Agoraphobia – The Whats & Whys

What is agoraphobia?

Agoraphobia is an anxiety disorder that is strongly correlated with panic disorder. The would agoraphobia comes from the Greek and basically means “fear of the market place” but the condition can be related to all sorts of situations and places and is a much more complex problem. 

To use the NHS definition, agoraphobia is a fear of being in situations where escape might be difficult or that help wouldn’t be available if things go wrong.

Agoraphobia is fairly common – 7% of women and 3% of men suffer from the disorder during their lives.

What are the symptoms of agoraphobia?

Most people with agoraphobia have experienced panic attacks. The symptoms of agoraphobia are mainly around reassurance.  People who have had a panic attack in a particular situation fear revisiting that location and the avoidance build over time. 

The symptoms are a multitude, such as:

  • Avoiding public transport
  • Getting anxious in a traffic jam
  • Sitting at the end of the seats in a cinema
  • Avoiding other people’s houses
  • Finding it hard to be alone at home
  • And eventually, being too afraid to even leave the house.

Why do people develop agoraphobia?

In general, people develop panic disorder before agoraphobia.  The way that people cope with the anxiety is key – some people naturally face their fears whereas others retreat. People with separation anxiety and agoraphobia may only leave the house when accompanied. 

Stressful experiences like a death in the family or a change at work often occur before the onset of panic attacks and agoraphobia. Some people are vulnerable to anxiety in life, but it is a trigger that spirals the panic and brings on a panic attack.

What keeps the vicious cycle going?

The way that anxiety builds into a trigger is through self-perpetuating factors. In anxiety, the worry is a fear of fear. We get stuck in the fight or flight process and it feels like the only way out is to avoid the situation. Your body “remembers” your reaction and it is reinforced. We can divide the perpetuating factors into three classes – 

  • Psychological factors
  • Coping strategies
  • Negative thinking 
  • Low self-esteem

  • Social factors
  • Pressure at work or home
  • Being alone
  • Physical factors
  • Poor sleep
  • Use of drugs or caffeine 

Most importantly, how is agoraphobia treated?

Like most anxiety disorders (actually, all anxiety disorders!), cognitive behavioural therapy is the gold standard treatment. Cognitive therapy looks to challenges beliefs  (such as “I am going to get trapped in the supermarket queue and have a panic attack”). It helps us to challenge these thoughts by using Theory A/Theory B or the downward arrow.

The behavioural part of CBT is exposing yourself to feared situations. You might start slowly, such as going to see an old friend or going for a walk in a park, before moving up to trickier tasks such as going alone to a cinema and not sitting at the end of the row or going to the supermarket on your own.

What can we take from that?

You don’t have to suffer in silence (you can always join one of the No Panic support services or recovery groups) and most importantly, you can recover. You deserve to recover and although it might be hard (and I’m not hiding that it can be tricky), you can recover.

Bellsie

More Reading: https://nopanic.org.uk/agoraphobia/

Watch our YouTube Video on agoraphobia: https://youtu.be/fhqTOnCb0p0

How can No Panic help?
No Panic specialises in self-help recovery and our services include:
Providing people with the skills they need to manage their condition and work towards recovery.
Our aim is to give you all of the necessary advice, tools and support that you will need to recover and carry out this journey. No Panic Recovery Programs

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