Agoraphobia, in the most general terms, is a fear of being in public places.
It is an anxiety disorder and in the most severe cases, people suffering from this disorder are housebound.
Typically, it starts off as a mild anxiety about a particular place or situation that escalates over time into a generalised fear of being in public.
Agoraphobia is a disabling fear. It is associated with panic attacks and anxiety. Often the reason behind the person not being able to be in public places, or leave the perceived safety or their own home, is the fear of having a panic attack, of losing “control” or embarrassing themselves.
The symptoms and signs of agoraphobia may include:
- Anxiety in response to being away from an environment that is seen as “safe”.
- Physical symptoms of significant anxiety and sometimes a panic attack such as
- racing heart rate,
- sensation of choking,
- nausea, and
- feelings of extreme fear or dread.
- Anticipation of anxiety if the person is required to leave their safe environment.
- Low self-esteem and loss of self-confidence.
- Reluctance to leave the house or venture beyond familiar surrounds,
- Increased irritability and depressed mood.
What are the effects if left untreated?
If left untreated, agoraphobia can severely reduce a person’s quality of life.
- Social interactions are likely to be reduced leaving the person feeling isolated.
- There is an increased risk of developing depression.
- Financial difficulties arise due to inability to go to work.
- Weight gain may result due to overeating and exercise reduction/restriction.
- There is an increased risk of substance use (alcohol and drugs).
- Relationships are impacted (family and friends).
- The individual develops an increased dependence on other people.
- Self-esteem is reduced.
- Health risks increase eg elevated blood pressure.
How is Agoraphobia diagnosed?
Diagnosis is usually made initially by a General Practitioner or Psychologist based on the patient’s reported symptoms.
A GP may run a series of medical and blood tests to check the symptoms are not caused by an underlying physical illness. Anti-depressant or anti-anxiety medication may be prescribed by your GP, and referral to a psychologist or psychiatrist for further evaluation and treatment.
People with agoraphobia often respond very well to treatment—and often in a relatively short amount of time. The specific treatment approach and length of treatment depends on the individual and their symptom severity. But in general, most anxiety disorders are treated with behaviour therapy (CBT and exposure), medication, or some combination of the two.
- Cognitive Behavioural Therapy (CBT) – focuses on thoughts as well as behaviours. CBT helps you identify and challenge the negative thinking patterns and irrational beliefs that fuel your anxiety.
- Exposure Therapy – focuses on confronting your fears in a safe, controlled environment. Through repeated exposures to the feared situation, either in your imagination or in reality, you gain a greater sense of control. As you face your fear without being harmed, your anxiety gradually diminishes.
- Medication – A variety of medications, including benzodiazepines and antidepressants, are used in the treatment of anxiety disorders. Medication may sometimes be used in the short-term to relieve severe anxiety symptoms so that other forms of therapy can be pursued.
The number of sessions required will depend on the individual’s situation and level of symptomology. Some sessions may initially need to be conducted in the person’s home.
Author: Nicole Wimmer, B Sc (Psych), MA (Psych), PG Cert Mgmt, Grad Dip Safety Science, MAPS.
Nicole Wimmer is a Psychologist with extensive experience in helping people to overcome problems with anxiety. While addressing current presenting issues with clients, Nicole also focuses on developing skills in the client to better equip them to deal with future challenges as they arise.