Phobias are never pleasant for their sufferers, but in many cases it is possible to avoid the situations that trigger those feelings of fear. However, for agoraphobics, those avoidance techniques can cause serious problems that greatly affect their quality of life.
If you suffer from this often debilitating phobia or believe you may be showing the first signs, take a look at the treatments and self-help options available.
What is agoraphobia?
Many think of agoraphobia as simply a fear of open spaces, but the truth is the triggers can be far more complex than that. According to the NHS, many agoraphobics are fearful of any situation where they feel unable to escape, such as travelling on public transport, shopping or simply leaving the house.
Up to two people in 100 are estimated to suffer with this panic disorder, which usually starts between the ages of 18 and 35 and affects twice as many women as men.
The symptoms of agoraphobia may not only be physical but also psychological and, as a result, behavioural. Physically, agoraphobics often experience symptoms similar to those of a panic attack - rapid heartbeat and breathing, nausea, chest pain, trembling, feeling hot and sweaty, and faint. An upset stomach, ringing in the ears, diarrhoea, dizziness and difficulty swallowing are also not uncommon.
Psychologically, thoughts about the physical symptoms are often a worry for agoraphobics. For instance, they may fear that a panic attack will be life-threatening or be worried about the embarrassment of suffering an attack in front of others. The thought of losing control, trembling or that you might feel unable to escape from some particular situation gives many sufferers a sense of anxiety or dread.
The fear is often so intense that the sufferer will avoid any situation that may give rise to the symptoms, whether that be crowded places, public transport, queues or shops. Agoraphobics therefore often become isolated, refusing to leave the house for long periods, or requiring a trusted friend or relative to accompany them when going out. This isolation can also lead to depression or stress that exacerbates the situation.
If you are finding it increasingly stressful leaving the house, or have adopted avoidance strategies to help you cope, visit your GP and explain your symptoms, either in person or by telephone consultation.
The good news is that approximately one third of agoraphobics are eventually cured of their fears and remain free of symptoms. Around a further 50 per cent see a marked improvement in their symptoms, and only one in five continue to suffer severely.
In terms of treatment, changes to lifestyle and self-help techniques are usually the first port of call, though talking and relaxation therapies and even medication can be prescribed where the symptoms are very severe.
Dealing with agoraphobia requires a step-by-step approach, and simple lifestyle changes and techniques can help sufferers to cope with the symptoms, thereby gaining confidence in dealing with trigger situations or environments.
Reducing general stress levels can help, so a healthy diet and regular exercise are advised, while drugs, alcohol and other stimulants, though they often appear to relieve the symptoms in the short-term, can make things worse in the long run and should be avoided.
There are also techniques you can learn to help you cope with a panic attack. For instance, staying still and focusing on something clearly visible and non-threatening, such as an item in a shop or the second hand of your watch, can help you to stay calm until the fear passes. Deep, slow breathing, counting slowly to three each time you inhale or exhale will keep the panicky feeling of being unable to breathe to a minimum.
Other techniques are more challenging initially. Creative visualisation, where you resist the negative thoughts and replace them with thoughts of a peaceful, relaxed situation can help you to focus on something other than the panic attack itself, while challenging your fear by reminding yourself that it is not real and not life-threatening in itself is another technique that can help to relieve the symptoms.
Many GPs will recommend you enrol on a guided self-help programme that will help you with these techniques, and offer practical advice on dealing with the symptoms and even underlying causes of your phobia. Self-help manuals can be read at home, while there are also web-based programmes available.
Cognitive behavioural therapy is a treatment that helps sufferers to break the cycle by finding new ways of thinking about the problem, shifting those thoughts from fearful to a more positive approach. It is often combined with exposure therapy, where the sufferer is set increasingly challenging goals over the course of the treatment.
Some agoraphobics also find that applied relaxation can help them to cope with their symptoms. This treatment uses exercises that teach the sufferer how to spot the first signs of tension, and use relaxation techniques to relieve the stress.
In severe cases, medication may be prescribed.
If you are concerned about your own agoraphobia or that of a loved one, talk to your GP to discuss your options. Alternatively visit www.anxietyuk.org.uk, a user-led charity that offers online support surgeries, a helpline staffed by those with personal experience of anxiety, and access to reduced cost therapy.
Do you suffer with agoraphobia? What have you found helps you cope with your fears and symptoms? Leave your comments below...