Agoraphobia or fear of open spaces and public places

For many people, the upcoming festival season is synonymous with joie de vivre and outdoor events that attract throngs of lively crowds. For those who suffer from agoraphobia, this period is not one of enjoyment and seems to take on nightmarish proportions. 

What is agoraphobia?

Agoraphobia is the phobia (irrational fear) of public places, open spaces, and crowds. A person who suffers from it, called an agoraphobe, feels anxiety or panic in situations that are not dangerous or scary in themselves and makes the effort to avoid them for fear of being unable to escape or get assistance if a problem were to arise. This medical condition is one of a group of anxiety disorders.

The situations that cause agoraphobia are varied. Here are a few common examples that are very likely to occur during festival season:

  • being outside of one's home (which is perceived by an agoraphobe as a safe place)
  • finding oneself in a crowd or waiting in line
  • finding oneself in a wide open space
  • using an elevator
  • crossing a bridge
  • taking public transit

An agoraphobe who cannot avoid a phobic stimulus (a situation that triggers a phobic reaction) must confront these situations at the cost of great distress. However, this situation can be dealt with more easily if the affected person is accompanied by a trusted individual. 

Onset of agoraphobia

Agoraphobia generally occurs at the end of adolescence or at the start of adulthood. It appears suddenly or progressively and tends to become chronic. Its causes are unknown. Its onset often occurs following a traumatic event or a panic attack which occurred in a public place. It is often accompanied by other anxiety disorders. Women are more often affected by it than men. In Canada, there are thousands of documented cases of agoraphobia.

Symptoms of agoraphobia

The main symptoms of agoraphobia are anxiety and panic. Panic attacks result in various manifestations such as:

  • shortness of breath
  • sweating
  • hot flushes
  • nausea
  • headaches
  • dizziness
  • trembling
  • spasms
  • racing heart
  • desire to escape
  • loss of contact with reality
  • feeling that you are not yourself

The person in a state of panic, caused by agoraphobia, can feel as though they are about to die. In reality, a panic attack is not life-threatening, unless it worsens a potentially fatal condition (such as a heart condition or respiratory illness).

The fact remains that the distress felt during episodic anxiety and panic is very real to agoraphobes and leads them to adopt avoidance behaviours related to phobic stimuli. In the mid to long-term, this behaviour can become a source of family tension, social isolation, reclusion, unemployment, and psychological problems such as depression.

Diagnosis and treatment of agoraphobia

The diagnosis of agoraphobia must be made by a doctor, based on a detailed interview with the patient which aims to identify phobic stimuli and exclude other possible causes of anxiety and panic such as taking medication, substance abuse or an underlying illness.

Treatment of agoraphobia includes cognitive behavioural psychotherapy. This therapy helps patients to objectify the object of their fear and to control their phobia and its manifestations using various desensitization techniques (information, role-playing, and exposure). The success rate for this type of therapy is high. If needed, the treating physician can prescribe an anxiolytic (antianxiety medication) as an add-on treatment. The use of other drug treatments may be considered.

Furthermore, relaxation techniques such as diaphragmatic breathing can be taught to agoraphobes to help them control their anxiety and panic attacks.

Untreated agoraphobia can run a variable course; in some cases, it can disappear on its own.

More information for better management of agoraphobia

Agoraphobes and their loved ones can turn to various online resources to learn more about agoraphobia and its treatment, or to find a support group or healthcare professional that can help. Here are a few of them:

Moreover, several books on agoraphobia have been published. Performing a simple search using the keyword "agoraphobia" in your favourite library's database or website will allow you to find a great number of book titles.

Your pharmacist can help

If you suffer from agoraphobia, don't hesitate to speak to your pharmacist, who will take the time to listen to you and provide all the necessary information you need to better manage this anxiety disorder. If needed, your pharmacist will direct you to other healthcare professionals who are likely to be of assistance and accompany you on the road to recovery. If you must take prescribed medication, he/she can inform you about its effects and how to use it.

Having trained professionals who care about your health at your disposal, will definitely improve your condition significantly. Who knows, perhaps you will soon make plans of your own to take advantage of festival season!

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Agoraphobia or fear of open spaces and public places

For many people, the upcoming festival season is synonymous with joie de vivre and outdoor events that attract throngs of lively crowds. For those who suffer from agoraphobia, this period is not one of enjoyment and seems to take on nightmarish proportions. 
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