What is Agoraphobia?
Agoraphobia is an irrational fear of panic brought on by places, which can be induced by "unsafe" places ranging from confined vehicles to wide open spaces. (Unlike the traditional definition of agoraphobia, wide open spaces are not the only triggers.) The word originates from the ancient Greek root word "agora," referring to a place of assembly or market place.
Extreme cases may prevent people from getting out their front door.
Agoraphobia also arises from fear of situations where escape from threat may be difficult, or where help may not be available.
Agoraphobia is often associated with fear of crowds, bridges (constricted passages) or of being some place alone or without help.
This fear extends to public transportation (buses, trains, ships, or planes), large open spaces (parking lots, bridges), large but enclosed spaces (stores, movie theaters), crowds or standing in line.
Agoraphobia is neither a social nor specific phobia, but instead is in a category of its own. While a social aspect may exist (such as a fear of crowds) the key component is a fear that escape is not possible or that embarrassment can't be avoided. The same venue with no people present may induce the same fearful reaction, though a crowded location may induce Agoraphobia because the crowd itself makes escape difficult.
Additionally, Agoraphobia is somewhat special in that the sufferer may be fine in virtually any venue if they have a "safety person" with them, some companion that makes escape unnecessary.
Many agoraphobics suffer from panic disorder, in which panic attacks have no known specific trigger and seem to arise for no discernible reason. Agoraphobia then may develop when the sufferer fears the return of an irrational panic attack while in some public venue.
Symptoms of Agoraphobia
Fear of Being Alone
- Fear of Being in Crowded Places
- Fear of Losing Control in Public
- Fear of Being in Hard to Leave Places
- Unable to Leave Home Without a Companion
- Sense of Helplessness
- Overdependence on Others
- Avoiding People
- Intense Need to Escape
- Extreme Irritability
- Extreme Anxiety
- Expecting Bad Outcomes
- Fear of Losing Control
- Fear of Death
- Panic Attacks
- Heart Palpitations
- Chest Pains
- Gastrointestinal Distress
- Nausea or Diarrhea
- Shortness of Breath
- Choking Sensations
- Excessive Sweating
- Confusion or Lack of Focus
- Chills or Heat Flush
- Feeling Faint or Dizzy
- Trembling or Shaking
- Tingling Sensations
Causes of Agoraphobia
Other panic disorders or phobias can play a developmental role in the onset of Agoraphobia, and the diagnosis is often difficult, as are discerning the causes of the condition.
Agoraphobia and panic disorder are believed to be closely related and both are thought to have a hereditary component.
Agoraphobia is classed as neither social anxiety nor as a specific phobia, and is categorized separately. Agoraphobia can be somewhat different for each person, and may have its roots in social anxieties, panic disorder (in which panic attacks seem to occur without identifiable cause) or specific phobias.
Progression from panic disorder to agoraphobia is a well-known concern.
An interesting comparison can be drawn between Agoraphobia and Claustrophobia, which may provide clues to the roots of Agoraphobia. An illustrative instance is being a passenger in a car, train, bus, etc. While the claustrophobic individual is afraid because the car is a tightly enclosed space, the agoraphobe is afraid because getting out of the car (or simply having to be the passenger) is difficult. While the claustrophobic person may not be able to find any relief, the agoraphobic passenger may have no issues at all if the driver is a "safe companion".
The agoraphobic person fears the onset of a panic attack in places that are outside their "comfort zone", while the claustrophobic person fears the confinement of the space itself. From this, it may be somewhat more apparent how some aspects akin to social anxieties and the fear of embarrassment (without being able to escape) might play a role in the development of Agoraphobia.
Much like specific phobias, however, Agoraphobia can also be triggered by places without any people. The "classic" cultural definition of Agoraphobia has long been the fear of simply going outside, for instance, regardless of whether other people are present, yet this definition is off base. (The place itself is not the cause of the fear.)
Agoraphobics often develop a need for "safe places", which can be anyplace they have felt comfortable before. The issues, then, revolve around concerns such as loss of safety, the inability to retreat, loss of control, fear of being alone and the fear of a panic attack. If an individual has had an embarrassing situation in a given kind of place, the location then becomes "unsafe", which may in some ways be similar to a specific phobia.
In all kinds of phobias, external experiences and / or reports can further reinforce or develop the fear, such as seeing a family member or friend who is affected. In extreme cases, indirect exposures can be as remote as overhearing a reference in conversation, seeing something in the news, on TV, or in the movies.
Agoraphobia, like most phobias, stems from a subconscious overprotection mechanism, and as with many phobias can also be rooted in an unresolved emotional conflict.
Treatments for Agoraphobia
Cognitive Behavior Therapy (CBT)
- Habit Strategies To Relax
- Cognitive Therapy (CT)
- In Vivo Exposure
- Response Prevention
- Group Therapy
- Energy Psychology