Agoraphobia

Get help without leaving the house.

Agoraphobia can develop from having panic attacks. This page explains what you can do to prevent it from happening if you already have panic attacks. It will also discuss what to do if you already have agoraphobia to help you to recover.

Before discussing self-help, I shall provide a quick overview that you can use at home to take away the fear and help you get your life back.

TOP 10 key points about agoraphobia

1. Agoraphobia isn’t just a fear of open spaces: Contrary to popular belief, agoraphobia is not simply a fear of open spaces. While some individuals with agoraphobia may experience this, the core fear is actually about situations where escape might be difficult or help wouldn’t be readily available if something went wrong. This can include crowded places, public transportation, being alone outside the home, or even being in certain enclosed spaces like airplanes or elevators.

2. It’s a complex anxiety disorder: Agoraphobia is more than just intense fear; it’s a recognized anxiety disorder. This means it involves not only the emotional aspect of fear but also physical symptoms like panic attacks, dizziness, nausea, and rapid heartbeat.

3. It’s surprisingly common: Agoraphobia affects millions of people worldwide, impacting individuals of all ages and backgrounds. It’s often more prevalent in women than men.

4. The cause is unclear: While the exact cause of agoraphobia remains unknown, a combination of factors likely plays a role. These include genetics, brain chemistry, traumatic experiences, and personality traits.

5. Avoidance is a key feature: People with agoraphobia often develop coping mechanisms to manage their fear, such as avoiding situations that trigger anxiety. T

6. It’s highly treatable: The good news is that agoraphobia is treatable with various evidence-based therapies. Cognitive-behavioural therapy (CBT) is often the first line of treatment, helping individuals understand and challenge their anxieties and gradually expose themselves to feared situations. Medications can also help manage co-occurring symptoms like depression or panic attacks.

7. Recovery is possible: With proper treatment and support, most people with agoraphobia can significantly improve their quality of life. Recovery takes time and dedication, but it’s achievable.

8. Professional help is crucial: If you suspect you or someone you know might have agoraphobia, seeking professional help is essential. A mental health professional can provide an accurate diagnosis, develop a personalized treatment plan, and offer ongoing support.

9. Stigma can be a barrier: Unfortunately, mental health conditions like agoraphobia often carry stigma. It’s important to remember that agoraphobia is a medical condition, not a personal weakness. Open communication and understanding can help individuals with agoraphobia feel supported and less isolated.

10. There’s hope and support: Living with agoraphobia can be challenging, but it’s important to remember that you’re not alone. Many resources and support groups are available to help individuals on their journey towards recovery.

What is agoraphobia?

People often think that agoraphobia is having a fear of being outside, in large spaces. I find it more helpful to think of it as a fear of situations where you believe you might have a panic attack or not be able to escape from. Somewhere you do not feel safe, and every part of you wants to return to where you think you will feel safe.

It is this fear that eventually causes the avoidance. Over time, you can start to avoid more and more situations until you are afraid to leave your home and may even feel unsafe if you are at home alone.

What causes agoraphobia? Signs and symptoms

It often starts with panic attacks. Suppose the attacks are not treated and become more frequent. In that case, you might begin to live in fear of the next attack, which might result in panic disorder, which in turn may turn into panic disorder with agoraphobia.

The first panic attack.

It often comes out of the blue. One minute you are feeling ok. The next, your heart is pounding, you are finding it difficult to breathe, shaking, sweating, your pulse is racing, and you are terrified. Often, finding out that you have just experienced a panic attack may not give you the reassurance you need, especially if you start to experience frequent panic attacks. Pretty soon, your headspace is full of thoughts relating to panic.

  • Am I going crazy
  • Other people can see what is happening to me
  • When will it happen again
  • Why is this happening
  • Will I die
  • How do I know it is just a panic attack?

Even though some of you can start to accept that the physical symptoms you are experiencing are part of a panic attack, it is almost impossible to think this during an attack. Your whole life can be quickly turned upside down, coping with attacks as they happen and living in fear of the next one.

It is tough to “get out of your head” with panic disorder as the symptoms are so severe and naturally worry you. It can seem such a roller coaster ride that you try to make sense of what is happening.

You start looking for triggers that can help you understand what caused the last panic attack.

If you notice that you have had several panic attacks in the shopping mall, it makes sense that you might be fearful of returning to the mall. What happens if it happens again there?

The start of avoidance

You might decide to return to the mall, and as soon as you go inside, you quickly scan the building to ensure you know how to get out, in case you need to.

Going into shops may cause you to feel anxious, and no longer concentrate on what is for sale as your head is more concerned with what you are starting to feel in your body.

You can feel panic starting, and rather than face that again, you quickly leave and return home.

Once home, your anxiety starts to calm down. Your brain is quick to note this.

  • Shopping mall = Panic
  • Home = Safe

Even the thought of the mall makes you anxious and afraid. Next time you need something, you might go to the local store instead of the mall.

This is the start of avoidance and the development of an anxious mind

People with agoraphobia may avoid

  • Going outside
  • Public transport, cars
  • Driving
  • Being alone
  • Restaurants; eating in public
  • Walking outside, going to the gym, exercise
  • Shopping malls
  • Sunlight and heat.
  • Using public restrooms

Our brain works to protect us from danger. The brain might notice similarities in the shopping mall and the local store. Your thoughts might quickly turn to worry if something might happen in the smaller store.

This is enough to send alarm bells ringing in your brain that something is wrong, and you get a stress response. You start to panic again.

Over time, you might start to notice that there are fewer places where you feel safe. Fewer places where you do not panic until the only place that you feel comfortable is at home. This is agoraphobia.

If you have an attack at home, it can be more bearable as you do not have to worry about what other people are thinking of you or how to get out of where you are.

If agoraphobia is left untreated, you may start to feel unsafe if you are at home alone.

Having someone around means, you have help at hand if you need it or help distract you from what you are feeling in your body and mind.

Thought processes

Having agoraphobia can take up a lot of your headspace.

Suppose you have had anxiety, panic or agoraphobia for a long time. In that case, you may hardly notice how much of your headspace can be taken up with planning. For example, if you have run out of milk, you might not be able to pop out and get some. You might have to ask someone else to get it.

If you decide to go yourself, you may need someone to come with you. You need to plan when to leave, what store to go to, what to do if you panic, how you will get out and back to the safety of your home as quickly as possible. For many people with agoraphobia, you may not be able to go to the store, as the only place that you may feel safe is your home.

Our thought processes can change with anxiety. To help you see what I mean, think back to life before agoraphobia.

Were your thought processes similar to how they are now? You probably see that things that take up your headspace now and create anxiety symptoms in your body would not have caused you thought before you became anxious.

Treatment for agoraphobia, therefore, needs to look at how you think, as it is thought processes that can keep the anxiety going. Your thoughts relating to panic and fear can now fire in your brain and create fear in your body. All of this happens without your knowledge; it is automatic. You can learn to take control and make your brain respond more helpfully.

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