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Everyone has gone through a period of their life where they feel especially anxious. Perhaps a parent passed away, or there was a fight with a life-long friend. Maybe there was a cross-country move to a new town, and you feel unwelcome and homesick. Whatever the circumstance, every single one of us has encountered stressful situations that cause us to feel out of control. It is a normal part of living in an imperfect world.
But what happens when feelings of anxiety become so overwhelming that if feels like it's taking over? What if we wake up in the middle of the night with our hearts pounding, our chest on fire? What if we start avoiding trains, elevators, cars, or even our mailbox? If going outside of the confines of one’s home seems overwhelming, a person may be struggling with agoraphobia. Here’s what to know about agoraphobia, the causes, and best practices for treating it.
What is Agoraphobia?
Agoraphobia is a type of anxiety disorder that causes people to avoid situations that cause them to feel trapped, helpless, panicked, or embarrassed. Those with agoraphobia experience symptoms of panic, nausea, or dizziness when they encounter certain situations. Many of us think that agoraphobics are unable to leave their homes, and this is true in many cases. However, some agoraphobics only experience symptoms during certain situations, i.e. airplanes, cars, or paying bills. About .8% of the population in the United States suffers from agoraphobia.
Symptoms
Those with agoraphobia are usually:
· Afraid to leave their home for long periods
· Afraid of certain social situations
· Afraid of losing control or “going crazy”
· Afraid of feeling trapped in a public place
· Detached from friends, family, and loved ones
· Difficulty sleeping
· Anxious, aggressive, or angry
Causes
Agoraphobia does not usually come on overnight. It is a gradual process that culminates in one feeling less and less free to leave their home or go to a public place. Those who develop agoraphobia usually have high-strung, analytical, and obsessive personalities. They may have been an anxious child who was prone to feelings of panic.
Many times, a triggering event is what changes a person from “anxious” to “agoraphobic.” Most agoraphobics were living normal lives but felt uncomfortable in their own skin. The triggering event may be a social situation that causes a mini panic attack. Or perhaps a person felt trapped on an airplane and began to experience feelings of panic.
After that triggering event, the person becomes gradually more afraid to experience those panicky feelings in that situation. They associate the situation with feelings of panic. This is where avoidance behavior begins. It may start with avoiding planes, but then can move to cars, seeing friends, work, or public places. Eventually, the fear of the panic becomes greater, and the person can do less and less. That is how many agoraphobics end up in their homes. They did not start that way, it is merely the last stop at the end of the journey.
Treatment
Exposure therapy is a very helpful way for agoraphobics to overcome their fears. The patient is slowly exposed to situations and taught skills to cope with the feelings of panic. They must continue this process over and over again until they are no longer afraid of the feelings.
Cognitive-Behavioral Therapy is also a common form of treatment. CBT can help the patient understand their disorder and teach them how to utilize thought replacement techniques. Thought replacement takes negative, self-defeating thoughts and replaces them with more realistic, positive thoughts. For example:
· Negative: I can’t breathe. I feel like I’m going to die. I have to get out of this plane!
· Positive: I feel a little anxious right now. I accept my anxiety. It’s not going to hurt me. I will get through this flight.
· Negative: What if I can’t think of anything to say and I embarrass myself at the party? What if I have to leave and everyone notices?
· Positive: I am feeling a little bit anxious right now because I haven’t been to a party in a long time. It’s ok, it’s no big deal. I will stay for a short while, say hello, and then leave whenever I want. Nobody cares if I have to leave.
It is important to note that the patient must not pretend his or her anxiety does not exist. Ignoring or fighting the anxiety will only make symptoms of panic worse. Instead, thought replacement techniques can be utilized to acknowledge anxiety, accept it, and sit through it anyway. It is learning how to rationally talk to oneself and eventually, calm down.
Helping Someone Who Has Agoraphobia
If a loved one is struggling with agoraphobia, they must find the support that they need. Let them know that you understand their fears, but remember not to encourage them. Enabling someone with agoraphobia can make the agoraphobic feel as though they have a legitimate reason to be afraid. Working with a therapist can help both of you find healing through this process.
Do you struggle with agoraphobia? Do you often feel trapped, anxious, or panicky? If so, please contact Straight Talk Counseling at 714-828-2000 or visit our website at straighttalkcounseling.org. One of our professional therapists would be happy to speak with you.