Agoraphobia

Of those with panic disorder about half have another disorder: agoraphobia.

Panic disorder can occur with or without the presence of agoraphobia. Psychologists refer to agoraphobia as being the avoidance or endurance with distress of situations which may be difficult to escape from or in which help is not available if a panic attack occurs. Agoraphobia usually starts when people are adults, unlike most fears or phobias. Those with agoraphobia live in fear and terror of being trapped . They also worry that they may have a panic attack, vomit or have diarrhoea when out in public. They try very hard to avoid situations from which they are unable to escape. They also fear places where help may not be easily available if they need it.

The agoraphobic often starts having one fear, such as being in a crowd, but in many cases the feared situations multiply to the point that the person fears even leaving home. Agoraphobia combines with panic. This combination of fears of not getting help and of feeling trapped then leads to incapacitating isolation. The agoraphobic lives alone unable to venture out.

You or a loved one may have agoraphobia if:

You worry about being somewhere where you are unable to escape or get help in case something dreadful happens, like a panic attack.
You become very anxious over normal everyday activities like leaving home, travelling or being in large groups of people.
You avoid the places that you worry about so much that it takes over your life, and you become a prisoner of your anxiety.

Many people have anxiety about crowds, worry about feeling trapped or going out of their home. If you cope with life without major changes or constraints or curbs on your activities then you are probably not agoraphobic.

As an example, if entering a large sporting arena provokes tremendous anxiety, then you can choose to live a happy life avoiding major sports events. If your main passion in life is attending live sporting fixtures or if you have just started working as a sports journalist then this fear is terribly disabling and a major problem.

Case example

“Sarah had had some problems with panic attacks in her 20’s but these had resolved with psychotherapy. Now aged 46 she was recently divorced, and had financial problems. She was overworking and although she prides herself in coping with whatever cards life deals her was feeling stressed. Going shopping at the large shopping mall was stressing her because of the crowds. On a busy Saturday she parks her car in the car park and enters the shopping mall. Inside she feels as though the crowd of shoppers is crushing in on her, and she feels trapped. She’s so scared that she rushes out of the mall. A few weeks later she is finding shopping in grocery stores stressful because of increasing anxiety. Soon driving in traffic is a problem. She is now suffering from agoraphobia and is at risk of becoming housebound without treatment.”

It is common for agoraphobia, panic and anxiety to affect those who are normally free of major deep-seated emotional problems. So if you suffer from anxiety, it doesn’t mean you’ll need years of psychotherapy the problem is treatable.