Breanna hadn't left her home in months; she felt safe within the walls of her house but was frustrated with her inability to go out into the world. There were a few times she got dressed and even made it as far as opening the front door, but that was it; she couldn't go outside. He husband was supportive but she knew he was also frustrated, he wanted to enjoy going out to dinner, joining co-workers at an office party - and to do those things with his wife. Instead, he ran the household errands, going food shopping, picking up prescriptions, and anything else that needed to be taken care of outside the house. He attended office parties by himself and settled for bringing take-out food home instead of eating out.
Therapy sessions were done online, eliminating Breanna's need to leave and visit her therapist's office. Today, however, Breanna's therapist was coming to her and going to work on leaving the house. Breanna was nervous, no, nervous was not the word, Breanna was on the verge of having a panic attack just thinking about walking out the front door. She knew she needed to do this, for her and for her family - last month she missed parent teacher conferences at her children's school - but the thought petrified her.
Not everyone with agoraphobia is a prisoner in their home. Some continue to work or go out, but being in certain places requires careful planning and developing self-help strategies. For example, you might go to food shopping late at night when the store is least crowded, wear sunglasses in the mall to avoid eye contact with others or only go to restaurants if you can get a table close by the front door.
What is Agoraphobia?
Agoraphobia impacts over 1 percent of all adults in the United States according to the National Institute of Mental Health with more than 40 percent of those adults showing severe symptoms. Agoraphobia is defined as the fear of open spaces, but sufferers may explain it more as the fear of public places. The Anxiety Disorders Association of America states, "Some people stop going into situations or places which they've previously had a panic attack in anticipation of it happening again." They avoid places where escape or exit is difficult, such as malls, public transportation or large arenas. As they limit where they feel comfortable going, their word continues to get smaller. Some, like Breanna, stop leaving their house.
Symptoms of Agoraphobia
Agoraphobia seems to stem from the fear of having a panic attack in public. Although these attacks frequently happen outside the home, they can occur anytime, anywhere, including in your sleep or upon first waking up. The symptoms of a panic attack are:
- Heart palpitations
- Shortness of breath
- Chest pain
- Stomach upset
- Dizziness or feeling faint
- Feelings of detachment
- Fear that you are "going crazy"
- Numbness or tingling
Most symptoms of panic attacks, besides from the actual feeling of fear, are physical. Many times those suffering from panic attacks first get diagnosed after visiting the emergency room or their doctor for unexplained physical symptoms, such as chest pains.
Treatment for Agoraphobia
While each person with agoraphobia is unique and may respond differently to treatments and medications, studies have shown that a combination of cognitive behavioral therapy, exposure therapy and medication is the most effective in treating symptoms. Because agoraphobia can often occur after a traumatic event, talk therapy to understand and come to terms with the event or situation also helps.
Self-help Strategies for Agoraphobia
Learn about panic disorder and agoraphobia. Sometimes, knowledge about panic disorder can help. Understanding what may happen helps you be prepared for symptoms and you can take steps to help reduce some of the symptoms.
Track your symptoms and triggers. Keeping a journal can help you see patterns or triggers to your panic attacks and develop specific strategies for dealing with those situations and events.
Avoid smoking and caffeine. These substances may increase panic attacks or make you more susceptible to a panic attack.
Use relaxation strategies. Deep breathing, meditation, yoga and other relaxation techniques, when used on a daily basis, may reduce your overall feelings of anxiety. In addition, when you practice deep breathing on a daily basis, it is easier to use it when in an anxiety-provoking situation to help you calm down.
Add exercise to your daily routine. A daily exercise program has been shown to reduce symptoms of both depression and anxiety. Depression is often a problem for those with agoraphobia because of the feelings of isolation.
Look for a support group. It is great therapy to find a group of people that understand exactly what you are going through and can continuously offer their support and encouragement in a setting where you have no fear of being judged. If you can't find an in-person support group in your area, there are a number of support groups online.
Take up a hobby. Having something productive and creative to do each day helps you feel better about yourself. Sufferers of agoraphobia can have low self-esteem and feel "useless." Doing something creative is not only therapeutic but can give you a feeling of accomplishment.
Seek help. There are treatments available for agoraphobia which have been found to help many people. Talk with your doctor or therapist to create a treatment plan and work toward getting your life back.
"Agoraphobia Among Adults," Reviewed 2010, July 29, Staff Writer, National Institute of Mental Health
"Panic Disorder & Agoraphobia," Date Unknown, Staff Writer, Anxiety Disorders Association of America
"Panic Attacks and Panic Disorder," Updated 2011, June, Melinda Smith, M.A., Jeanne Segal, Pd.D., HelpGuide.org