What is Agoraphobia?
Agoraphobia is an anxiety disorder characterised by an uneasiness, fear or dread about leaving familiar surroundings. This may include a reluctance to travel, particularly on public transport, or to be in crowded places.  It is associated with severe physical symptoms of anxiety and panic attacks. It is a condition related to anxiety, depression, panic and other phobias.

The word agoraphobia is derived from the Greek ‘agora’ which means ‘market place’ and ‘phobia’ meaning ‘fear of’.  It was first considered to be simply a fear of being in a public place (e.g. the market place). However the fear and dread about leaving home (or another ‘safe’ place) is considered not to be associated with fear of the public place in itself, nor of lots of people, but actually the learned fear from a previous experience of a panic attack in such a location.

A person may have a panic attack (for any number of reasons including stress) and then a real fear develops that it may happen again and situations are avoided which remind a person of the previous panic attacks. Panic attacks are frightening and embarrassing so it is a natural reaction to do things to avoid what is perceived to have caused the panic attack.   A fear can be developed for almost anywhere. It can be open public places such as shopping centres, railway stations, airports or closed places like churches, theatres, buses, trains, aircraft or quiet places such as empty streets or a store at closing time. The situation can become very generalised from a fear of one place to the point where a person cannot leave home at all.

The onset of agoraphobia can be sudden and unexpected or it can take months or years for the condition to develop from a mild phobic anxiety to a feeling of dread of many public situations. The fear of leaving the house may literally extend even to collecting the milk, mail or newspaper from the front step or gate.

There may be many factors which play a part in the development of agoraphobia such as the stress of loss, separation or the death of a family member or close friend; such sudden life changes may bring emotional stress.  Long-term emotional stress, which builds up gradually, often without its seriousness being recognised, can trigger panic attacks, which can gradually develop into agoraphobia.  Once a person develops agoraphobia it is further reinforced by feelings of hopelessness, anger, frustration and guilt about the agoraphobia itself.

What are the Symptoms?
Whilst the symptoms of agoraphobia may fluctuate, they may include:

• feelings of depression
• abuse of tranquillising drugs and alcohol for relief of symptoms
• fear of loss of control
• other phobias
• loss of self-esteem and self confidence
• frustration and anger with oneself
• anxiety and panic attacks
• confusion

The physical symptoms of anxiety and panic attacks may include:

• feeling of light-headedness
• feeling of being detached or distant from surroundings or even from one’s own body
• buzzing in the ears, blurred vision, a dry mouth, tingling in the face and arms
• difficulty in breathing - perhaps breathlessness without apparent cause
• sudden feeling of extreme panic
• heart palpitations
• indigestion
• dizziness
• severe backache without apparent cause
• headaches and other muscle aches and pains
• weakness of the legs
• sweating
• nausea
• shaking hands
• fear of fainting
• fear of heart attack

What Treatment is Available?
Living with an illness like agoraphobia can be extremely isolating, and can make reaching out for treatment difficult.  It is important to recognise that there is real help available and that people can unlearn the fear that has developed over time. Reaching out and asking for help is the first step to managing this illness.
Rehabilitation programs offered by trained therapists are proving successful in restoring the ability to cope with everyday life.  Programs with a cognitive-behavioural approach to agoraphobia are often the most beneficial.  The majority of people undertaking these programs experience a definite change in symptoms. In many cases a full recovery without future episodes of agoraphobia is possible.

Alcohol and self-prescribed drugs generally do not lessen the symptoms of agoraphobia, and may well increase the levels of stress and depression experienced.  Whilst there are certain medications, which may be of assistance, long-term drug therapy is generally not the best treatment.

Self-help support groups can play a helpful role in the recovery process, enabling you to meet other people who know what it is like to live with this illness.

Where to Get Help

• Anxiety, Panic & Agoraphobia Support Groups, including ‘Triumph Over Phobia’ groups, Anxiety Disorders Alliance, tel 1300 794 992
• Mental Health Information Service, tel 1300 794 991.  There are specialist anxiety clinics in most hospitals and in university clinics. See your GP for a referral
• Therapeutic Axis provides counselling in Sydney and psychotherapy in Sydney for persons suffering from or affected by agoraphobia.
• Contact Us