Agoraphobia

Agoraphobia is a fear of open spaces and large crowds, usually accompanied by social embarrassment. The term was originally coined to describe the fear of the marketplace. "Agora" is the ancient Greek word for market. A person suffering from agoraphobia experiences intense anxiety and wants to flee the scene, but finds it difficult or awkward to do so.

A feeling of fear or panic appears in a crowd of people, on a deserted street, in a shopping center, in a room with an open door or window. The thought that the street is a dangerous place is imprinted in the mind. Agoraphobia manifests itself in the fear of moving alone outside the comfort zone (one's own home), but when accompanied by a fellow traveler, the agoraphobe feels good and confident.

A type of agoraphobia is considered to be the fear of public speaking. The fear of failure, shame, the possibility of doing something wrong and not being liked by other people has a social connotation. It is believed that people are especially susceptible to phobias in large cities.

Agoraphobia makes a person vulnerable when he is at a distance from a group of people, when he can be seen from any side. Such a phobia can lead to seclusion within the walls of one's own home and an unwillingness to leave it. Such people may even be afraid to meet someone else's gaze with their eyes.

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Causes of agoraphobia

In some patients, the onset of agoraphobia may be preceded by a feeling of acute anxiety (for example, a person finds himself in a store where there is a fire, and the doors are narrow), but this is rare. Psychoanalytic theories say that a certain benefit for the patient can be obtained by adapting him (meeting) to some symptoms of agoraphobia: for example, a person who is subconsciously afraid of marriage (marriage) should not meet with possible admirers (admirers) of his fiancée (groom).

The causes of agoraphobia are divided according to the type of blockage:

• physical;
• emotional;
• mental.

On the physical level, it has been found that the majority of people with agoraphobia suffer from hypoglycemia (a painful condition that occurs when blood glucose levels drop).

Emotional blocks are determined by strong fears, worries, premonitions of disasters that never happen. There are agoraphobes who were strongly attached to their mother, completely dependent on her, and now consider themselves responsible for her happiness. It is enough to correct the relationship with the mother, and the problem disappears.

The mental level includes fears of death and insanity. Everyone knows that most fears come from childhood. Often, the child was left alone with his fear, did not dare to talk about it. An agoraphobe could have faced death or insanity of a loved one in childhood. Having grown up, he began to associate even changes with death, which causes a violent reaction in the form of panic. In the unconscious zone are hidden: fear of moving, the transition from youth to adulthood, marriage, pregnancy, the birth of a baby, a change of job, etc. At the limit of the emotional and mental level, all these fears rush out.

A distinctive feature of people suffering from agoraphobia is a rich, uncontrollable imagination. Such mental activity is perceived by the agoraphobe himself as madness. It is necessary to understand and be aware of one's own hypersensitivity, to control its manifestations.

The causes of agoraphobia may be the result of mental or physical factors. Stress, strong emotional reactions in a particular life situation definitely increase the risk of agoraphobia.

Agoraphobia also appears as a result of long-term use of sleeping pills and tranquilizers, which belong to the class of psychoactive substances called benzodiazepines.

Possible causes of agoraphobia also include:

• excessive alcohol consumption;
• addiction to drugs;
• mental trauma in childhood;
• experienced stressful situations – loss of loved ones, serious illness, dismissal from work, war, earthquake, etc.;
• mental illnesses (depression, eating disorders).

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Symptoms of agoraphobia

Agoraphobia, physical symptoms are rare, as most people with this phobia prefer to avoid situations that provoke panic. Physical symptoms include:

• increased heart rate;
• hyperventilation (breathing accelerates and becomes shallow);
• heat, blush;
• stomach disorders;
• swallowing problems;
• changes in sweating;
• feeling of nausea;
• trembling sensation;
• dizziness, pre-fainting state;
• ringing or noise in the ears.

Agoraphobia, symptoms of psychological manifestation:

• fear that others will see your attack of fear (feeling of embarrassment, humiliation in connection with this);
• worries about possible cardiac arrest, lack of air, sudden death;
• fear will drive you crazy;
• lack of self-confidence, low self-esteem;
• feeling of loss of control;
• depressive state;
• a constant feeling of fear, groundless anxiety;
• fear of being alone;
• the emergence of confidence that without support it will be impossible to survive and carry out life activities.

Agoraphobia, behavioral symptoms:

• elimination of circumstances that provoke an attack of fear (from avoiding a ride in a crowded train car to a complete refusal to leave home);
• a feeling of confidence when accompanied by someone;
• taking “doping” before leaving the house – alcohol, pills;
• salvation by escaping from a stressful place into one's "shell".

Treatment of agoraphobia

Treatment of agoraphobia depends on its type - with or without panic disorder. They use psychological therapy or complex treatment - medication with psychotherapy.

Treatment with tranquilizers and antidepressants is prescribed to patients with panic symptoms. Sometimes, it is necessary to select the most suitable drug in several stages, so the therapy should be carried out under the supervision of a doctor. Antidepressants belonging to the group of selective serotonin reuptake inhibitors (SSRIs) have a number of side effects: headache, insomnia, sexual dysfunction, nausea.

Treatment of agoraphobia with tricyclic antidepressants is possible, but the list of negative consequences from their use is much wider.

Benzodiazepines (alprazolam, clonazepam) are used to relieve anxiety, but they are addictive and also have a number of side effects such as confusion, drowsiness, loss of memory and balance.

How to treat agoraphobia with psychotherapy?

Experts have a variety of techniques at their disposal, including hypnosis and cognitive behavioral techniques.

It became possible to identify the subconscious causes of agoraphobia with hypnosis treatment. Agoraphobia is eradicated at the deep layers of consciousness. This technique is applicable for anxiety disorders with the complete exclusion of panic states and attacks of fear, neutralization of uncomfortable situations.

Cognitive behavioral therapy is applied in stages. First, the patient understands what his agoraphobia is and learns skills to control panic attacks. The psychotherapist explains the reasons that cause uncomfortable situations, which aggravate the problem. Negative perception is replaced by a favorable, relaxing one.

Secondly, the specialist corrects unhealthy behavior through desensitization (gradual increase in stress factors). The patient applies his knowledge in practice, which allows him to overcome the frightening situation.

How to get rid of agoraphobia?

Behavioural therapy may be effective, provided, of course, that the patient wants to change. MAO inhibitors may also be helpful).

How to get rid of agoraphobia on your own? The following recommendations may help you:

• Relax, listen to calm music, close your eyes and imagine yourself crossing the threshold of your home. Do not force the events even mentally. At first, it will be enough to cross the threshold. Increase the distance gradually, monitor the feelings that visit you (at the slightest discomfort, go back). Initially, increase the time of stay, only then increase the distance. Upon achieving positive and lasting results, move on to action;
• determine what keeps you in the house. Find your "anchor point". It can be a door handle, some corner of the room. When the place is found, you will be overcome by a feeling of peace and security. The size of the "anchor point" should be no more than 1 cm. With your eyes closed, in complete relaxation, move your comfort point to another part of the apartment. If the experiment is successful, you will feel good in the new zone. Do this exercise as many times as you want until you are sure that you are the one creating your comfort zone.

Agoraphobia causes muscle spasms throughout the body, which can lead to compression of blood vessels, bronchi, pressure on the diaphragm, stomach, and intestines. Prolonged spasms disrupt the functioning of the circulatory system, and hypertension and migraines develop. For example, gastritis can be purely psychological in nature and develop due to spasmodic conditions during a panic attack. Agoraphobia can cause irreparable damage to mental and physical health, so it is necessary to seek help in time.