Agoraphobia: causes, symptoms and treatment

There are many people who are afraid of tangible things such as spiders or snakes, but there are other types of fear that are much more complex. Today we will talk about an anxiety disorder that causes a lot of discomfort to some people despite the fact that for others it may seem something banal.

Today we will talk about agoraphobia, a fear that some people suffer from being in certain places or situations as we will explain below. We will see what are the symptoms, causes and treatment indicated in these cases.

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What is agoraphobia?

The etymology of the word agoraphobia is found in Greek, as it is the combination of two words in this language. In ancient Greece they called public squares "agora", while "phobia" corresponds to "phobos", which means fear.

Thus, a first orientation to the meaning of agoraphobia would be something like fear of public spaces. Indeed, those who suffer from agoraphobia fear being involved in large spaces with many people around them. These people can suffer from very great generalized anxiety and even experience panic attacks.

But the scope of agoraphobia is not limited in these types of situations. This great discomfort can also be experienced in contexts where there are many people in confined spaces, for example, such as a theater or a restaurant. In reality, any place that is far from the safe place of home can become a hostile place that causes this anxiety.

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Causes

The person suffering from agoraphobia suffers alterations in their psychological state due to the anxiety they experience in certain contexts. It is necessary to point out that going by train, to the theater or even to the doctor can cause quite a clinical picture, so it is not correct to conceive agoraphobia as "fear of spaces open ”.

Although closed spaces generally give more security to the agoraphobic person, symptoms may also appear that would make them want to leave the site. Always the thoughts of the agoraphobic person are more in relation to the possibilities of escaping from the place than in the place is yes. The agoraphobic wants to feel that he can easily find shelter in a crisis, and being close to home is the preference.

On the other hand, it is necessary to emphasize that the crowd of people is an important factor. If the person escapes from crowded spaces, she feels safer. This makes the person choose to go to certain places at certain times of less influx.

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Symptoms

Who suffers from agoraphobia tries not to expose themselves to places where they do not feel safe. There they do not show fear. But avoidance behavior as such is a clear symptom of this phobia.

Unfortunately, it is difficult to lead a functional life for these people and they suffer from their self-imposed limitations. The world we live in often pushes us to literally step out of our comfort zone.

Generally agoraphobia is explained by a first episode of anxiety in such circumstances in the life of the affected person. The person at some point in their life may have had the bad experience of having a panic attack. In such a situation, one suffers from very high levels of anxiety, being able to faint.

From this personal experience the agoraphobic develops his disorder. From this moment in his life the fear of suffering a similar situation again takes hold of the person. The fear of a new fainting spell, of having a heart attack without being helped, and ultimately of losing control or even dying is part of the imagination of the affected person.

This ends up triggering a physical response in which the body somatizes all these insecurities. Those who suffer from agoraphobia may experience tremors, palpitations, sweating and even vertigo or suffocation.

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All the symptomatology at a psychological level is included in the DSM-5. These symptoms are highlighted below:

• Great fear or anxiety in more than one of the following five situations: use of public transportation, closed spaces, open spaces, having to wait and queue, and find yourself alone and away from home.

• The agoraphobic escapes from such situations by having thoughts that are related to the possible eventual difficulty in leaving the place where he is.

• The affected person assumes that they can easily present panic or other symptoms that lead to an uncomfortable or disabling situation.

• Not knowing the area in which one is is always a source of anxiety.

• Being accompanied by someone is important to avoid all these thoughts.

• The situation does not generate the real danger that the person feels, there being a very notable disproportion.

• The normal way of functioning of the person is affected, and may have repercussions in the social or professional area.

• The symptoms described remain for 6 months or more.

Treatment

As with other phobias and considering the effectiveness rates, cognitive-behavioral psychotherapy is postulated as the frame of reference to treat this disorder. Although there are different ways of approaching these types of cases, the main objective is to gradually reduce the avoidance behavior.

This is done through gradual exposure to feared contexts. The therapy tries first of all to discover what the moments in which anxiety appears are like. Treatment then focuses on empowering the person to increase the sense of control in such settings.

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Exposing the person to the situation they fear in a gradual and controlled way allows them to face the fears and see that there are no terrible consequences. It is necessary to go through these trial-error exercises so that all the associated symptoms due to thoughts and memory disappear.

In addition to exposing the person to feared situations, techniques that use imagination also work very well. It is a very recurrent strategy in the initial stages in which the person can see himself in a situation and face her insecurities in his mind.

Little by little the stressor stimulus disappears thanks to these techniques, which are really very effective in many cases. Of course, it is necessary for a professional psychotherapist to conduct the sessions so that the reduction and final extinction of anxiety is a fact. In the end, the patient can return to a normal life, ceasing to compromise personal, social and professional life.

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Bibliographic references

• American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing, 938, 217–221.

• Wyatt, Richard Jed; Chew, Robert H. (2008). Wyatt's Practical Psychiatric Practice: Forms and Protocols for Clinical Use. American Psychiatric Pub, 90–91.

• Yardley, L., Britton, J., Lear, S., Bird. J. and Luxon, L.M. (nineteen ninety five). Relationship between balance system function and agoraphobic avoidance. Behav Res Ther, 33 (4), 435–439.