Fear of Public Places: Living With Agoraphobia
Some people avoid leaving the house because they fear something bad will happen or they will lose control. This condition, known as agoraphobia, can be devastating.
Everyone has fears. You may become squeamish at the sight of a spider or freeze up when you look down at the ground from the top of the bleachers. But some people react in extreme ways to their fears.
Imagine a life where you are afraid to drive, go shopping or attend a concert. Intense fear of losing control in public keeps you from going to the movies with a friend or meeting a loved one for dinner. You avoid crowds and are afraid to use public transportation. This behavior keeps you from having normal relationships. You may even stop leaving your house.
This condition is called agoraphobia, a fear of public places. People with this disorder may stay away from situations that make them feel helpless or trapped. They may also fear embarrassing themselves in public.
Often linked to panic disorder Agoraphobia tends to surface for the first time between late adolescence and the mid-thirties. Two thirds of those affected are women. Often, the first sign is a panic attack. About one in three people with a panic disorder also has agoraphobia.
A panic attack happens out of the blue. The randomness can make those with panic disorders fear more attacks. They may start to avoid going where they think a panic attack might happen - or where they've had them before. This is how the fear of being in public starts.
People with agoraphobia may avoid planes, buses and trains because escape might be too difficult. They may stop driving, going to work or running errands. They may turn down social invitations and avoid crowds, bridges or sports arenas. In the most severe cases, a person may refuse to leave the house.
Signs of agoraphobia may include:
Taking extreme measures to avoid public places Fear of losing control in public Unusual temper or agitation Fear of being trapped and alone Feelings of doom, terror or dread Irrational need to flee from a perceived threat Panic signs: rapid heartbeat, shortness of breath, sweating, trembling Nausea, vomiting, abdominal discomfort Fear of leaving the house
Treatment People with phobias can learn to face their fears. The success of treatment depends on how severe the condition is. Agoraphobia is a chronic problem, but it can respond well to treatment. Treatments include:
Systematic desensitization. Therapy that involves relaxing and imagining a situation that makes you feel anxious. You start with the least fearful situations, then move toward the most threatening. Medications. The use of anti-anxiety and/or antidepressant drugs. Cognitive behavioral therapy. Treatment that substitutes new patterns of thinking for less desirable ones. Exposure therapy. Exposure to the situation that you fear, with the goal of overcoming the phobia.
Agoraphobia can be managed, and getting early treatment may keep your symptoms from becoming too severe.