Agoraphobia: an anxiety disorder

Nowadays mental condition and illnesses are very important issues that should be talked about more often in modern society. This may be due to a common contributing factor. Many people still believe that mental illnesses are rare and that only “other people” suffer from them. This is incorrect. Mental illness occurs in different varieties and forms. Not to forget that anyone in your surrounding could be affected by any mental illness.

Agoraphobia represents an intense fear of having a panic attack in a place where there are a lot of people, for example, in a mall or on the subway. But also places where it would be difficult to seek help in case you would suffer from a panic attack, such as on a boat or on a plane.

Agoraphobia does not resemble phobias against, for example, snakes or insects. It is more about a general fear of losing control and not being able to get away from the place where you are. Agoraphobia could also be defined as a fear of mortality and fear of social judgement. Sometimes it may be difficult to recognise agoraphobia. For example, if you do not dare to flying an airplane, it may either be a part of agoraphobia or it may be a fear of flying. Therefore a clear diagnosis is hard to deduct.

Sometimes there is no clear cause of an agoraphobia. Possible risk factors in the development of agoraphobia are the following three:

• An earlier panic attack

Once a person has experienced a panic attack at a certain location, this can cause a fear of getting additional panic attacks at that particular location. After feeling this obnoxious feeling, the need for seeking a safe place will become a first priority, this safe place could be ‘home’.

The affected ones will become calmer once they have set foot in a safe place. By repeating this after experiencing several similar episodes they will desperately seek after safety and isolate their selves no matter if it is with a free will or not.

By not wanting to leave their safe place, they will avoid other places too, not just the locations where a panic attack has taken place, but also other similar places where the mind says that there is a risk of a panic attack occurring out of fears. They will also pay more attention to their bodies, for example when an affected person starts to sweat and hyperventilate. These physical reactions quickly link to the emergency of a possible panic attack.

• Violent events and traumas

When a person have experienced a stressful event, such as the death of a loved one, or the separation of their parents, there is a greater change for that person to develop agoraphobia. A violent experience, such as a robbery in the shopping centre, can also be a risk factor.

• Heredity

When agoraphobia occurs in your family, it is more likely for you to follow that person’s footsteps and suffer from agoraphobia. This may explain that heredity plays a great role in other illnesses too. This could depend on “sharing the same genes” by being blood related. But fears can also be easy to develop as a child when a parent suffers from that particular fear.

There are several different treatments that can be tested in case a person is diagnosed with agoraphobia. There are heavier variants of treatments and there are things that can be performed at home. Breathing exercises/meditation.

• You should develop some control over your breathing to do progressive relaxation.
• You must start concentrating on the toes and feet up to your shins and knees then move all the way up your body.
• You let all the tension flow out of your muscles and regulate your breathing calmly, so you will learn to relax when you feel pressure.
• Exposure in vivo With this treatment you are exposed to your fears. Exposure in vivo is a highly effective technique and can be used by curing other phobias as well. The patient will train with the help of a therapist.
• Facing situations and places that makes the patient feel frightened.
• Confronting these fears does not happen in one go. This happens step by step. This must be performed with progressive exposure, and no more than what can be tolerated. Accidental exposure can make the patient worse. The affected and the therapist discuss when it is time for the next step. The exercise is becoming increasingly difficult further the therapy goes. But by repeating the exercise repeatedly, the patient will become less anxious and will not feel the need to avoid the fearful situations and places as often.
• In cognitive therapy, there is more focus on ‘changing’ anxious thoughts in the dreaded situation. In the treatment of the phobia, examination the anxious feelings with the therapist must happen in order to understand the person affected by the phobia. What they feel, what they think, why they are anxious in certain places and situations. For example, keeping track of where anxious feelings are present or where the affected one feels afraid for suffering from a panic attack.

You look at the behaviour showing during an anxiety attack and what thoughts someone is having at that particular moment. The goal of the therapy is seeing that these thoughts are not realistic at that moment. For example, when you are standing in line at the checkout, there is no real reason to be afraid.

The thoughts that can’t be escaped, not able to breath and no one prepared to help can be changed with the right attitude. The affected person will be feeling frightened at first, but finally he will become calm. Step by step learn to avoid the regular negative thoughts.

• Medication Besides behavioural therapy, agoraphobia can also be treated with medication. Antidepressants or anti-anxiety medication and can help to reduce the anxiety.

However, it is also important to change behaviour and thoughts in order to overcome agoraphobia. The goals of these treatments are that the patient no longer avoids the fearful situations and places but instead learns to deal with the fears. That way will the patient regain control over  its life.