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The potential of fear is so very broad, leaving a person feeling as though their world is diminishing.
Yours sincerely,
Agoraphobia
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In cases of agoraphobia, it is not the actual onset of panic that induces the person’s fear but the possibility of panic that they will not be able to get out, be able to reach for help; the possibility of causing others distress or of embarrassing oneself. These fears can be familiar and repetitive for those experiencing them. However, dependent on the arisen circumstance, new potential fears can exhibit. Sometimes affecting the agoraphobic person from multiple sources. That’s to say, it is not only one situation that can cause someone who is agoraphobic distress. Agoraphobia, the avoidance of places or situations that may cause panic, most commonly in a public place.
The beginnings of agoraphobia are not particularly notable. They can be easily confused with anxiety and panic-based disorders. The transition to agoraphobia can be a consequence of an event that has occurred that has induced panic. The occurrence of increased anxiety or panic over longer periods (e.g., six months), can be the precursory catalyst that allows for agoraphobia to develop. For instance, if a traumatic or difficult situation resulted in a panic attack, that situation or location is synonymous in the individual’s mind, as a potential where this could happen again, and that they would not be able to get away or seek help or embarrass themselves once more. This aversion is felt by most people when such an event happens. For those individuals who do not develop agoraphobia, adequate coping mechanisms are used to manage when revisiting a difficult past event. However, for agoraphobia, this is an entry point to the emergence of a cycle of avoidance. Increased avoidance has the potential to heighten anxiety and agoraphobia symptoms worsen. Most commonly, in agoraphobia cases, if left to manifest, individuals can become housebound, exacerbating isolation, and the worsening or likelihood of depression.
The prevalence of agoraphobia is found in women and the typical onset for this disorder is (averagely) 20 years of age. However, agoraphobia can happen at any point for any individual. This phenomenon may contribute that it is more acceptable for women to be fearful. Traditionally men are raised to minimalize fear and encouraged to be more logical within our society. Furthermore, women tend to be diagnosed with mental health issues more than men and are more readily encouraged to report events where they are made to feel fearful. In essence, it is more socially expected for women to be fearful and therefore, restriction free in that specific context to demonstrate those sorts of behaviours.
Some of the symptoms experienced by individuals with agoraphobia are chest pains, excessive sweating, upset stomach and hyperventilation, when in a situation that induces panic. This reaction of fear and anxiety is out of proportion, but it feels painfully real for the sufferer in those moments. The freedom of movement and flexibility in an individual’s life can begin to wane if suffering from agoraphobia. Getting early treatment is encouraged. This means contacting your doctor or health professional and sharing your experiences. They will be able to assist you through your journey to recovery. Certain methods of treatment are sought through therapy. Commonly used therapy techniques are cognitive behavioural therapy (CBT), exposure therapy (ET) and applied relaxation techniques. A professional can help you deal with the core causes of your anxiety or panic that may have led to agoraphobia. Or the professional can solely deal with the here and now, in order for you to get you through each day. These sorts of therapy are more often than not, person-centred. This means you are guiding your sessions.
There are self-care measures you can begin to use to try and alleviate stressors. Please note: These are suggestions, if the techniques become too distressing and you feel as though you cannot carry out any of these suggestions, please stop. You may need professional support, even for elements of self-care that touch upon your diagnosed or undiagnosed agoraphobia. Consistency is key. If you continue with these practices, be consistent. From your sleeping routines, eating schedule and daily exercise. Furthermore, avoiding unhealthy coping mechanisms is also beneficial. For example, misuse of alcohol and drugs negatively impacts anxiety levels. This advice also includes caffeine consumption (sorry guys!)
The aim is to learn to self-soothe when you are in a calm and safe space. Meaning, do not carry out these techniques when you are in a period of heightened anxiety or panic. Deep breathing from your abdomen, muscle relaxation techniques, where you tense and release from the top of your head (if possible) to the tip of your toes and imaginary desensitization (which is used to unlearn your fears). Again, please note: These are suggestions, if the techniques become too distressing and you feel as though you cannot carry out any of these suggestions, please stop. Meditation is also something to explore. There are many Apps available in the Apple Store and Play Store such as Headspace, Serenity, and Simple Habit. Finally, be mindful of how we speak to ourselves. Our inner voice’s words should not scare a child. Focus on how you would speak to a small child and speak to yourself in the same manner. Speaking kinder to oneself and showing self-compassion have so many benefits for your mental health. A speaking kindly practice can be a keystone in improving self-esteem and confidence; elements that are needed when working to diminish the impacts of agoraphobia.
If you are a person with a loved one who is agoraphobic or believes they could be, these are some suggestions for you to support and help those that you care for:
Be a support system and listen
Learn about the agoraphobic person's triggers
Know and be able to identify your loved one’s physical and mental impacts (e.g., excessive sweating)
Be empathetic and patient (no one wants to be agoraphobic)
Agree on parameters and stick to them - if you have agreed to support an agoraphobic person challenge one of their fears. Agree before leaving the house on all aspects of the experience e.g., are you holding the loved one’s hand? can you not move more than three feet away from them, for them to feel calm and reassured? If you get into a crowded place, what is the exit strategy?
Focus on shared goals – if leaving the house is too much, find another goal that may be achievable that is directed towards leaving the house. For example, getting your loved one to sit on the doorstep and water some plants if plants are something that brings them joy.
Agoraphobia is a limiting disorder for those who live with fear and panic and associated symptoms. The disorder can develop after a stressful life event such as the loss of a loved one and research has shown that the disorder is present to a greater extent if seen in family history. Agoraphobia can also be sporadic if the scenario the individual is fearful of, is not something they face daily. However, one of the indicators that it may be time to seek support from a family member or friend, is when those relationships start to become impacted by your increased difficulty in managing daily functions such as leaving the house by yourself or going for lunch at the country pub down the road. Patience and empathy are paramount, especially in those moments of fear and panic. A calm external force is far more helpful than judgement and ridicule. Sometimes giant leaps are not possible but by taking small and manageable steps, there is nothing that can impede your progress toward broadening your world and lessening the impacts of agoraphobia.
Further reading and useful links:
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