What exactly is agoraphobia? The word agoraphobia actually means fear of open spaces; however, the essence is a fear of panic attacks. If you suffer from agoraphobia, you are afraid of being in situation from which escape might be difficult – or in which help might be unavailable – if you suddenly had a panic attack.
You may avoid grocery stores or freeways, not so much because of their inherent characteristics but because these are situations from which escape might be difficult or embarrassing in the event of panic. The fear of embarrassment plays a key role. Most agoraphobics fear not only having panic attacks but what other people will think should they be seen having a panic attack.
Some of the more common situations that agoraphobics avoid include:
- Crowded public places such as grocery stores, department stores or restaurants.
- Enclosed or confined places such as funerals, bridges, or the hairdresser’s chair.
- Public transportation such as trains, buses, subways, or planes.
- Being at home alone.
The most common feature about agoraphobia is the anxiety about being far away from home or far from a “safe person” (usually spouse, partner, a parent, or anyone you have an attachment to). If you do have agoraphobia, you are not only phobic about a variety of situations but tend to be anxious much of the time. This anxiety arises from anticipating that you might be stuck in a situation in which you would panic.
Agoraphobia, in most cases, appears to be endangered by panic disorder. First, you become aware that your attacks occur more frequently in confined situations away from home or when you are by yourself. This is when you start to avoid these situations for fear of panicking, and you might go from mild, moderate or severe problem. In mild cases, you feel uncomfortable in confined situations but not actually avoid them, and you can continue your day to day activities. In moderate cases, you start to avoid some situations, such as public transportation, elevators, driving far from home, or being in restaurants. This only places the restriction level at only partial, and there could be some situations away from home or your safe person that you can handle on your own with some discomfort. In severe cases, it is an all-inclusive restriction of activities to the point where you are unable to leave your house without being accompanied.
Possible Treatment Options
- Relaxation Training, Panic Control Therapy, and Interoceptive Desensitization: Use the same treatments as for panic attacks.
- Exposure: Exposure Therapy means you face, or expose, yourself to a feared situation. Situations that you have avoided are gradually confronted through a process of small incremental steps.
- Cognitive Therapy: To help you replace exaggerated, fearful thinking about panic and phobias with more realistic and supportive mental health. You learn to identify, challenge, and replace counterproductive thoughts and constructive ones.
- Medication: Current medications utilize SSRIs such as Zoloft, Lexapro, Celexa, or Cymbalta are likely to be used in more severe cases where a person is household bound or highly restricted in what they are able to do. Low doses of tranquilizers such as Xanax or Klonopin may also be used to help people negotiate the early stages of exposure.
- Assertiveness Training: Since agoraphobics often have difficulty standing up for themselves and their rights, assertiveness training is frequently part of the treatment.
- Group Therapy: Treatment for agoraphobia can be done very effectively in a group setting. There is much support available in a group, both for realizing that you are not alone and for completing week-to-week homework assignments.
If you or someone you know is dealing with mental health, issues please seek help. I am available at firstname.lastname@example.org. There is help for you.