agoraphobic symptoms are treatable, it is a good thing.

Types of agoraphobia:

Even though many persons with agoraphobia also have panic disorder, agoraphobia can be diagnosed without a history of panic disorder.

Even when this happens, the individual is paralyzed by the fear of being trapped in uncomfortable or embarrassing circumstances.

However, they don’t worry about having full-blown panic episodes at all. Some people may be scared of experiencing an uncomfortable anxiety symptom, such as vomiting or a strong migraine, rather than a more serious physical problem. For example, the individual may be scared of losing control of their bladder or fainting in public with no one to assist them.

At least a third of people with panic disorder will develop agoraphobia. About 0.9% of the adult population in the United States suffers from agoraphobia. However, it can begin earlier in adolescence.

Symptoms of agoraphobia:

People that have agoraphobia are typically:

  • Terrified of being alone in a social scenario, afraid of leaving their house for extended periods.
  • Scared of losing power in public.
  • Scared of being in situations where it would be impossible to leave, such as a car or elevator that is isolated or estranged from others.
  • Worried or disturbed when out of their comfort zone.

Panic attacks are frequently associated with agoraphobia. These usually occur in people who suffer from anxiety or other mental health conditions [2]. Panic episodes can cause a variety of severe physical symptoms, including:

  • Shortness of breath, dizziness, and chest pain
  • trembling, sweating, and hot flashes
  • chills
  • nausea
  • diarrhea/numbness
  • sensations of tingling

People with agoraphobia may experience panic attacks when they enter a stressful or uncomfortable situation, increasing their anxiety about being in an uncomfortable scenario.

Causes of agoraphobia:

It is not well known what causes agoraphobia. It is, however, frequently connected with an existing panic disorder.

Panic disorder creates brief, acute bouts of dread for no apparent reason. A third of persons who have panic disorder develop agoraphobia. However, agoraphobia can emerge on its own.

These are some examples:

  • Having another anxiety disorder, such as panic disorder or social anxiety disorder
  • Yet another phobia
  • A history of Agoraphobia in the family
  • Abuse or trauma history
  • Chemistry of the brain

Learned associations can also contribute to the emergence of agoraphobia. When you have a panic attack in a specific circumstance or environment, you may be afraid of it [3].

Food sensitivities and agoraphobia:

This disorder is more closely associated with food sensitivities than with anything else. Often, agoraphobics consume a lot of sweets, caffeine, and sugary refined carbohydrates [4].

They often breathe shallowly and have poor posture. A major life event can trigger agoraphobia after food sensitivity has developed as well.

Some risk factors for developing agoraphobia:

The following are risk factors for developing agoraphobia:

  • Experiencing panic attacks and other phobias.
  • Other anxiety disorder diagnoses.
  • Experiencing traumatic life experiences, such as losing a loved one, an attack, or abuse.
  • A nervous or anxious disposition.
  • Reacting to panic attacks with excessive anxiety and dread.
  • Being related to someone with agoraphobia [5].

Complications of agoraphobia:

Without treatment, agoraphobia can significantly diminish a person’s quality of life. 

For instance:

  • Work, education, socializing, hobbies, and several forms of exercise outside the home are inaccessible.
  • Financial difficulty, social isolation, loneliness, and boredom can amplify misery and increase the risk of depression.
  • The individual may see that their fear is unjustified but feel unable to overcome it.
  • They may experience anger and frustration towards themselves.
  • These unpleasant emotions harm self-esteem and contribute to sadness, anxiety, and other phobias.
  • The individual may attempt to cope with harmful practices (such as comfort food, drugs, or alcohol), increasing other health issues [6].

Diagnosis of agoraphobia:

Agoraphobia can be diagnosed based on symptoms and indicators. You’ll have to tell about your symptoms to your doctor, including when they started and how often they happen.

They might ask about your health history and family history. You may undergo blood tests to rule out the physical causes of your symptoms [5].

Your symptoms must fulfill certain criteria stated in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) to be diagnosed with agoraphobia. The DSM is a guidebook that healthcare providers frequently use to diagnose mental health issues.

You must experience acute fear or anxiety in at least two of the following situations to be diagnosed with agoraphobia:

  • Travel on public transportation, such as a train or bus, being in open spaces, 
  • Being in confined locations, such as a store or parking lot, being in a crowd, being away from home alone

There are additional diagnostic criteria for panic disorder with Agoraphobia. It would be best if you experienced recurring panic attacks, and at least one panic attack must be followed by:

  • Fear of having additional panic attacks
  • Stress about the repercussions of panic attacks, such as having a heart attack or losing control; a shift in your conduct as a result of the panic attacks

If another illness causes your symptoms, you will not be diagnosed with agoraphobia. They cannot also be the result of substance abuse or another disorder.

What triggers agoraphobia?

Agoraphobia is typically a consequence of panic disorder, an anxiety disease characterized by panic attacks and acute terror.

It can result from connecting panic episodes with the places or situations in which they occurred and therefore avoiding those places or situations.

What’s the difference between anxiety and agoraphobia?

A person with agoraphobia dreads having anxiety attacks or losing control in specific situations. Still, a person with social anxiety fears being criticized or embarrassed in social contexts is the distinction between social anxiety and agoraphobia.

What does a person with agoraphobia look like?

A common problem of agoraphobia is the inability to feel secure in large crowds. You may feel the desire to have company in public areas, such as a friend or a family member. Because of the anxiety, you may not be able to venture out of your house.

Does agoraphobia run in families?

Parents can pass on agoraphobia to their children. According to the Encyclopedia of Mental Disorders, agoraphobia runs in families.

Although agoraphobia can be a genetic condition, it typically does not manifest until late adolescence or early adulthood.

What is the best treatment for agoraphobia?

Agoraphobia is typically treated with a mixture of counseling, medication, and lifestyle modifications. A therapist can assist you in overcoming your fears.

Using cognitive-behavioral therapy (CBT), a mental health professional can assist you in identifying anxious-provoking thoughts.

Are you born with agoraphobia?

There is always a reason: if you weren’t born with it, we could make sense of it, and most people aren’t born with agoraphobia.

According to Boston, hypnotherapy can facilitate access to the subconscious mind, where behaviors are often hidden. However, this method remains understudied and quite controversial.

Other methods of therapy involve either talking through a person’s process of thinking, talking about their history, childhood, and family, and many more.

How long does agoraphobia take to treat?

According to research, a person can recover from agoraphobia in months instead of years or permanently. On average, and without medication, you can anticipate treating a patient to remission in 12 to 16 weeks or fewer with the proper treatment.

Agoraphobia self-help tips:

The key to conquering agoraphobia is learning to control anxiety symptoms and progressively venturing into the circumstances you fear [12].

Consult your physician or therapist for specific advice; however, the following are some general pointers for self-care:

Breathe deeply — hyperventilation (breathing too rapidly and shallowly) can worsen panic attack symptoms. Take a deep breath consciously to relax your body [13]. With each inhalation, your focus should be on expanding your abdomen rather than your chest.

Use relaxation techniques – learning to relax may involve meditation, deep muscle relaxation, or regular exercise. You can try a few different relaxation techniques before finding one you like.

Find out about your condition – resolving agoraphobia entails understanding how anxiety affects the mind and body.

Change your lifestyle – it may help reduce or avoid caffeine, alcohol, and some drugs. Stress-relieving hormones are released into the body when you exercise regularly. See your doctor for further information and guidance [14].

Gradually increase exposure – this entails encountering the scary environment in a controlled way. You’ll observe that nothing bad will happen due to this.

To manage anxiety, most people begin by finding a safe place to be, enlisting the help of a friend or therapist for moral support, and practicing calming techniques like deep breathing and other coping mechanisms.

With continuous practice, the fear of the place or scenario will ease. Systematic desensitization is another name for this process. It’s crucial to have the counsel of a mental health expert.

Educate yourself – One of the problems of overcoming Agoraphobia is learning to correct your erroneous notions of particular unsafe locations with no easy option to flee.

Learning how to respond to the anticipated anxiety of entering open and closed areas might help you manage fear and worry.

Find support – Take a look around your community to see what resources are available if you’re one of the millions who have a specific phobia.

In-person and online support groups can be an encouraging component in the lives of those who seek to control their anxiety about leaving their house and accessing open or closed places. Don’t be afraid to inform loved ones about your phobia and ask for their support in dealing with it.

Recruit a professional- If you are afraid of being in large crowds or open places, get aid from a mental health expert or your primary care physician.

Even if you think you can cope with your anxiety right now, avoiding situations will only worsen in the long run. You don’t have to let fear interfere with the life you want to lead and keep you from the locations you want to travel.

Find someone who can help you get started on your journey to discovering the appropriate treatment for you today and take the first step.

How to treat agoraphobia?

There are several ways to treat Agoraphobia. You will almost certainly require a combination of therapy options.

Psychotherapy for anxiety:

Psychotherapy, often known as talk therapy, entails meeting regularly with a therapist or other mental health expert. This allows you to discuss your anxieties and any issues contributing to your fears.

For maximum success, psychotherapy is frequently paired with drugs. It is typically a short-term medication that you can stop taking once you have overcome your anxieties and anxiety [7].

Cognitive Behavioral Therapy (CBT)

People with agoraphobia are often treated with cognitive-behavioral therapy (CBT). Cognitive-behavioral therapy (CBT) can help alleviate agoraphobic symptoms.

Regaining a sense of self-control in your life can be made easier by learning techniques for dealing with stressful situations by replacing unhealthy thoughts with healthy ones [8].

Exposure Therapy

Exposure therapy can also be combined with other forms of psychotherapy to help conquer your concerns. You’re gradually introduced to the things or places you’re afraid of in this therapy. Over time, you may find less afraid [9].

Anxiety medications

Certain drugs can help alleviate the symptoms of agoraphobia or panic attacks [11]. These are some examples:

  • Drugs that inhibit serotonin reuptake, such as paroxetine (Paxil) or fluoxetine, are used to treat depression (Prozac)
  • Serotonin and norepinephrine reuptake inhibitors with selectivity, such as venlafaxine (Effexor) or duloxetine (Cymbalta)
  • Amitriptyline (Elavil) and nortriptyline are examples of tricyclic antidepressants (Pamelor)
  • Anxiety drugs like alprazolam (Xanax) or clonazepam (Klonopin)

More tips for helping agoraphobia:

Along with guidance from a mental health professional, there are things that you can do in your daily life to possibly help lessen the symptoms and effects of agoraphobia. These include but are not limited to:

Elimination and Challenge Diet:

Eliminate all foods that could cause problems in the diet. It is strongly recommended to consume a vegetarian diet without animal products (meat, milk, eggs, and cheese), avoid white foods (white flour, white rice, white pasta, white bread, white sugar), and no caffeine (tea, coffee, soda, and chocolate). Using the “Elimination and Challenge Diet,” a person should attempt to identify any foods they may be sensitive to. 

Spirituality 

Practicing prayer is essential. Turn your thoughts to a sacred theme when anxiety arises. Many people have found relief through prayer.

If we do not ask God in this way, it is a law of our nature to expect that he can help us when we cannot. There have been numerous studies that demonstrate the benefits of prayer.

Consider getting a massage

A massage provides several benefits. If possible, give yourself a full body massage or rub your feet. Massage is more than just psychological relaxation; it has healing benefits that cannot be easily defined for emotional and mental disorders [10].

Introduce regularity in your life

Keep a regular schedule for everything you do, including eating, exercising, and sleeping.

Agoraphobia develops gradually:

An individual with agoraphobia is likely to develop the condition after experiencing a stressful event – such as losing their job or breaking up with a partner.

They feel distressed and minimize their contact with the outer world (called ‘avoidance behavior’). As time passes, people may perceive more and more public areas as ‘out of bounds’ until they are permanently limited to their houses.

A stressful life event might also set off a panic attack in certain people. Since panic attacks are so painful, the person may avoid any circumstance or place that they think can trigger another attack until many situations and places are finally feared and avoided.

Is agoraphobia permanent?

Around a third of persons with agoraphobia eventually obtain a complete cure and remain free from symptoms.

About half of those who take the medication see an improvement in their symptoms, but they may also experience flare-ups at times, such as when they are anxious.

One out of every five agoraphobics struggles with their symptoms even after treatment.

When to see a doctor?

Agoraphobic avoidance is unusual in non-clinical samples of adolescents and is usually not related to panic attacks.

However, teenagers with agoraphobia symptoms and panic disorder exhibit similar clinical correlations compatible with a panic/agoraphobia spectrum model.

Agoraphobia can seriously impair your ability to interact with others, work, attend key events, and even perform routine tasks like running errands.

Don’t permit agoraphobia to limit your horizons. If you experience any of the symptoms or signs listed above, contact your doctor.

Conclusion 

Untreated, agoraphobia can severely affect a person’s quality of life. Attending work or school, spending time with friends, and participating in hobbies and other extracurricular activities become impossible.

Therefore, treatment for agoraphobia must begin immediately. The treatment methods discussed above can be effective in managing agoraphobia. Contact your doctor if you experience symptoms that persist.

References:

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  2. Asmundson, G.J., Taylor, S. and AJ Smits, J., 2014. Panic disorder and agoraphobia: An overview and commentary on DSM‐5 changes. Depression and Anxiety, 31(6), pp.480-486.
  3. Wardle, J., Hayward, P., Higgitt, A., Brewin, C. R., & Gray, J. (1997). Causes of agoraphobia: The patient’s perspective. Behavioural and Cognitive Psychotherapy, 25(1), 27-38.
  4. Armstrong, P. (1992). Back to life. Print Origination Formby. Met-seysidc.
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  6. Wittchen, H. U., Nocon, A., Beesdo, K., Pine, D. S., Höfler, M., Lieb, R., & Gloster, A. T. (2008). Agoraphobia and panic. Psychotherapy and Psychosomatics, 77(3), 147-157.
  7. Furukawa, T. A., Watanabe, N., & Churchill, R. (2007). Combined psychotherapy plus antidepressants for panic disorder with or without agoraphobia. Cochrane Database of Systematic Reviews, (1).
  8. Porter, E., & Chambless, D. L. (2015). A systematic review of predictors and moderators of improvement in cognitive-behavioral therapy for panic disorder and agoraphobia. Clinical Psychology Review, 42, 179-192.
  9. Malbos, E., Rapee, R. M., & Kavakli, M. (2013). A controlled study of agoraphobia and the independent effect of virtual reality exposure therapy. Australian & New Zealand Journal of Psychiatry, 47(2), 160-168.
  10. Dey, L., Gnerlich, J. L., & Yuan, C. S. (2003). 31 Complementary and alternative therapies for other disorders. Textbook of Complementary and Alternative Medicine, 355.
  11. Perna, G., Daccò, S., Menotti, R., & Caldirola, D. (2011). Antianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition. Neuropsychiatric Disease and Treatment, 7, 621.
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  14. Kiropoulos, L. A., Klein, B., Austin, D. W., Gilson, K., Pier, C., Mitchell, J., & Ciechomski, L. (2008). Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT?. Journal of anxiety disorders, 22(8), 1273-1284.