Agoraphobia (A comprehensive Guide)

In this brief guide, the agoraphobia will be discussed along with other anxiety disorders given in DSM 5, causes of agoraphobia, and how agoraphobia can be treated.

What is Agoraphobia

Agoraphobia is a psychological condition, in which the person experiences excessive worry in places from where escape might not be possible. 

Person with agoraphobia experience fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.

You fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd.

When an individual is uncertain about future consequences he or she might face in an unfamiliar and new situation, there will be fear and apprehensions.

This is the body’s natural response and is named as Anxiety.

For instance, giving a presentation in front of the whole class or the first day of a job may cause feelings of fear and nervousness.

Certain amount of Anxiety is necessary for survival and it might actually keep some people motivated to do work and engage in problem-solving.

Anxiety becomes problematic when it starts interfering in daily routine and stops the person from being productive.

If the anxiety feelings cross the threshold level and last for six months, then it is called Anxiety Disorder.

How to Differentiate Anxiety and Anxiety Disorder?

There is a difference between normal Anxiety and Anxiety Disorder, having a knowledge of that will help the person treat it properly.

Anxiety

Anxiety is defined by The American Psychological Association (APA), is an emotion which is characterized by worrying thoughts, feelings of tensions and physical discomfort like stomach ache or increased blood pressure in the face of potential danger.

Anxiety causes distress but it does not always require medical attention.

Anxiety is necessary for survival. Since the earliest days of humanity, whenever any danger approached, it causes adrenalin to rush.

The adrenaline is a body hormone and it triggers the anxious reactions, ”fight-or-flight.

This, in turn, causes our ancestors to either confront the danger and fight it or run to take refuge in a safe place.

Now, the anxiety is revolving around money, work, health, family life and other areas of life that require an individual’s attention.

A common example of Anxiety would be looking at both sides of the road before crossing it because of the fear of being hit by a car.

Anxiety disorders

When the anxiety exceeds in intensity, it turns into Anxiety Disorder.

It is a mental health diagnosis given to people with excessive worry, apprehension, nervousness, and fear.

Anxiety disorders change how an individual behaves and handles emotions that consequently cause physical symptoms.

Mild level of anxiety causes discomfort and unsettling feelings but severe anxiety disturbs a person’s day to day life.

As defined by the American Psychological Association, diagnosis of Anxiety disorder is given when the individual is experiencing persistent intrusive concerns or thoughts.

Normal Anxiety when it exceeds a level that it starts interfering in daily life, it becomes an Anxiety Disorder.

Symptoms of Anxiety Disorder

There are many types of Anxiety Disorder and with their distinguished symptoms, however, more general type of Anxiety Disorder is called Generalized Anxiety Disorder (GAD) which is most prevalent and consist of basic Anxiety symptoms such as:

Feeling on the edge, restless, irritable, worried, sleep disturbance, problem in concentration and restlessness.

In daily life, these symptoms are normal to experience but those with GAD experience them on a higher intensity and persistently.

Types of Anxiety Disorder

Anxiety Disorders include the following types of diagnosis classified by The Diagnostic and Statistical Manual of Mental Health Disorders: Fifth Edition (DSM-V):

Separation Anxiety Disorder: Excessive fear of separating from those to whom the individual is attached lasting for 4 weeks in children and 6 months in adults.

High level of anxiety when anticipating or being away from home or attachment figure

Persistent worry of losing a loved one

Persistent worry of harm to oneself

Refusal to go out, away from caregiver

Fear of being alone or sleeping away from home

Nightmares with theme of separation

Selective Mutism: Failure to speak outside of home in social situations even in school

They can speak at home when the parents are present

Inability to speak even in the presence of close friends or immediate family members

Specific Phobia:

Excessive fear related to a particular object or situation, for instance, height, animals or flying

Avoidance of the phobic stimulus

Children might show signs of this disorder by clinging, throwing tantrums, crying or freezing

Social anxiety disorder, or Social phobia:

Fear of being in situations where others might judge based on performance

Fear or having conversation or meeting unfamiliar people

The individual fears that his anxiety symptoms will show and he will be negatively evaluated

Avoidance of social situations or endured with extreme fear

Panic disorder:

Unexpected persistent panic attacks

Sudden intense discomfort that reaches a peak within a minute

Symptoms include sweating, palpitations, pain in chest, heat sensations or chills, fear of dying or losing control

Excessive worry about having an unexpected panic attack

Agoraphobia:

Extreme fear and avoidance of situations, events or places where escape is not possible in the face of danger

It can be fear of open spaces, public transportations, enclosed places, being in a crowd or going outside of home

They can avoid public situations to the extent that their everyday life becomes extremely difficult

Generalized anxiety disorder:

The symptoms of generalized anxiety disorder have been explained earlier, this is the most common disorder among the population of having an anxiety disorder.

It includes excessive worry about almost everything that causes discomfort and disrupts the day-to-day life of a person and those around him.

Anxiety Attack

Anxiety attack is like a panic attack but its intensity is a little less and it can stay for a longer period of time and may worsen with the stressful event approaching.

Every individual with anxiety attacks experiences symptoms differently and in different severity.

Because not all the symptoms of Anxiety attack happen to everyone and they change every time.

The symptoms are as follows:

• Sweating
• Dry mouth
• Worry and apprehensions
• Failing dizzy
• Restlessness
• Tingling or numbness
• Shortness of breath
• fear

A panic attack stays for a minute or two but an anxiety attack can stay for longer periods of time. 

Causes of Anxiety

Like many other mental conditions, the causes of anxiety disorders are not fully understood.

Those who are already prone to anxiety may develop anxiety disorder after any traumatic or extremely stressful life event.

There can be some Medical causes of Anxiety. Any underlying medical condition might be causing the symptoms of anxiety.

Examples of such conditions include:

diabetes

heart diseases

drug misuse or withdrawal

thyroid problems

rare tumours

as a side effect of any medications

There are some risk factors that might be leading to the development of Anxiety-related disorders.

These risk factors include

Personality Type

Stress buildup

Having blood relatives who have anxiety or anxiety disorder

Going through certain trauma

Other mental disorders like depression or OCD

Substance use

Current life situations can also cause Anxiety.

Like, feeling under stress while studying or preparing for exams, losing a closed one, less sleep hours, too much work pressure, money problems or being out of work.

Treatment of Anxiety

Sometimes because of Anxiety, other conditions take place such as depression, substance dependence and sometimes they are the underlying cause of Anxiety.

Such conditions have strong effects on the mental health of a person and need to be taken care of immediately before treating any anxiety disorder.

Medications, psychotherapy and behavioural therapies are the forms of treatments for Anxiety Disorder.

They will be discussed one by one.

Self-treatment

In order to manage anxiety or anxiety disorder without having to go under clinical supervision, many people choose self-treatment at home.

These techniques might not be effective for a person with severe anxiety or in the long run.

Following are the techniques for people with mild anxiety and who need short term benefits:

Relaxation techniques: Relaxation techniques have great benefits even if the person does not have anxiety.

These include deep breathing, yoga, resting in the dark, meditation and long baths

Stress management: one of the main reasons for elevated anxiety is stress-related work.

Learning stress management techniques helps in limiting the trigger.

These include organizing beforehand for the upcoming deadline, making to-do lists and committing to take time out from work or study

Support network: anxiety turns into depression when the person stops seeking support and going out with friends.

Anxiety can be managed by talking things out with people who care and are supportive.

And for those who are not comfortable with seeking help from familiar people, there are online platforms available where they can talk it out

Exercise: exercising is a great way to release bodily tensions.

If hardcore exercise is too much, a person can get incredible benefits just from sticking to a daily brisk walk.

It improves physical health as well as increases positive feelings

Professional Support

Psychological counselling is a standard treatment for anxiety.

The techniques used in counselling can be cognitive behaviour therapy, psychotherapy or eclectic therapy which is a combination of other therapies.

Cognitive Behavior Therapy: CBT aims at changing the harmful negative thoughts upon recognizing them that maybe playing a role in sustaining the anxiety.

It focuses on psychoeducation the client about cognitive distortions and with the help of relaxing techniques and systematic desensitization in some cases, manages the anxiety.

CBT has been proven to recover the person from Anxiety altogether by exposing the person to fearful stimulus and making them confront the situations they tend to avoid because of anxiety.

Management by Medications

In milder to moderate cases, a person can get better by professional counselling alone.

However, sometimes the symptoms become so distressing that he needs medication.

There are different kinds of medications for anxiety management that control mental and physical symptoms.

These include Benzodiazepines, beta-blockers, antidepressants, and tricyclics.

Benzodiazepines: They manage the anxiety symptoms quite quickly but they are highly addictive and have few side-effects.

Valium or Diazepam are commonly prescribed Benzodiazepines

Antidepressants: they target depression but are prescribed for anxiety as well.

These are serotonin reuptake inhibitors and they have side effects of nausea, sexual dysfunction, and jitters when the treatment begins.

Prozac or Fluoxetine and Celexa or Citalopram are commonly used antidepressants

Sometimes the side effects can get severe, in such cases, seek medical advice immediately.

Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.

Conclusion

Anxiety is a natural response of a body in times of facing danger or a possible threat to survival.

It is not a medical condition as long as it is not severe enough to affect daily life.

When Anxiety exceeds its normal amount and distresses daily life for six months, it becomes an Anxiety Disorder.

There are different types of Anxiety disorders, among them, GAD is the most prevalent and common.

Other types are specific phobia, social anxiety disorder, selective mutism, agoraphobia, and panic disorder.

Causes are complicated but any traumatic event in life can trigger anxiety.

The treatment includes self-treatment at home, having psychological help and medications as well.

It has been suggested that having a good sleep routine, keeping check-lists and a balanced diet improves the anxiety symptoms and manages it for the short term.

What we recommend for Phobias

Professional counselling

• If you are suffering from Phobias then ongoing professional counselling could be your ideal first point of call. Counselling will utilize theories such as Cognitive behavioural therapy which will help you address the fears you are facing.

Weighted Blankets

Weighted Blankets may help you sleep better if your phobias are affecting your quality of sleep. Weighted blankets apply enough weight on you that they make you feel much more relaxed and calm at night.

Frequently Asked Questions

References

Mayo Clinic

Medical News Today

Healthline 

Recommended Readings

 The Agoraphobia Workbook: A Comprehensive Program to End Your Fear of Symptom Attacks 

Overcoming Panic Disorder and Agoraphobia – Client Manual (Best Practices for Therapy Series) 

The Anxiety and Phobia Workbook 

My Un-Normal: How anxiety and agoraphobia affects us and how to deal with it 

Un-Agoraphobic: Overcome Anxiety, Panic Attacks, and Agoraphobia for Good: A Stepbystep Plan