Agoraphobia: Fear of Public Places - Causes, Symptoms and Treatment
Agoraphobia is one of the types of anxiety disorder in which you feel intense amount of nervousness and anxiety in open and public places. If you're afraid to go out in a public place after life threatening events like disasters, political riots or an accident, then it is completely a normal reaction. However, if this fear of being in public places last for six months or more, you might be suffering from Agoraphobia.
Generally, a person having agoraphobia is fearful of
- Public places like movie theaters, elevators, malls, warehouses and stores
- Large and open places like bridges, tunnels and vehicles parking areas
- Public vehicles like buses, trains, planes and ships
- Crowded situations in road traffic, concerts and carnivals
- Going out of home without a trusted company
You get the feeling of being trapped, and feel that there is no way out from these places in case you need to escape. You tend to avoid any such public places like shopping malls, theaters, public transportation, parks, roads with traffic, etc. You won't feel safe in such public places, and feel helpless.
Person with agoraphobia may completely isolate, and confine oneself inside home only as a result of fear of going out among crowded and public places.
How Common is Agoraphobia?
National Institute of Mental Health (NIMH) estimates that at least 5.6% of adults show symptoms of agoraphobia at some point during their lifetime. Women are more likely to suffer from agoraphobia than men. The disorder usually starts during the midlife of a person that is his/her twenties or thirties. It has been seen that agoraphobia is more common in divorced and separated people.
Causes of Agoraphobia
The exact cause of agoraphobia is still not clearly known. However, it has been seen that people suffering from agoraphobia had previously been suffering from Panic Disorder. The persistent occurrence of panic attacks develop the fear to be anywhere outside of home. The person starts dreading that he/she might get panic attack anywhere, and might not be able to escape out of such places. As a result, the person develops agoraphobia.
Several studies also show that heredity and genes play a significant role in agoraphobia. People with family history of agoraphobia are more likely to develop this disorder. The disorder can also be caused by an occurrence of distressful event in any public places, having a serious impact on the mental state of the person.
Symptoms of Agoraphobia
We can broadly see two categories of symptoms occurring in person with agoraphobia.
- Intense fear and anxiety when exposed to an open public place
- Worrying prior to occurrence of any situation in public, open spaces
- Not being able to go outside of home without a trusted person
- Feeling of helplessness and embarrassed
- Avoidance of any public, crowded places and confining oneself within home
- Anger and irritability
- Having trouble in doing activities like crossing a road, walking through a bridge or traveling through tunnels
These symptoms mainly occur as result of panicking, when the person is exposed or possibly going to be exposed to a dreaded public place.
- Trembling and shivering
- Sweating and clammy hands
- Abdominal discomfort
- Difficulty in breathing
- Racing heartbeat and chest pains
- Dizziness and fainting
- Nausea and vomiting
- Numbness or tingling around limb areas
- Hot and cold flushes in body
- Buzzing in the ears
When to visit doctor?
You should seek help from a doctor if
- The distress and anxiety of being in public places have extended over a time period of six months.
- You’ve been avoiding or trying to avoid any public affairs for the same time period.
- You’ve gone through panic attacks more than once in a month when exposed to an open, public place.
How Agoraphobia is treated?
The treatment is a gradual process which would involve appropriate medications, cognitive behavioral therapy, self-help methods and joining support groups. Eventually, you’ll find yourself fighting through your fear, and getting stronger.
The medicines commonly used for bringing the symptoms of agoraphobia in control are anti-depressant medicines which help regulate Serotonin levels of the brain. These brain chemicals are responsible for determining your mood and feelings. Also, anti- anxiety medicines are used to control the fear and anxiety. Your doctor will conduct regular assessment and monitor the medications to decide how long you’d be taking them.
Cognitive Behavioral Therapy (CBT)
You need to visit a therapist along with the medications. Cognitive behavioral therapy will teach you skills and ways to deal with your inner feelings and fear, and help you get down to the root of your problems. Your therapist will coach you on returning back to a normal life, and taking your inner thoughts in control. The main aim of CBT is to make you realize your own negative thoughts, and instill positive thoughts through regular counseling sessions.
You can also get supported self-help therapy yourself if you feel anxious to visit a psychotherapist directly. There are many self-help books, guidelines and practice activities you can conduct yourself online. You’ll be able to learn about the problems and ways to cope with it yourself. Eventually, you can have an appointment with a therapist when you become comfortable.
As the therapy and medicines advances gradually, you can also join several support groups having the same disorder of agoraphobia. You meet and interact with people having similar stories and learn how they are coping up with the disorder and get new ideas. Support groups provide with great motivation and confidence to beat the disorder out of your life.