The causes of agoraphobia: the fear of fear

Agoraphobia is the fear of situations from which it seems difficult to escape or where it might be difficult to get help if anxiety symptoms develop.

As a consequence of this anxiety disorder, the person avoids the feared situations, supports them with great anxiety or needs to be accompanied when facing them.

In this article we will analyze the symptoms and causes of this "fear of fear".

• Related article: "Agoraphobia: the fear of losing control"

How does agoraphobia manifest itself?

Agoraphobia is more frequent in women and in recent years its prevalence has risen. Regarding the age of onset, it usually occurs in adolescence, although we can find cases that start at any age.

We can talk about different degrees of agoraphobia: there are people who do not leave home and therefore totally avoid the feared situations, others who endure the situations with great anxiety but deal with them on their own and others who only leave the house if they are accompanied.

Most common feared situations

Although the fears of each person with agoraphobia can be very different from those of the rest, below We will describe the situations that are most frequently feared or avoided by those who have this disorder.

Fear or anxiety is not caused only by the feared situations but also by your these situations. This fear has to do with the impossibility of escaping (whether due to physical restrictions or social convention) and with the fact of being alone.

1. Closed spaces

Among others, this category would include supermarkets and department stores, cinemas and theaters, classrooms, restaurants, parking lots, tunnels, elevators...

2. Open spaces

They can be indoors, such as stadiums, large rooms, and lobbies, or outdoors, such as courtyards, wide streets, or the countryside.

3. Travel by means of transport

Many people with agoraphobia fear having an anxiety attack while traveling by car, bus, train, boat, or plane. This is because they imagine that heit would be very difficult to escape from the vehicles if their fears were fulfilled; For example, having a panic attack in the middle of the highway can be a real mess.

• Related article: "Amaxophobia, the irrational fear of driving"

4. Crowds

Parties, meetings, discos, shopping centers, crossing bridges or standing in line are some of the situations and places that people with agoraphobia tend to avoid. In these cases, the anxiety is largely caused by the fear of being judged by other people.

5. be alone

In cases of agoraphobia, the fear of not having trusted people or be in a place that provides security, such as the house itself; This is why being away from home is a fairly common agoraphobic fear. However, staying home alone is another situation that is commonly feared.

Symptoms and “catastrophic consequences”

In general, most people who have agoraphobia suffer or have suffered spontaneous panic attacks, that is, they have occurred without an apparent cause.

People with agoraphobia are afraid of those situations in which they consider that they may suffer anxiety symptoms (panic attacks) as well as its possible catastrophic consequences. However, the fear of the consequences of anxiety is irrational since panic attacks are not dangerous for those who suffer.

The most frequent anxiety symptoms in panic attacks are the following: sensation of choking, palpitations, dizziness, sweating, unsteady legs, tightness, chest pain or discomfort, abdominal discomfort, depersonalization (feeling detached from oneself) and derealization (feeling of unreality).

Between the catastrophic consequences of symptoms that agoraphobics mistakenly anticipate we find: fainting, having a heart attack, die, screaming, losing control, going crazy, vomiting, drowning, being trapped or helpless and being unable to get to a safe place, not receiving help if experiencing anxiety symptoms...

• Related article: "Panic attacks: causes, symptoms and treatment"

Causes of agoraphobia

When talking about the causes of agoraphobia, it is important to bear in mind that certain personal characteristics can predispose to this disorder or be a consequence of it: dependency, low assertiveness, low self-confidence, social withdrawal, high anxiety, fear of negative evaluation, high approval seeking, ineffective coping strategies stress, tendency to avoid problems instead of facing them...

Childhood experiences such as overprotection or lack of affection may also be involved. Also, many people with agoraphobia say they were going through a stressful time at the beginning Of the same.

This stress can be related to work, a divorce, the death of a loved one, a conflict of a couple or relative, to an illness or operation, to a move, to a birth or an abortion, among others.

The origin of the “fear of fear”

Regarding the causes of fear, sometimes there are traumatic experiences away from home (such as an accident, robbery, or blackout), others are seen suffering trauma or showing fear in a certain situation, or threatening information is conveyed to the person.

can also be incorrectly associating certain symptoms of anxiety or panic to an external situation and thus it becomes feared. For example, anxiety symptoms may be experienced after a labor conflict and occur more frequently. intensity when traveling by bus a few minutes later, erroneously attributing them to the fact of traveling in bus.

Avoiding the feared situation maintains the fear

Anticipating anxiety symptoms or catastrophic consequences of these causes the person to avoid what they fear and, in turn, those avoidance behaviors maintain anxiety expectations and danger since it is not checked to what extent the threat expectations are realistic or not.

In the long run, avoiding feared situations in the long run can cause depression, low self-esteem, greater dependence on others, reduced social contact, appearance of work and family problems, etc.