“Once it happens for the first time, dread takes over.”
What is Agoraphobia?
Do you stay home in anticipation of experiencing extreme anxiety in public? You might suffer from Agoraphobia.
Agoraphobia is classified as an anxiety disorder by the American Psychiatric Association, characterized by the avoidance of places and/or situations that may cause acute panic, or a feeling of being trapped without a way out. At it’s worst, individuals feel unable to leave their home due to anticipatory anxiety of what might happen if they were out in public.
Agoraphobia Stats – Population Trends
According to data from the National Comorbidity Survey Replication (NCS-R) study, it is estimated that 9% of U.S. adults suffered from agoraphobia in the past year. Women represent a slightly greater proportion of the diagnostic population compared to men (9% vs 8%, respectively). Severity was distributed rather evenly among those with a formal diagnosis (Mild 28.7%; Moderate 30.7%; Serious 40.6%). The problem can occur throughout the lifespan, and is often seen in adolescents.
Panic Attack as Antecedent
The root cause of Agoraphobia is panic. Panic is another expression of anxiety where the individual is triggered into a fight-or-flight physiological response secondary to an external stimuli. Physical cues are often strongly associated with the panic experience, thus increasing the risk of having another panic attack in the future.
For instance, imagine you are on an icy highway and suddenly lose control of your vehicle. Your adrenal cortex suddenly kicks in causing a fight-or-flight response. Now, let’s say that this happens next to a grain silo. It is likely that the next time you are on that particular stretch of highway with the silo, you will experience panic (fight-or-flight) as a result of the visual cue, the silo.
The Panic-Agoraphobia Connection
In the case of Agoraphobia, the individual has previously experienced a panic attack in public. Regardless of the original trigger, the panic event in the past was so embarrassing, that thinking of being in a similar public location around people causes extreme fear. This leads to an inability to leave home as a way to resolve the anxiety associated with what might happen.
Unfortunately, agoraphobia has the potential to be extremely debilitating. Social contributors, such as family members doing necessary daily activities (e.g., getting the mail, grocery shopping, etc.), reinforces fear avoidance. Thus, the individual builds a world where they never have to leave the security of their home. This has a big impact of emotional wellbeing and physical health (fitness).
Treatment of agoraphobia is two fold, and requires the intervention of a clinician specializing in Cognitive Behavioural Therapy. Specialists from the field of Behavioural Medicine are often called upon for consultation and treatment planning:
Step 1: Take Control of the Panic Response: Every treatment plan must focus on the acquisition of skills for managing the panic response. This requires leaning a series of CBT techniques (PMR, Thought Stopping, etc.), designed to interrupt the fight-or-flight physiological response.
Step 2: Systematic Approach To Stepping Out: In Step I, you learned the skills necessary for both preventing panic and ending a panic attack once it has started. Now, with the guidance of a clinician in your home, a systematic approach to entering stress provoking activities away from the home can be approached. This requires considerable preparation and a mutual commitment to exposure therapy.
Final Thoughts – It Can Happen To Anyone
Agoraphobia is a very treatable challenge faced by about 10% of the American population. It is seen across many demographic variables – Anyone under the right circumstances, can experience a panic attack in public, the associated embarrassment, and the resulting fear of being in that situation in the future. Intelligence is not a protective factor. With a proper care team, Agoraphobia is easily treated.
Have Your Say!
What do you think? Have you experienced challenges associated with panic? Where did it happen, and what did you do? Do you suffer from Agoraphobia? Send your comments via our contact form.