When you hear of someone being agoraphobic it is easy to think of some kind of recluse sitting in a room, shutting out the outside world and afraid to venture outside. That is the traditional mental image that many of us have and it couldn't be further from the truth.
Agoraphobia is not so easy to define. The severity of the condition can vary dramatically from one individual to another. A few people do become housebound, or even confined to one room by the condition, but there are also a large number of agoraphobics who can go out and about, are able to travel some distance from home even if it is within certain defined circumstances.
To fully understand agoraphobia you need to look at the root cause of it which is essentially a fear of panic attacks. Agoraphobia tends to be a condition that develops slowly. It nearly always occurs after someone has their first panic attack. After, it is easy to start worrying about having a repeat attack, you may start to go out of your way to avoid the situation or place that you associate with your first panic attack. This fear of the symptoms of panic can lead you to start making changes to your lifestyle to avoid another panic attack. This is an indicator that you either have or are at risk of developing agoraphobia.
Agoraphobia is not a simple condition and usually manifests itself as a collection of linked phobias. Many agoraphobics avoid being in any situation where they can feel trapped (claustrophobia) Some have a fear of being left alone (monophobia) and are only happy to go somewhere if they are in the company of someone they trust.
All of this can be linked back to the fear of a panic attack. The symptoms of a panic attack can be extremely frightening and the fact that it is difficult to predict when one will occur makes them an extremely powerful motivator in this avoidance behavior.
To recover from agoraphobia effectively you need to be able to master your fear of panic attacks.
Panic attacks present very real physical symptoms; a fast or erratic heart beat, tingling in the extremities, physical shaking, sweating and breathlessness are all classic symptoms. Attack can appear to start for no apparent reason but the thinking now is that they are caused by an over sensitivity of the part of the brain that controls the fight or flight response.
The fight or flight response is our bodies natural reaction to fear. It is normal and safe, designed by the body to protect us from danger. When the body's natural defense mechanism gets confused we can end up have dramatic reactions to perceived dangers that are completely out of proportion. Our body is preparing to face danger, yet there is no real danger.
When this first happens it can be frightening and it is easy to convince yourself that you are suffering from some medical condition. The fear that this generates causes you to start to avoid a situation that can lead to another episode.
Forms of CBT Cognitive Behavioural Therapy are now the recognized treatment for panic attacks and anxiety. They retrain the body to react normally to perceived threats and take away the fear, by doing so they can help to alleviate the symptoms of agoraphobia.
Having touched on agoraphobia and panic, we should also look at anxiety. What is the difference between panic and an anxiety attacks. The two phrases have become confused but are actually quite easy to differentiate between.
Panic attacks present very real physical symptoms as previously mentioned. Anxiety attacks on the other hand are less physical. Instead you would experience more of a feeling of dread, worry or anxiety with only mild physical symptoms. The two are closely related. Anxiety can lead to panic attacks and panic attacks can leave people with a sense of anxiety.
So panic, anxiety disorder and agoraphobia are all related and interlinked which is why the CBT that treats one condition will often help to alleviate or stop another.