Agoraphobia: Trapped by our fears
“With agoraphobia you feel safe only when you are in certain environments. Your anxiety increases every time your ’safe place’ is unavailable, blocked, or becomes more distant.”
Thomas Marra
The world can be terrifying, dangerous, and stressful. On some level, we all experienced that fact during the COVID-19 pandemic when going outside and being around other people was a danger to our physical health if exposed. Unfortunately, staying inside can be just as damaging to our mental health. Let’s talk about Agoraphobia.
Agoraphobia, which comes from the Greek term for “fear of the marketplace," is a type of anxiety disorder where a person is afraid to leave their perceived safe or “home” environment. We usually associate agoraphobia with fear of leaving our house, however, it can be other places where a person also feels safe.
In severe cases, an individual may consider their home the only safe environment, finding ways to avoid leaving their house for extended periods of time, sometimes even for years.
People with agoraphobia usually experience panic disorder; however, some do not. Like other anxiety disorders, those with agoraphobia experience significant, difficult-to-control stress from anxiety-inducing situations, which can quickly become overwhelming.
The phobia is frequently worsened by a fear of embarrassment over having an episode in public or a fear of not being able to escape a situation. The disorder usually starts with a stressful, triggering event, like losing a job or the death of a loved one, escalating into avoidance of certain events and turning inward, ultimately leading to wider-scale isolation.
Symptoms of agoraphobia are similar to a panic attack; chest pain, light-headedness, shortness of breath, rapid heart rate, excessive sweating, chills, flushing, and an upset stomach. To some sufferers, it feels like a heart attack, a painful tightness in the chest that spreads across the shoulders and up the neck. When the anxiety hits, it can happen fast; one moment, everything is fine, and the next, the world feels like it’s falling away.
The Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR) defines agoraphobia as a “marked fear or anxiety about two (or more) of the following five situations: 1. Using public transportation (e.g., automobiles, buses, trains, ships, planes), 2. Being in open spaces (e.g., parking lots, marketplaces, bridges), 3. Being in enclosed places (e.g., shops, theaters, cinemas), 4. Standing in line or being in a crowd. and 5. Being outside of the home alone.”
Agoraphobia is believed to be caused by a combination of genetic and environmental factors but is generally a response to an external stressor. It can also be caused by other anxiety disorders, like Panic Disorder, Obsessive Compulsive Disorder (OCD), and Post-traumatic Stress Disorder (PTSD). Agoraphobia can also be brought on by other health issues, such as migraines; Research indicates there is a relationship between agoraphobia and a deficit in the vestibular system. The vestibular system is dependent on the inner ear and is the basis for our sense of balance and orientation in the world around us. Agoraphobics with vestibular issues have to rely on other sensory cues for coordination, particularly visual and tactile, and being in unfamiliar environments can become more physically dangerous.
Regardless of the severity, treatments for agoraphobia involve medication and therapy, systematic desensitization, and relaxation techniques. The sooner the individual pursues treatment, the better. Early diagnosis and treatment greatly increase the chances that treatment will be effective, so don’t be afraid to seek help. Agoraphobia can be very serious, but addressing it quickly can help minimize the harm and suffering.
As people pursue treatment, the help and support of loved ones can make the road to recovery much easier. Having a friend and ally when out and about in anxiety-inducing spaces can help keep those with agoraphobia calm. Those allies are a reminder that the community is not out to get you. Besides, everything is easier with the help of a friend.
There are a lot of tools to help with agoraphobia. The first step is to talk to a doctor. Even if the doctor is not a psychiatrist, their capacity to help is tremendous. As previously addressed, there are a myriad of treatment options available, and though agoraphobia can be complex, making small steps toward recovery will snowball into a better quality of life.
“Fear is interest paid on a debt you may not owe.”
Everyone you meet is fighting a battle you know nothing about. Be kind. Always.
“Our anxiety does not empty tomorrow of its sorrows, but only empties today of its strengths.” C.H. Spurgeon
“As a counselor, social worker, and marriage and family therapist, my licenses allow me to help Texas residents with issues interfering in life and relationships. My clients experience changes over time in therapy, not just in addressing life changes and decisions but in understanding that they can be confident in who they are, what they can do, and how to make a plan for success.
Register & schedule for mental health counseling via our home page.)
As a certified Life Coach, I also work with clients (worldwide) to attain personal or work-related goals and live more peaceful and satisfying lives. Please contact my offices at 210-970-1511 for information about scheduling Life Coaching appointments.” - Clifton Fuller.
Read more about the difference between Counseling and Life Coaching Here.
Note: Clifton is the author of “The Marriage Vampire” (dealing with narcissistic personalities), now available on Amazon.
Clifton Fuller
LCSW, LPC, LMFT
