Attacking Agoraphobia

You start to aggressively tremble in the supermarket. You are panicking at the park and even your small, cramped office. Could you have agoraphobia?

Agoraphobia is the intense fear of having a panic attack in a place or situation in which you feel trapped or unable to get to safety. That first panic attack with its surge of adrenaline, rapid heartbeat, and other symptoms can feel physically overwhelming like a traumatic catastrophe. It makes people retreat to a safe space, often their home.

Some experts believe that the pandemic has pushed more people than ever towards agoraphobia with its restrictions on socializing.

An estimated 1.3 percent of adults in the United States experience agoraphobia at some time in their lives. Agoraphobia is usually first identified in young adults, with a mean age of diagnosis beginning in the mid to late twenties. It is more common among women than men.

There is no consensus on the childhood experiences, psychosocial risk factors or personality characteristics that lead to a diagnosis of agoraphobia. However, there are several common factors including parental overprotectiveness, the presence of childhood fears or night terrors, experience of grief or bereavement early in life, unhappy or traumatic childhoods or genetic predisposition.

It isn’t clear what causes agoraphobia. It is often linked to an existing panic disorder. Panic disorders cause short, intense attacks of fear for no apparent reason. About a third of people with panic disorders develop agoraphobia. But agoraphobia can also occur alone.

Agoraphobia can make you feel extreme fear and stress so the natural tendency is to avoid situations that promote that uncomfortable feeling. Symptoms of agoraphobia may include:

·       Chest pain or rapid heart rate

·       Fear or a shaky feeling

·       Hyperventilation or trouble breathing

·       Lightheadedness or dizziness

·       Sudden chills or flushing (red, hot face)

·       Excessive sweating (hyperhidrosis)

·       Upset stomach

Agoraphobia can’t be diagnosed unless someone has experienced at least six months of symptoms, severe enough to affect daily life.

To be diagnosed with agoraphobia, you need to meet the criteria set by the American Psychiatric Association. You must experience extreme fear or panic in at least two of the following situations:

·       Using public transportation

·       Being in an open space

·       Being in an enclosed space such as a movie theater, meeting room or small store

·       Standing on line or being in a crowd

·       Being out of your home alone

Agoraphobia is treated through a combination of therapy, medication and lifestyle changes. A therapist can help you work through your fears. With cognitive behavioral therapy, a mental health provider can help you to nail down thoughts that cause anxiety. A therapist can help you work your way up to participating in activities that usually evoke fear.

Your health care provider may also suggest medication such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). These medications treat depression and anxiety disorders associated with agoraphobia.

You can also manage agoraphobia with lifestyle changes like avoiding alcohol, drugs and caffeine, eating a well-balanced diet, exercise regularly and practice breathing exercises.

There is no way to prevent agoraphobia but it can be easily managed in its early stages. Keep in mind some people with severe agoraphobia never leave their home and have to depend on others. Left untreated, agoraphobia may lead to other conditions such as depression, alcohol or drug abuse and other mental health disorders.

Early intervention may promote a symptom-free existence. About a third of those diagnosed with agoraphobia are able to overcome the condition. Some learn to manage their symptoms along with the anxiety that goes with it. Many people with agoraphobia require about 12 to 20 weeks of cognitive behavioral therapy plus medication to see significant change in symptoms.

Just know that you are not alone and your condition is surmountable. It just takes time to see results but you will get there. Talk with your doctor right away if you think you may have agoraphobia.