What is Agoraphobia?

Agoraphobia is a debilitating anxiety disorder characterised by a pervasive dread of leaving familiar surroundings. This fear often manifests as a reluctance to travel, especially on public transportation, or to venture into crowded spaces. Moreover, the condition is often accompanied by severe physical symptoms of anxiety and panic attacks.

Derived from the Greek words "agora" (marketplace) and "phobia" (fear), agoraphobia was initially understood as a simple fear of public places. However, research has revealed that the underlying fear is not of public spaces themselves but rather the learned anticipation of a panic attack in such environments.

A person may experience a panic attack, triggered by stress or other factors, and subsequently develop a deep-seated fear of experiencing another. To avoid these distressing episodes, individuals may begin to avoid situations that remind them of previous panic attacks. This avoidance behavior can reinforce the fear, making it increasingly difficult to venture outside.

The fear of agoraphobia can extend to almost any location, including open spaces like shopping centers and airports, as well as enclosed spaces like churches and theaters, or even quiet places like empty streets. In severe cases, the fear can become so generalized that individuals may feel trapped in their homes.

The onset of agoraphobia can be sudden or gradual, developing over months or years. Various factors can contribute to its development, including stressful life events like the loss of a loved one or sudden changes in circumstances.Additionally, long-term emotional stress, often unrecognized, can also trigger panic attacks and lead to agoraphobia.Once established, agoraphobia can be further reinforced by feelings of hopelessness, anger, frustration, and guilt.

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 incredibly isolating, making it difficult to seek out the necessary treatment.However, it's crucial to remember that help is available and that the fear associated with agoraphobia can be unlearned. In fact, reaching out and asking for assistance is the first step toward managing this condition.

Rehabilitation programs offered by trained therapists have proven effective in restoring the ability to cope with everyday life. In particular, programs that employ a cognitive-behavioral approach to agoraphobia often yield the most significant benefits. Indeed, the majority of individuals who participate in these programs experience a noticeable improvement in their symptoms, and many achieve a full recovery without future episodes of agoraphobia.

While alcohol and self-prescribed drugs may provide temporary relief, they generally do not alleviate the symptoms of agoraphobia and can even exacerbate stress and depression. Although certain medications may be helpful in some cases, long-term drug therapy is typically not the most effective treatment.

Additionally, self-help support groups can play a valuable role in the recovery process. By connecting with others who understand the challenges of living with agoraphobia, individuals can gain valuable insights and support.

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 and psychotherapy in Sydney for persons suffering from or affected by agoraphobia. Need help? Call us 
• Learn more about agoraphobia at Better health channel.