Agoraphobia is commonly understood to be a fear of open spaces or going outside, but in fact it is more complex. With agoraphobia the anxiety or fear appears to be associated with being in places or situations from which escape might be difficult or embarrassing (for example trying to get out of a crowded room or social situation), or in which help may not be available in the event of having a panic attack.
This anxiety may thus result in avoiding a range of situations, for example, being alone, inside or outside the home; being in a crowd of people; travelling by car, bus or plane; or being on a bridge or in a lift. Anxiety about getting, or dealing with a panic attack, can exacerbate the feelings of anxiety associated with the situation.
You may find that if you experience agoraphobia you also dislike being alone (monophobia), and may also become anxious in small confined spaces (claustrophobia).
A phobia may begin apparently without cause, but may be linked to periods or incidences of stress or trauma. The anxiety that is linked to phobias may be partly a learnt response, e.g. if parents or other family members are particularly anxious about aspects of life. Phobias
experienced by other family members may also result in ‘learnt’ behaviour, picked up by others within the family. Agoraphobia may result from the stress associated with the loss of a person on whom sufferer depended for his/her sense of security.
Agoraphobia can be exacerbated by well-meaning family or relatives who try to help the individual by doing everything for them, so they don’t have to leave home, or helping them to avoid the situations they find most stressful and anxiety-provoking. This can reinforce the phobia, and can lead to an individual being completely housebound.
A talking treatment such as counselling can be helpful. The most effective approach is cognitive behavioural therapy (CBT) where the person is encouraged to understand the link between the experience of the situation and the anxiety engendered by it. By gently encouraging the person to face their fears, they also feel more in control of them, and thus are able to reduce the level of anxiety.
Support groups or self-help groups can also be useful as it can be helpful to know you’re not alone; such groups can also facilitate the sharing of relaxation or anxiety management techniques.
Medication is not generally used although anti-depressant or anti-anxiety medication may be prescribed for short-term use.