Agoraphobia

Regarding agoraphobia, you have the wrong idea of ​​what this anxiety disorder involves. It is very common to have the belief that this is a phobia of public places or open spaces, but this is very ambiguous in relation to what agoraphobia really is.

It is precisely for this reason that this topic will be discussed in depth below.

What is agoraphobia?

In the first place, it is important to know the etymological origin of the word ‘agoraphobia’, which in turn, is the main cause that this disorder is believed to be the fear of open spaces.

The word agoraphobia is made up of two Greek words, ‘Agora’ and ‘Phóbos’. The word ‘Ágora’ means ‘Public Square’, while ‘Phóbos’ means ‘fear’ or ‘fear’. If we put both words together, it would literally come saying ‘fear of public squares’, which has been interpreted as the fear of public or open spaces.

However, agoraphobia goes much further. This is an anxiety disorder characterized by a huge and uncontrolled fear of experiencing a panic attack in a public place. But this disorder is even more complex, since it is also the fear of the sensations caused by anxiety attacks .

Likewise, agoraphobics are afraid to leave their comfort zones, precisely because they do not want to have a seizure in public. The mere fact of thinking that they are in an ‘unsafe’ place, can cause them real annoyances.

It is also important to note that for agoraphobic people, it is difficult to leave their homes without someone they trust accompanying them. This, mainly, for fear that, in case of an anxiety attack, they will not be able to receive help. Therefore, agoraphobia is characterized by the following:

• Fear of having anxiety attacks in public places.
• Fear of making a fool of yourself in public because of a panic attack.
• Fear of leaving the home without a trusted person.
• Fear of the sensations caused by anxiety attacks.
• Fear of having a panic attack and not getting help.
• Fear of being in a place where it is not easy to escape.

What are the causes of this phobia?

So far, the specific causes of agoraphobia are unknown. However, a relationship with the appearance of this disorder has been found with various factors, both biological, psychological and social.

As for the biological factor, it has been possible to associate the appearance of agoraphobia with the presence of low levels of serotonin in some parts of the brain. The decrease in serotonin can be a consequence of the consumption of certain substances, a mutation in the genes, a genetic decompensation, or all these factors together.

In addition to this, agoraphobia is usually linked to stressful situations that an individual may experience. Thus, many of the people diagnosed with this disorder have claimed to have lived an extremely stressful experience just before developing agoraphobia.

Are there risk factors or predisposition to develop it?

Yes. Some people with certain characteristics may be more likely to develop this anxiety disorder than others. For example, people with low self-confidence or who seek approval from others are more likely to suffer from agoraphobia.

In addition, those who try to avoid uncomfortable situations instead of coping with them in a healthy way are also prone to developing this disorder. The same happens with those who feel the need to always be in control, which makes them fear new and unfamiliar sensations. Other predisposing factors are:

• Feeling that nothing can be done to control the sensations that are experienced.
• Be constantly alert to sensations perceived as abnormal.
• Growing up with overprotective parents.
• Perceiving psychological disorders as something shameful.
• Being an introvert or being socially withdrawn.

Symptoms of agoraphobia

The main symptoms of agoraphobia are fear, anxiety and excessive worry about specific situations or events. The symptoms of this anxiety disorder are as follows:

• Sweating
• Tachycardia.
• You want to go to the bathroom.
• Shortness of breath or trouble breathing
• Sickness.
• Dizziness.
• Pressure in the chest.
• Tremors
• Alteration in vision.

The symptoms listed above are typical of anxiety, an adaptive response to keep us safe from danger. However, in agoraphobic people, these symptoms occur in situations that do not pose a real threat. Said situations or scenarios are the following:

• Being in public spaces or crowded places, such as squares, shopping centers, train stations, elevators, airplanes, public transport, among others.
• Places where escape can be difficult, such as a theater, cinema, boat, and so on.
• Fear of having a panic attack and suffering from its symptoms, such as nausea, dizziness, chest pain …
• Fear of making a fool of yourself in public, and therefore fear of situations such as falling, urinating on yourself, vomiting …

It should be noted that agoraphobic people tend to alter reality, maximizing the situations they perceive as threatening, thus causing them to be disproportionate to the danger they really pose.

In addition, those who suffer from this disorder experience constant anxiety , which can cause many problems in their daily lives. By fearing certain situations in advance, feelings of anxiety are activated, which are precisely those that you want to avoid. This makes agoraphobia a loop that is difficult to get out of.

How does this disorder affect people who suffer from it?

A person with agoraphobia could be greatly affected by this disorder, since it causes limitations in their day-to-day life. Agoraphobia can begin as a simple fear of a specific place due to a traumatic event.

However, when the fear of that place begins to spread to other places and causes the person to change, for example, their route to work, the disorder can be aggravated. Consequently, the affected person will begin to fear more places, to the point of not wanting to leave their home.

This, of course, has a negative impact on their social relationships , since the individual will stop attending meetings with their friends in public places. It also affects relationships, since the person will avoid doing many activities outdoors or in public places, such as the cinema.

In turn, the work environment will be affected, since the person with agoraphobia will not want to use public transport. You may also fear being on avenues, and even your own office, as it scares you to think that you may have a panic attack in front of your colleagues and be ridiculed.

Complications

Because of the above, it is possible that someone agoraphobic lose or abandon their job, or in younger people, they stop attending classes. In addition, as a consequence of their confinement, some friendships may end up falling apart, and even their relationships break down.

In extreme cases, people with agoraphobia isolate themselves at home, without having contact with the outside world. This, consequently, will create dependency with others, such as family members, who will have to support the affected person.

However, due to the isolation that can be experienced, agoraphobics can feel lonely, and in some cases, fall into depression. Therefore, this anxiety disorder can destroy entire lives, making it very important to be able to treat it.

Safety behaviors adopted by agoraphobics

Many people who suffer from agoraphobia try to ‘live’ with this disorder, for which they resort to certain habits or behaviors that help them ‘cope’ with the problem. Thus, agoraphobics try to avoid situations or places that cause them anxiety at all costs.

Also, they may turn to a trusted person who makes them feel more secure when they have to leave the house. It is also common for them to use drugs such as anxiolytics, which help them feel more in control.

Other safety behaviors are to observe if there are medical assistance centers nearby, try to be near the exit of some place, carry a bottle of water, and so on. While these habits or behaviors can ease a person’s anxiety, they are not a treatment as such.

In reality, these behaviors only mask the problem, and even exacerbate it, especially avoidance behaviors. It is for this reason that, for effective treatment, it is extremely important that these habits are gradually eliminated .

Treatment of agoraphobia

Although the use of drugs can help relieve anxiety in patients with agoraphobia, they do not solve the problem. To treat this disorder, psychological therapy and exposure therapy are essential .

In order to carry out psychological treatment, it is essential that the affected person is willing to participate in the process. The first thing that is put into practice is the education of the patient regarding what anxiety means. In this way, you can understand that the symptoms generated by anxiety are normal and not dangerous for your health.

As for exposure therapy, it is carried out progressively, that is, the person is exposed to the situations that least generate anxiety . As the patient progresses, he is exposed to situations that can cause him more anxiety.

This process can take a long time, especially if the person with agoraphobia has lived with the disorder for years. However, as long as the patient is willing, they can significantly improve and change their quality of life .

Agoraphobia and panic attacks

Although agoraphobia and panic attacks are closely associated, they are two different things, which should be learned to distinguish . On the one hand, as has already been observed throughout the article, agoraphobia consists mainly in the anticipation of events.

This anticipation generates the fear or panic that causes so much discomfort to the person. However, the way you try not to experience these discomforts is by avoiding the situation itself. Therefore , agoraphobia is mainly based on avoidance behaviors .

This, consequently, aggravates the disorder, since by not facing the problem, the beliefs that the situation can really be dangerous are strengthened . On the other hand, panic attacks focus on the changes and physiological responses of the body to a threatening situation.

People with panic attacks, by being involved in a scenario that previously generated great discomfort, can maximize their anxiety symptoms . They will begin to imagine the most catastrophic situations and to pay special attention to the way their body reacts.

If you notice that your heart is beating fast, you may think you will have a heart attack . And if they notice that it is difficult for them to breathe, they will think that soon they will not be able to continue breathing, and they will eventually pass out.

Recommendations to deal with agoraphobia

As mentioned previously, being able to treat agoraphobia is essential so that affected people can have a good quality of life. If you have agoraphobia or know someone who suffers from it, the following recommendations will be of great help .

• Normalize the sensations : It is important that you learn to recognize that the sensations produced by anxiety are normal. Also, not all unpleasant sensations should be avoided, it is natural to experience them and they have an adaptive function.
• Analyze the situation : It is also helpful to analyze whether the situation you are experiencing is really dangerous or not. Wondering if the thoughts that invade the mind are possible, real, what are the worst scenarios and so on, can help.
• Progressively approach feared situations : If feared situations are avoided, fears are reaffirmed and the problem worsens. Progressively approaching such situations and dealing with them may help to see that they are not so bad after all.
• Shift the focus of attention : Instead of thinking about the unpleasant sensations that are experienced, it is important to try to focus on the positive aspects of leaving the comfort zone.
• Think about positive change : Although treating agoraphobia may seem impossible or very difficult, this is possible. It is essential that affected people do not give up during treatment. When in doubt, thinking about the positive things that will be obtained by improving can be a great encouragement.

Finally, the support of friends and family of people with agoraphobia is essential. Feeling supported will give you more strength to continue treatment. Anyone suspected of having agoraphobia should see a specialist as soon as possible. The earlier the intervention, the faster the recovery.