According to statistics, residents of large cities and megalopolises are more susceptible to manifestations of agoraphobia and panic disorders. In rural areas, this disease is much less common. Among those suffering from agoraphobia, women predominate. This may be explained by the principles of some socio-cultural strata that allow a woman to be weak. The second factor that makes the statistics inaccurate is that men are more likely to drown their psychological problems in alcohol than to seek help from a doctor. Most often, agoraphobia occurs in young people and teenagers.
Symptoms of agoraphobia
The severity of agoraphobia varies greatly among people.
Someone with severe agoraphobia may be unable to leave the house, while someone with mild agoraphobia may be able to travel short distances without problem.
Symptoms of agoraphobia can generally be divided into 3 types:
- physical;
- educational;
- behavioral.
Physical symptoms
Physical symptoms of agoraphobia usually only appear in situations or conditions that cause anxiety.
Physical symptoms of agoraphobia may be similar to those of a panic attack and may include:
- fast heartbeat;
- rapid breathing (hyperventilation);
- feelings of heat;
- increased sweating;
- chest pain;
- difficulty swallowing (dysphagia)
- diarrhea;
- shiver;
- dizziness;
- tinnitus;
- feeling of weakness.
Cognitive symptoms
Cognitive symptoms of agoraphobia are feelings or thoughts that may be associated with physical symptoms.
Cognitive symptoms may include fear that:
- a panic attack will make a person look stupid or embarrassed in front of other people;
- a panic attack will be life-threatening, for example, you may worry that your heart will stop or that you will not be able to breathe;
- will not be able to escape from a place or situation if a panic attack begins;
- you will lose your sanity;
- lose control in public;
- trembling and redness may appear in front of people;
- people might look at it differently.
There are also psychological symptoms not associated with panic attacks, such as:
- feeling that you cannot function or survive without the help of others;
- fear of being alone (monophobia);
- general feeling of anxiety or fear.
Behavioral symptoms
Behavioral symptoms of agoraphobia include:
- avoiding situations that lead to panic attacks - crowded places, public transport, queues;
- fear of leaving the house for a long time;
- the presence of someone you trust when you go somewhere;
- avoiding places far from home.
When to seek medical help?
Talk to your GP if you think you have symptoms of agoraphobia and it is interfering with your life.
Contact your doctor if you have any of the following signs:
- chest pain;
- shortness of breath;
- headache;
- dizziness;
- episodes of fainting;
- unexplained weakness;
- feeling that the heart is beating irregularly;
- depression;
- suicidal thoughts.
Patients with agoraphobia are most often afraid of the following situations:
- staying away from home or usual places,
- places with large crowds of people, including public meetings, large stores, markets, train stations,
- places that cannot be left unnoticed and quickly (beauty salons, medical institutions, concert halls),
- city and intercity public transport,
- open empty spaces (square, field, square).
The increased anxiety that is observed in people with agoraphobia is caused not only by the traumatic situation itself - they are terrified that their condition will be noticed by others, and they fear ridicule, shame, embarrassment and helplessness. As a result, over time, the disease intensifies, and the patient, who has not made successful attempts to get rid of agoraphobia, becomes increasingly immersed in his fears.
Causes and risk factors
Most cases of agoraphobia develop as a complication of panic disorder.
It can develop if panic attacks occur in a specific situation or environment. You worry so much about a panic attack that your symptoms return when you are in a similar situation.
This causes the person to avoid that particular situation or environment.
Why is it developing?
Let's look at what the main reasons for the development of this phobia are.
- Genetic memory of the past. Primitive people experienced extreme horror when they found themselves in open space. Today, a person may experience fear if necessary to find himself outside his “shelter”.
- Depression. There is soul-searching, rethinking of life values, the formation of fears, and an artificial decrease in self-esteem. Difficulties arise when communicating with other people, it is difficult for a person to exist in society, there is an opinion about his unworthiness.
- Antenatal memory. The baby, being in the womb, feels protected. If something threatens him, for example, premature birth or the mother’s desire to have an abortion, or her nervous state - all this creates a fear of going outside.
- Physical injury. In rare cases, physical injury can trigger the development of such a phobia. We are talking about injuries sustained in large crowds of people or outside the apartment. There is an opinion that only home is safe.
- Psychological trauma. The consequences of family violence, rape, terrorist attacks, as well as any serious shock to the human psyche can trigger the formation of fear.
Agoraphobia can develop under the influence of such factors:
- presence of increased emotionality,
- use of antidepressants,
- neurological pathology,
- great fear,
- presence of personality disorders,
- severe emotional shock,
- alcohol abuse or drug use,
- rich imagination.
It is worth considering that some people have a greater predisposition to developing agoraphobia. Namely, those in whom the following traits dominate:
- increased anxiety,
- self-criticism,
- suspiciousness,
- soul-searching,
- low self-esteem,
- excessive responsibility
- perfectionism.
Diagnostics
First of all, the doctor will ask about the symptoms, how often they occur and in what situations.
He will also want to know how symptoms affect everyday behavior. For example, they might ask:
- Do you have difficulty going outside (leaving the house)?
- Do you avoid certain places or situations?
- Do you use any avoidance strategies to help you cope with your symptoms? For example, relying on others to do shopping.
It can be difficult to talk to someone about feelings, emotions and your personal life. Try not to feel anxious or embarrassed. Your doctor should know as much as possible about your symptoms. This will help them make the correct diagnosis. They can then recommend the most appropriate treatment.
Physical examination
The doctor may want you to undergo a physical examination. In some cases, they may decide to do blood tests. This is to look for signs of any physical conditions that may be causing the symptoms.
An overactive thyroid gland (hyperthyroidism) can cause symptoms similar to a panic attack.
The treating physician must rule out any underlying medical conditions to make a correct diagnosis.
Characteristic manifestations
I bring to your attention the symptoms that characterize the presence of agoraphobia.
- Spatial orientation disappears. A person has difficulty determining when and where he came from, and where he is now. At the same time, he makes frantic attempts to seek shelter.
- Increased blood pressure, characterized by tinnitus and dizziness. It is observed in many cases in the presence of factors causing fear.
- Speech disorder. Difficulties arise even with the pronunciation of individual words, and it is impossible to ask for help. It is possible that short-term amnesia may occur. There may be a hearing disorder that will go away with the disappearance of panic.
- Deviations in the autonomic nervous system:
- hyperthermia,
- increased sweating,
- high respiratory rate per minute,
- tachycardia,
- possible disorder of the gastrointestinal tract.
Treatment of agoraphobia
Treatment of agoraphobia and panic disorder should occur in stages.
The steps are as follows:
- Find out more about the condition, lifestyle changes you can make and self-help techniques.
- Sign up for a guided self-help program.
- Try a more intensive treatment such as cognitive behavioral therapy (CBT). Talk to your doctor about medications.
Cognitive behavioral therapy (CBT) helps you solve problems by thinking more positively. This frees you from unhelpful behavior patterns.
Various treatment methods for agoraphobia are described below.
Lifestyle changes and self-help techniques
Learning more about agoraphobia can help you control your symptoms.
There are techniques you can use during a panic attack to help control your emotions.
Here are some self-help methods:
- Stay where you are.
Try to resist the urge to run to safety during a panic attack. If you are driving, stop and park where it is safe. The purpose of this is to allow the emotion to pass. The condition may be unpleasant, but you will see and make sure that it passes.
- Concentrate.
Focus on something non-threatening and visible outside of you. This could be the time passing on the clock, or a sound, a smell, or any other sensation that does not relate to you.
Remember that frightening thoughts and sensations are a sign of panic. They will pass if you let them.
- Breathe slowly and deeply.
Feelings of panic and anxiety can get worse if you breathe too quickly. Try focusing on slow, deep breathing. Count slowly to 3 on each inhalation and exhalation.
- Experience your fear.
Try to understand what your fears are and challenge them. Start with the least anxiety-provoking situation and work your way through it. Let the anxiety happen and pass. Then ask yourself: “Was it as bad as I thought, did something happen?” Often the answer will be no.
— Creative visualization.
During a panic attack, try to resist the temptation to think negatively.
Think of a place or situation in which you felt calm, relaxed, and at ease. As soon as this image appears, try to focus all your attention on it.
- Don't fight the attack.
Trying to fight the symptoms of a panic attack can often make the situation worse. Calm down. Accept that although it may seem scary, a panic attack is not life-threatening.
Making some lifestyle changes can also help.
For example:
- regular exercise;
- healthy diet;
- stop drinking alcohol and other harmful substances;
- Avoid caffeinated drinks.
Guided self-help program
If self-help methods and lifestyle changes aren't working, try a guided self-help program.
It includes working with self-help instructions. The manuals contain information and practical advice on how to cope.
Guided self-help for agoraphobia is based on cognitive behavioral therapy. It aims to change unhelpful and unrealistic thinking patterns.
