Tom was headed to the big party. He silently reviewed who would be there, what he might say to them and how long he would stay. He looked over his clothes, flicking away a spot of dust on his collar. He had forgotten to get the suit dry cleaned before the event. He hoped no one would notice.
He arrived at the hotel and walked into the big ballroom. Suddenly, Tom began sweating. He looked around the room and did not see anyone he knew. He felt panicked, as though everyone in the room was watching him and passing judgment. He felt that the walls were closing in on him, and it was all too much. Tom had to turn around and walk out the door. He was afraid he would pass out from the terror of the moment, even though no one had said a word to him.
Tom has a problem called agoraphobia, the technical term for a fear of any place where escape may not be possible. It includes a fear of crowds, large, open spaces, and particularly means of travel like airplanes, subways and buses. In its most severe form, agoraphobia can mean a fear of ever leaving your house and confronting the rest of the world, which in the agoraphobic’s mind is anticipated to be filled with terrible things that may do him or her harm.
It’s All Greek
The term agoraphobia comes from the Greek term “fear of the marketplace,” an apt description of the fear and anxiety certain situations generate. Most agoraphobics will avoid public transportation, large crowds, bridges, elevators or any social situation where they may be confronted and surrounded, even if it’s something as benign as a large party of peers, as in Tom’s case.
Although it’s a mental issue, the physical symptoms of agoraphobia are all too real. The stress of the situation can cause heart racing, sweating, extreme stress, raised blood pressure, trembling, shaking, breathing problems, nausea, diarrhea, chest pains, problems swallowing, faintness, dizziness, a hot flash or cold chills, and an extreme fear of dying.
To be clinically diagnosed with agoraphobia, one must suffer symptoms for six months or more. It is usually part of another mental disorder, such as panic disorder or can be tied to a specific phobia, such as flying. An estimated 1.8 million American adults older than 18 have agoraphobia, which usually arrives in the 20s and in most cases before age 35. That amounts to less than 1 percent of the population, and the disease is mostly found in women as opposed to men. But agoraphobics are found in every race, sex, religion and region of the country.
An agoraphobic attack is usually manifested by extreme dread of a situation that may or may not occur but seems all too possible in the agoraphobic’s mind. When driving over a bridge, the agoraphobic may fear collapse. In public transportation, the agoraphobic fears there may be an accident. In simple social situations, the agoraphobic may feel that people will judge them or otherwise embarrass them, even if there is no such history of these confrontations. In short, it’s a life filled with a vision that things will go horribly, terribly wrong, trapping the agoraphobic in an unwanted and potentially deadly situation.
Developing this disorder can ruin someone’s life. People with agoraphobia typically create a so-called “zone of safety,” usually their own neighborhood or home. Anything outside of the perimeter of this zone creates growing anxiety and sometimes outright panic. That means school and most employment outside of homeschooling and online work is out of the question.
Because many agoraphobics are unable to work, shop or run errands for themselves, they wind up having to be taken care of by family members who will fill prescriptions, go grocery shopping and deal with the hundreds of small details that make up life. For the agoraphobic, family relationships may be the only outlet. Developing interpersonal relationships outside the home is blunted by the obvious restrictions of agoraphobia, to the point where social interaction is all but impossible.
What Doctors Say
There is no definitive cause of agoraphobia, but like all mental conditions, most medical professionals believe it runs in families and has a genetic cause. Those who have frequent panic attacks, which are bursts of fear prompted by seemingly nothing, may develop agoraphobia as a coping mechanism.
Because agoraphobia can resemble heart problems, it may baffle medical professionals at first. But with time, ruling out other causes via physical exam, and the right questions, the root cause of agoraphobia finally may come into vision. Most agoraphobics have symptoms of nervousness or anxiety, have a close family member with the syndrome, or are currently experiencing such stressful events as the death of a parent, physical and mental abuse, or have been recent robbery victims.
Left untreated, agoraphobia can lead to severe depression, other extreme phobias (like germs), or self-medication with alcohol or drugs to cope with the guilt, isolation and loneliness caused by the condition.
The treatment for agoraphobia generally involves talk therapy. It can be challenging for patients because the therapy finally may cause them to confront the roots of their anxiety. The medical professional may recommend anti-anxiety medications and such tests as walking outside the safety zone briefly, accompanied by a trusted friend, spouse or companion. There are also classes for people with specific fears, like flying, that may be helpful for guiding agoraphobics toward breaking their bonds.
Ultimately, the goal is to make agoraphobics more comfortable in settings that used to cause panic. With professional help, they can adjust gradually to conquer their fears and may resume work, school and outside social activities.
Leave a Reply