Agora…..what ??? 

Agoraphobia is More than just a fear of open spaces.

Rather, it’s a complex panic disorder that often results in avoiding certain situations. Agoraphobia can result in some people not leaving the house at all.While to most people, Popping to the shops, picking up a coffee on the way to work, queuing up for a travel card and then hopping on a bus or train are everyday activities, people with agoraphobia could find these activities nightmares and have to deal with them with great effort and many a times avoid them all together. 

Rarely talked about like most other mental illness related conditions, agoraphobia is one of the most common panic-related disorders in the UK. It is commonly associated with a phobia of open spaces or leaving the house but there is a lot more to it than that. For some people, the fear may revolve around specific circumstances like being in crowded public spaces.

Agoraphobia is surprisingly common with the NHS estimating up to two people in every 100 to have some form of panic disorder and a third of them going on to develop agoraphobia. It is notable that Agoraphobia affects both men and women and can develop at any age.

On the one hand, most agoraphobics can tell what it is they dread will happen to them if they are placed in their feared environment but on the other hand, some agoraphobics simply do not know what lies at the root of their fear. They are just terrified. In some cases, the phobia arises from a specific trigger or experience while for others, it’s more general. Notably, it is not necessarily places that trigger the panic, but the feeling of being trapped and unable to escape from the situation. This results in avoiding these places all together.  These can include being a passenger in a car, travelling on a train or bus, or standing in a queue.

When a person with agoraphobia encounters a situation they don’t feel comfortable with, they’ll usually experience symptoms of a panic attack. These include rapid heartbeat, shortness of breath, shaky limbs, feeling hot and sweaty and nauseous. It can be a very unpleasant experience. Following the panic attack, in most cases, avoidance follows making it the main characteristic of agoraphobia.  The individual concerned consciously avoids any situation that resembles the one that led to a panic attack. At its worst, agoraphobia can render people room-bound. Another common feature of agoraphobia is dependence on a trusted personThey consider these ‘support persons’ safe. While this can help them and act as a support system, depending on them too heavily, could lead to ‘Monophobia’, which is  the acute fear of being alone.

So how is this horrible condition treated ?. The first experts advice for anyone who may be experiencing signs of agoraphobia is to speak to their Doctor. This is important  in order to make a correct diagnosis and find suitable treatment options.

There are several options of treatment but early diagnosis determines which option is best. If an individual is starting to avoid places and situations in fear,  ‘graded exposure therapy’, or ‘systematic desensitisation’ is commonly the treatment of choice. Graded exposure therapy involves gradually re-entering phobic situations and learning to cope with anxiety and panic as it occurs until the anxiety experienced at each step has dissipated.

A trained cognitive behavioural therapist (CBT), is usually used in combination with graded exposure as it can be an effective way to talk about treatment options. A cognitive behavioural therapist actively focuses on specific problems present in daily life and teach the clients skills to recognise negative thinking patterns and negative automatic thoughts.  Identifying these distorted thoughts help people to modify the thoughts using them to create positive feelings and mood.

Other therapies used include, hypnotherapy which works by tapping into the subconscious mind where behaviours tend to be buried. It is important to note that even though these fears are irrational, for the person suffering the phobia, irrational thoughts can seem far more powerful than rational ones.

It’s not all doom and gloom says (Boston 2019). This condition is absolutely curable for most people, It’s about talking to the subconscious mind and playing with the perspective because interestingly, the mind often gets stuck in the past.

However, with understanding and knowledge, one can change a lot of things. In fact, it is avoidance and ‘the fear of the fear’ that tends to keep individuals stuck.

Having said this, awareness and understanding of agoraphobia is improving and treatment works well. Therefore, people should be confident about asking for help. However, we cannot ignore the 

the stigma like many other mental health illnesses that persists around agoraphobia. The most important message in all this is to remember that help is available and to seek help because there is no shame.

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