Agoraphobia: Signs, Symptoms, Risk Factors and Treatments

Agoraphobia might be considered a rare anxiety disorder, but surprisingly, it now affects approximately 1.7% of the general population. A type of panic disorder, Agoraphobia, is usually diagnosed in people younger than 35 and is characterized mainly by a fear of being in public places or social gatherings. A typical feeling of agoraphobia is intense or overwhelming anxiety or panic in crowded places from where one feels there is no escape or support nearby. It brings on the same type of symptoms as a panic attack and, in many cases, can impair daily life.

Agoraphobia Explained

According to the DSM-5-TR, the standard classification of mental disorders in the US, agoraphobia is defined as “marked fear or anxiety about actual or anticipated exposure of public spaces, with the symptoms of fear or anxiety occurring most of the time in at least two of five common, different situations.” In order to meet the criteria for an agoraphobia diagnosis, your anxiety experience should be due to at least two of the following situations: Experiencing agoraphobic anxiety for six months confirms a diagnosis of the condition.

Using public transportation
Being in open spaces
Being in enclosed spaces (e.g., shops, theaters, cinemas)
Standing in line or being in a crowd
Being outside the home alone.

Agoraphobia does not involve anxiety and fear from a realistic threat or occur due to substance abuse and withdrawal. Besides the above criteria, diagnosis of agoraphobia consists of an individual not just fearing exposure to public places; it involves an urgent need or making active attempts to avoid such situations.

Symptoms of Agoraphobia

The symptoms of agoraphobia may be classified into three distinct categories (physical, cognitive, and behavioral). Although the symptoms are like a panic attack, agoraphobia only occurs in a crowded environment, whereas panic attacks can occur at any time and place. Many people might not experience physical symptoms because of a conscious decision to avoid public and social situations that cause anxiety.

Physical Symptoms of Agoraphobia

Rapid heartbeat or chest pain
Hyperventilating (rapid breathing)
Excessive sweating (can be hot or cold)
Trembling and shaky feeling
Dizziness and feeling nauseous
Dysphagia (difficulty swallowing)
Chills or hot feeling
Upset stomach.

Cognitive Symptoms

Panic attacks that might embarrass you in public
Panic attacks, where you might get overly worried that your heart might stop
A trapped feeling that you might be unable to escape a public place in the event of a panic attack
You feel like you’re going insane
You have no control over yourself in public
You visibly tremble and blush in front of others
You get people staring at you
You feel you just cannot survive without support
The fear of being alone at home (monophobia)
Feelings of fear, dread, anxiety
Emotional distress ( out of shame and embarrassment)

Behavioral Symptoms

Desperately avoiding social meetings, crowded places, and public places that put you at risk of panic attacks
Staying at home intentionally
You always need someone to accompany you when going out
Constant fear and anxiety when forced to be in a social meeting or public place

The Causes and Risk Factors of Agoraphobia

Medical experts are yet to figure out what causes agoraphobia, although it is confirmed that the condition is associated with an existing panic disorder. Research has also found that one-third of people with panic disorder will develop agoraphobia. The main risk factors for agoraphobia include:

Panic And Anxiety Disorder

Panic and anxiety, when not treated, run the risk of contracting agoraphobia. Panic disorder, which is connected to the body’s flight or fight response, is a defense mechanism protecting you from untoward situations. Agoraphobia is a more intense response to panic attacks, filling one with fear and apprehension.

Other Factors

Stressful life events such as childhood abuse or trauma, death of a loved one, job loss, grief
Excessive sensitivity to anxiety disorder
Relatives with Agoraphobia
History of mental illness, depression, or eating disorders like anorexia and bulimia
Alcohol and drug abuse
Toxic relationships, traumatic separation
Phobia of being infected from crowded places
Dread of being a crime victim or accident

Treatment of Agoraphobia

Agoraphobia, like all mental disorders, is treatable. While most cases can be managed by coping strategies and therapy, such as cognitive behavioral therapy, more severe cases might need psychiatric evaluation and possible medication. Here are some coping and treatment techniques for Agoraphobia

Psychotherapy

Psychotherapy involving cognitive behavioral therapy is one of the main components of agoraphobia treatment. CBT is particularly effective in helping patients identify and challenge irrational thoughts and beliefs about feared situations, gradually exposing them to these situations in a controlled and supportive environment.

Medications

In some cases, medication may be prescribed to alleviate the symptoms of agoraphobia. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), and anti-anxiety drugs can help manage anxiety and panic attacks.

Exposure Therapy

Exposure therapy is a form of CBT that involves gradually and safely exposing individuals to the situations or places they fear. Over time, this exposure helps desensitize the person to their triggers and reduce their anxiety response.

Support Groups

Support groups provide a sense of community and understanding for individuals living with agoraphobia. Sharing experiences and coping strategies with others who face similar challenges can be highly beneficial.

Self-Coping Strategies

Learning effective coping strategies is essential for managing agoraphobia. These may include setting achievable goals, creating a structured daily routine, and gradually exposing oneself to feared situations. When you gain confidence in controlling your emotions, it may make coping with and managing agoraphobia easier.

Stay Put, don’t run: If you feel a panic attack coming on, do not run. If you’re driving, just pull over and park in a safe spot, telling yourself this will pass.
Stay focused: Focus on something visible that will distract your mind, such as something in a department store, the time on your watch, or perhaps just about anything occurring on the street.
Take deep breaths: Deep breathing by breathing slowly and deeply can help you calm down and neutralize the physical symptoms of a panic attack.
Challenge yourself: Challenge whatever it is you fear, and keep reminding yourself that it isn’t really something to feel anxious about. It is just a state of mind.
Visualization: While in a panic attack, resist as many negative thinking patterns as possible, like impending disasters. Instead, think of places that made you happy, such as past vacations, a happy place, or situations that make you calm and relaxed.
Never try resisting a panic attack: As contradictory as it sounds, the more you try to fight a panic attack or negative thoughts, the more persistent the onslaught. Connect with yourself, allow yourself to absorb the negativity, then challenge the thoughts, address their irrationality, and how your life is not in any threat.
Self-help strategies: There are other coping and management strategies that you can practice as part of a healthy lifestyle, such as mindfulness, meditation, yoga, exercise, Taichi, and muscle relaxation, to get rid of anxiety and stress.
Patience and persistence: Recovery from Agoraphobia is often a gradual process that requires patience and persistence. It’s essential to celebrate small victories and not be discouraged by setbacks.

Agoraphobia may be a challenging condition that can profoundly impact your life, but it doesn’t really need to be so. Like all anxiety disorders, agoraphobia can be managed simply by restructuring your mindset, the way you perceive your thoughts, and a positive behavioral response to them. Practicing the coping strategies and seeking support and professional help will quickly help you deal with agoraphobia and live a better quality of life.