Agoraphobia
By Charlotte Fantelli
The dictionary definition of agoraphobia is an extreme or irrational fear of open or public spaces, but to the sufferer it is so much more.
Panic attacks can blight a sufferers' life and often anxiety will lead to avoidance and they can find that leaving the security of their home is very difficult and sometimes impossible.
Agoraphobia can cause the sufferer to have different levels of fear and limitations depending the whether the condition is mild or severe. Some people with mild agoraphobia may be able to leave their home and live a relatively normal life but with elevated anxiety, whilst a severe sufferer may not be able to leave the house at all.
Agoraphobia is often much misunderstood and those who suffer the condition can become more and more isolated. Here we look at the condition and hope that in doing so the subject will become more understood.
Symptoms
Symptoms of agoraphobia include those related to anxiety (some or all of the following):
- Rapid or irregular heartbeat
- Hyperventilation (rapid breathing)
- Nausea (feeling sick)
- Chest pain
- Feeling hot and sweaty
- Difficulty in swallowing
- Diarrhoea
- Upset stomach
- Dizziness
- Trembling or shaking
- Ringing in the ears
- Feeling faint
People who suffer from agoraphobia will usually try and avoid feeling these anxious symptoms and this may lead to avoidance related issues such as becoming unable to go to certain places, even being unable to work, or becoming housebound.
Irrational thoughts
Along with the physical symptoms of anxiety, it is often the psychological affects and negative ‘spiral’ thinking that can affect the way a sufferer deals with their phobia. A sufferer may worry that a panic attack will make them look stupid in front of others, or that a panic attack will be life-threatening. Panic attacks can be so severe that when they strike the sufferer can imagine that their heart will stop or they will become unable to breathe. Other frightening thoughts can include the fear of being trapped in a place or situation where a panic attack may occur.
Many agoraphobia sufferers fear that they are ‘going mad’ or that they might lose control in front of others. Some also fear that they may start to shake or blush in front of other people or just fear that they may get stared at.
Causes
The symptoms of agoraphobia can be very similar to a panic attack. Very often it is a panic attack that occurs away from the home that sends an individual back to the security of their own four walls. It may be that, in an attempt to avoid feeling like this again, they then remain in the house. Other people may develop panic attacks at home and avoid going out into public places for fear of having those feelings in front of others.
Although agoraphobia is often associated with panic attacks, other causes can be found. People who have low self-esteem or are feeling depressed may simply decide that they don’t have the desire to go out in public, this can then lead to the anxiety of going out. Some people feel that they need the help of others to survive in order to function and will not go out alone.
Occasionally people with agoraphobia develop a condition called monophobia which is the fear of being at home alone.
Diagnosis
Your first port of call should be your doctor. You should always seek medical advice if your symptoms become so restricting that they impede your personal or professional life. You may feel that you need medication or that you are becoming depressed. Your doctor can help with these symptoms and feelings.
The symptoms of panic attacks, which have been mentioned above, should always be checked out by a health professional. Your doctor will be able to assess whether you are suffering from agoraphobia and/or rule out other disorders.
Treatment
If you feel that you may be suffering from agoraphobia it is important to get treatment as quickly as possible. The sooner you seek help, the greater your chances or overcoming the condition.
There are two main ways of treating agoraphobia, psychological therapy and medication. Your GP may refer you to see a mental health specialist. Either your specialist or your GP will discuss your different treatment options. If they do not then don’t feel afraid to ask, it is your right to approve and understand any treatment which may be offered. If it is not offered then ask them to outline what types of treatment are available and to outline the different advantages of each. It is also useful to know if there are any possible risks or side effects associated with either therapy or medications. It is important to find a treatment which suits your personal preferences, the severity of your condition and your health.
Talking Therapy
The most common form of psychological therapy is cognitive behavioural therapy or CBT. CBT is a very effective form or therapy and teaches you to behave in a way that challenges your negative thoughts. Your therapist should also be able to teach you useful techniques to deal with panic attacks such as breathing correctly. There are other techniques which you can learn in order to remain calm when having a panic attack.
CBT and other forms of ‘exposure therapy’ get the sufferer to challenge negative thinking and slowly allow themselves to be exposed to that which frightens them. This sounds very scary, but a good therapist will be able to guide you though the process and will take things at the right time for recovery.
Sometimes other forms of counselling are used, especially if there is a pinpointed problem that needs to be discussed or overcome. Counselling can often help a sufferer explore negative experiences and boost self-esteem.
Medication
It is sometimes helpful to use a combination of therapy and medication to treat agoraphobia. Occasionally symptoms of anxiety and related issues such as insomnia may require short-term medication. Medium term medication may be deemed helpful, but this will be assessed depending on your symptoms and any other comorbid conditions. It is very important you get an accurate diagnosis from a GP or psychiatry professional before any treatment is decided upon.
Read more about agoraphobia in Charlotte Fantelli's blogs.
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