This word literally means “fear of the market place” (phobia is fear, agora means market place) It’s often used to describe a fear of open spaces, and frequently includes:
- difficulties with going to shops, being in a crowd, public places including cinemas and restaurants
- using public transport – tubes, trains, boats and planes
- going over a bridge
- being far from home
For many, it’s often much more difficult, if not impossible, to do these things alone, though some suffering from agoraphobia may manage to go out and about if accompanied by a person they trust.
All the above different situations stem from one underlying fear. That is, a fear of being in a place where you are overwhelmed by panic, no help is available, and you’ll find it difficult if not impossible to escape to a safe place (usually to your home). When you are in a feared place you become very anxious and distressed, and have an intense desire to get out. So while panic disorder underpins agoraphobia, people may suffer from panic disorder with or without agoraphobia. To avoid this anxiety and panic many people with agoraphobia stay inside their home for most or all of the time. Sadly however they can then experience panic attacks even in their home, and so feel they have to have someone with them at all times.
Agoraphobia and panic disorder affect around 5% of the population. Agoraphobia is twice as likely to affect women compared to men, and most commonly occurs between ages 25-35. Without help, it can be a lifelong problem.
Agoraphobia affects up to one third of people with panic disorder. The person will often try to avoid places where they are likely to have panic attacks, and while avoidance can be successful to some degree in keeping panic attacks at bay, the restrictions on a person’s life usually just keep increasing, and affect both the person and those close to them.
The difference between men and women may be due to several factors:
- Women are often in our society encouraged to use avoidance as a way of coping with things that feel too difficult, and to behave in ways which make them more dependent and helpless
- Women may be more likely to seek help and therefore be diagnosed more frequently
- Men may use alcohol to try and deal with the problem
In some severe cases the anxiety disorder can have an extreme impact on a person’s life.
A recent article in the Daily Mail tells a story of a young girl unable to leave the home environment to attend Job Centre. The consequences of this are far reaching.
The treatment options for agoraphobia which research shows to be most effective are Cognitive Behavioural Therapy (CBT) and antidepressant medication. CBT can either be in the form of guided self-help e.g. using a book, computerised programme or watching a DVD or having individual or group sessions with a qualified mental health professional.
Cognitive Behaviour Therapy (CBT) works on the principle that your behaviour and emotions depend largely on your perception of what you understand is happening. What you think and anticipate can affect your reaction to events and people. Having understood what you are thinking and how to deal with your thoughts, it is possible to train yourself to respond in a different way. This new thinking and behaviour style can then lead to a potentially more satisfying way of life, becoming part of your normal lifestyle.
Antidepressant medicines are commonly used to treat depression, but can also help to reduce the symptoms of phobias. You don’t have to suffer from depression to be diagnosed with these medications. They work by interfering with brain chemicals (neurotransmitters) such as serotonin which may be involved in the anxiety symptoms.
What is the Success Rate of CBT?
Cognitive Behaviour Therapy techniques have been developed from extensive research.
Studies indicate that treatments for psychological disorders based on CBT principles:
- Are particularly effective for common mental health problems such as anxiety, depression, panic disorder, phobias (including agoraphobia and social phobia), stress, eating disorders, obsessive compulsive disorder, post-traumatic stress disorder and difficulties with anger.
- Can help if you have a low opinion of yourself, or physical health problems like pain or fatigue
- Can also be useful in conjunction with medication to help manage more severe mental health problems like bipolar disorder (previously called “manic-depression” and other forms of psychosis)
- Are as effective as medication in treating many psychological disorders and have been shown in some studies to be more effective in effecting long-lasting change and preventing relapse.
There are many celebrities who, it is reported, have at some point suffered with agoraphobia. Difficulties are raised in the media which can help shift the stigma associated with these very common debilitating disorders and enables more people to come forward and seek help.