Contrary to popular belief, agoraphobia is not the fear of people or public areas. According to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, individuals with agoraphobia suffer from the fear of having a panic attack. Crowds and public places are avoided because it could be difficult to leave or escape these situations should a panic attack occur. Running away from a place when symptoms of panic arrive, and having a panic attack in public are seen as embarrassing to sufferers of agoraphobia; therefore, they avoid places that they are unable to exit suddenly or get help if needed.
Panic Attacks
Individuals diagnosed with agoraphobia typically experience panic attacks when they perceive themselves to be trapped somewhere. Feelings of panic are manifested physically through heart palpitations, perspiration, shaking, shortness of breath, dizziness and nausea. Panic attacks are sometimes mistaken for heart attacks due to the commonality and severity of symptoms. According to the Surgeon General, symptoms of panic increase in intensity for approximately 10 to 15 minutes before they begin to subside, and usually last no longer than 30 minutes.
Anticipatory Anxiety
The fear of having another panic attack can be crippling. Sufferers of agoraphobia may obsessively ruminate and worry about future situations of confinement where they consider themselves to be more vulnerable to an attack such as planes, trains, buses and cars. Excessive worrying may result in the refusal to leave their homes at all. Cognitive behavioral therapy, which focuses on changing one's thoughts and controlling one's behavior, is the most effective type of treatment for agoraphobia, according to HealthGuidance.org.
Avoidance Behavior
Depending on the extent of their fear, people with agoraphobia may either endure confined settings, despite marked distress, or avoid them altogether. Avoiding methods of transportation is extremely limiting since it can prohibit people from going to work, or to the grocery store. Social functions or family gatherings may be missed due to the distressing fears associated with agoraphobia. Stairways are generally preferable to elevators, and places that are expected to draw crowds such as stadiums, malls and amusement parks are completely avoided.
Dependence on Others
People with agoraphobia have difficulty with self-sufficiency. They rely on others to assist them with travel, shopping, or just going outside. Their fear of having a panic attacked is heightened in situations where they are alone; therefore, they tend to travel with a companion. When agoraphobia causes an individual to be home bound, their dependence on others is increased significantly. Daily activities such as taking out the garbage, buying food and walking to the mail box become the responsibilities of others to fulfill.
References
- "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision"; American Psychiatric Association; 2000
- HealthGuidance.org - Agoraphobia Treatment
- SurgeonGeneral.gov - Anxiety Disorders
