Agoraphobia: What It Is and What You Can Do About It
Agoraphobia, translated roughly from Greek, literally means ‘fear of the marketplace.’ In the past, it was believed to be the debilitating fear of open spaces and public places. As more studies and research have shown, it is now thought as a result of continued episodes of panic attacks.
Agoraphobia often results when a person becomes extremely fearful of being trapped in a place or situation from which he cannot escape. He might also believe that escaping from that situation may prove to be difficult or that he may not be able to find help.
As a result, a person with agoraphobia begins to shun public places where there are too many people. He might also find it too constricting to ride buses, airplanes, cars and trains. In its severe form, agoraphobia may also keep a person from stepping out of his home, the only place where he feels safest.
Agoraphobia and panic disorder
Agoraphobia is the result of a panic disorder that has remained untreated, ignored or misdiagnosed. A panic disorder is the result of continued episodes of panic attacks, where a person suffers from intense discomfort and feelings of extreme fear.
Panic attacks can also occur without a warning and affects about one-third of the adult population annually. It may either occur in isolation or as a result of another disorder such as depression, anxiety or social phobia. Unlike anxiety, panic attacks can only last for a short while, usually 20-30 minutes.
Agoraphobia does not occur by itself. It usually makes its first appearance within 12 months of the recurrence of several episodes of panic attacks. In fact, one out of three people who suffer from panic disorder have a high possibility of developing agoraphobia. Agoraphobia, like panic disorder, is usually a chronic condition.
Symptoms of agoraphobia
Agoraphobia sufferers experience several symptoms all at once, including heart palpitations or increased heart rate, shortness of breath, numbness, dizziness, chest pain, trembling, sweating, extreme hot or cold, feelings of losing control, going crazy or dying.
While some episodes of agoraphobia can occur without warning, being in certain situations can trigger an attack. People who suffer from agoraphobia are actually afraid they might have a panic attack. If they are stuck in a situation where escape or help may prove difficult or awkward such as parties, crowded shopping malls or subways, they become more agitated and their feeling of panic swells.
To avoid the feeling of being ‘trapped’, people with agoraphobia stay away from public places. This is not because they are afraid of public places per se, but because they do not want to suffer from a panic attack while in those locations. To feel safe, they instead keep to familiar places, such as their homes or insist in having the constant company of a trusted person.
Treatments for Agoraphobia
The most common treatments for agoraphobia are Cognitive Behavioral Therapy (CBT) or medication. A combination of both may also be used in certain cases. CBT is a type of psychotherapy that is also used to treat other mental disorders. As a treatment, CBT involves altering a patient’s thinking patterns so he can manage and handle his fears.
Patients are taught to understand what agoraphobia is and to accept that the feelings of panic are normal, albeit amplified. Certain patterns of automatic thinking and behavior during an episode of agoraphobia may also be altered to help the patient cope should one occur.
To help patients handle their reactions, they are also taught to control their breathing as part of coping skills. CBT also involves exposing a patient to situations or incidents that usually trigger agoraphobia. CBT as a treatment is quite successful, helping about 85% of panic attack patients recover after only about 10 sessions.
Medication usually involves either anti-depressants or anti-anxiety drugs. Anti-depressants serve to reduce or totally prevent episodes of panic attacks, although they usually begin to take effect only after several weeks. Anti-anxiety drugs, on the other hand, are fast acting and can produce a calming effect in less than an hour.
Therapies used for Agoraphobia
Other forms of treatments and therapies to address and eliminate agoraphobia include family therapy, group therapy using CBT and relaxation techniques using meditation. Depending on the severity of the patient’s mental condition, a combination of several treatments may be used to produce the desired effect.
