Agoraphobia

A person with agoraphobia is afraid to leave environments they know or consider to be safe. In severe cases, a person with agoraphobia considers their home to be the only safe environment. They may avoid leaving their home for days, months or even years.

Translated, agoraphobia means ‘fear of the marketplace’. Generally, busy public places (such as supermarkets, shopping centres, trams, trains, planes and airports) are feared the most.

However, any public place – even a quiet church or an empty park – may seem threatening to a person suffering from agoraphobia.

Typically, agoraphobia often starts off as a mild anxiety about a particular event, place or situation that escalates over time into a generalised fear of being in public. Mental health experts believe that the root of agoraphobia is fear of the physical and mental sensations of anxiety and, often, of panic or of losing control or embarrassing oneself.

A person with agoraphobia is unwilling to visit ‘unsafe’ places because they’re afraid that doing so will trigger anxiety or a panic attack.

The symptoms and signs of agoraphobia may include:

• panic attack including symptoms such as breathlessness
• sweating dizziness
• fast heart rate choking sensations nausea
• feelings of extreme fear or dread
• which can sometimes accompany the condition. Agoraphobia usually begins with a stressful event – for example
• a person loses a job or a relationship ends

They feel distressed and limit their contact with the outside world (this is called ‘avoidance behaviour’).

As time passes, they may consider more and more public places as ‘out of bounds’ until they are eventually confined to their home. Since panic attacks are so unpleasant, the person may avoid any situation or place that they think might trigger another attack until many situations and places are eventually feared and avoided.

Untreated, agoraphobia can severely reduce a person’s quality of life.

For example: Activities outside of the home such as work, school, socialising, hobbies and many forms of exercise are out of reach. Financial hardship, isolation, loneliness and boredom may lead to greater feelings of distress and increase the risk of depression. The person may recognise that their fear is irrational, but feel powerless to do anything about it.

They may feel angry and frustrated with themselves

These negative feelings damage self-esteem and contribute to depression, and other anxieties and fears. The person may try to cope using unhealthy methods (such as comfort eating, drugs or alcohol), which in turn can cause or contribute to further health problems. Diagnosis is usually based on the person’s reported symptoms.

However, the doctor may run a series of medical tests to make sure the symptoms are not caused by an underlying physical illness. The doctor may suggest referral to a psychologist or psychiatrist for further evaluation and treatment.

Agoraphobia responds well to treatment

The treatment options suggested by your doctor or therapist will depend on your circumstances and preferences, but may include:

• instruction in self-help methods. The key to conquering agoraphobia is learning to control anxiety symptoms
• progressively going into the situations that you fear. Be guided by your doctor or therapist
• but general self-help suggestions include: – hyperventilation (breathing too fast
• too shallow) will make the symptoms of a panic attack worse

Consciously slow your breathing

Concentrate on expanding your abdomen, not your chest, with every inhalation. – learning to relax may include methods such as meditation, deep muscle relaxation or regular exercise. You may need to experiment to find the relaxation method or methods that work best for you.

– overcoming agoraphobia involves understanding how anxiety affects the mind and body. – it may help to limit or avoid caffeine, alcohol and certain medications. Regular exercise burns off stress chemicals and is known to reduce anxiety levels.

See your doctor for further information and advice

– this involves facing the feared environment in a controlled way.

This will help you to see that nothing bad is going to happen

Typically, you choose the least threatening environment first, take along a trusted friend or your therapist as support, and use slow breathing and the other coping methods you’ve learned to control your anxiety.

With regular practise, the fear of the place or situation will ease.

This technique is also known as systematic desensitisation

It’s important to have the guidance of a mental health professional. About agoraphobia Agoraphobia is a type of anxiety disorder Symptoms of agoraphobia anxiety in response to being away from an environment that feels ‘safe’ anticipation of anxiety if the person is required to leave their safe environment low self-esteem and loss of self-confidence reluctance to leave the house or venture beyond familiar surrounds depression Agoraphobia develops over time In other cases, a stressful life event triggers a panic attack Complications of agoraphobia Diagnosis of agoraphobia Treatment for agoraphobia a course of medications, such as antidepressants or anti-anxiety medications cognitive behaviour therapy and exposure therapy counselling and talk therapy relaxation training support groups Self-help methods to manage agoraphobia Breathe slowly Use relaxation techniques Find out about your condition Change your lifestyle Gradually increase exposure Where to get help Your GP (doctor) Clinical psychologist Psychiatrist Your local community health centre Mental Health Foundation of United States (Michigan) (616) 555-0200 Anxiety Recovery Centre Michigan (616) 555-0200 or 1300 ANXIETY (269 438).

Key Points

• Diagnosis is usually based on the person’s reported symptoms
• doctor may suggest referral to a psychologist or psychiatrist for further evaluation and treatment
• Agoraphobia responds well to treatment
• It’s important to have the guidance of a mental health professional