About 3-5% of the population, according to the latest studies, suffers from agoraphobia, an anxiety disorder whose name, of Greek origin, means "fear of the square". It is considered to be the fear or dread of having a panic attack in a public place. Agoraphobia occurs in women in double percentages than in men and is characterized by acute anxiety during public gatherings, while socializing or in unfamiliar environments. Finding out if you have this disorder is the first step in finding a solution.
Steps
Part 1 of 3: Understanding Public Behavior Associated with Agoraphobia
Step 1. Pay attention to the need for company when in public
People with agoraphobia often need to be assisted when they go to a new place because they are afraid of going out on their own. In addition, she has a hard time doing things on her own and finds comfort in the presence of a friend or partner.
If the thought of going to the grocery store to buy a carton of milk makes you feel anxious, you may be suffering from agoraphobia
Step 2. Evaluate if you are following fixed routes
Agoraphobic people may fear going to places where they might encounter situations that trigger anxiety. They also tend to create a "safe" route to go to work and to return every day.
If you have noticed that you take the same commute every day to get home and insist on walking the same streets, the same walkways and sidewalks because you are afraid of change, it could be agoraphobia
Step 3. Keep an eye on a possible reduction in relationship life
People with agoraphobia often restrict places to go to reduce the chances of encountering something that could trigger panic. A peculiar aspect of this disorder is experiencing discomfort when meeting new people and trying to confine one's existence in "safe areas" such as the home or office. If you have this condition, then you may notice that your relationship life tends to shrink.
Perhaps, before developing agoraphobia, you went with friends to bars, parties and the cinema, as well as to the office and school. Over time you may have started to worry more about panic attacks and stopped hanging around having fun. Then, when the school year ended, you didn't enroll in school again for fear of having them in class. Now you see friends less often and spend less time than you can at work. This type of behavior could indicate that you have agoraphobia
Step 4. Find out if you feel fear or anxiety when you are in the presence of a large crowd of people
Do you feel the labored breathing when you find yourself in a crowd in the mall, at a concert or in a market? You could be agoraphobic if just thinking about large gatherings creates symptoms of anxiety in you, that is, sweating in your hands, excessive worry, tachycardia and disconnected thoughts.
Even if you don't actually have a panic attack, the mere fear that it may arise in a situation involving social relationships can be a symptom of agoraphobia
Step 5. Try to perceive fear or anxiety when you are in confined spaces
The panic symptoms associated with agoraphobia can hit strongly when you feel like you have no escape routes. Evaluate your reactions when you are in confined spaces. Going through a tunnel by car or train, traveling by elevator, bus, plane, and train can trigger a panic attack or induce symptoms.
Step 6. Think about situations in which you have made up an excuse to escape
It is common for agoraphobic people to fear that they will not be able to escape from a place or situation. However, you may feel ashamed or embarrassed when you have to look for a pretext to get out of a situation. To hide your fear, you may be led to lie because you suddenly need to abandon a certain situation or event.
For example, you may experience an agoraphobic episode while at the stadium with a friend. Instead of clearly saying that you feel anxiety in the midst of a large audience, you could tell your friend that you need to go home to walk the dog. In addition to excuses similar to this, you could pretend to be sick to escape an uncomfortable situation
Part 2 of 3: Discovering the Personal Symptoms of Agoraphobia
Step 1. Check for any recurring anxiety
The main feature of agoraphobia is to feel anxious states in situations and places where you fear you have no escape routes. When you find yourself in these circumstances (more often away from your home) you may feel a sense of dread, as if something terrible is about to happen. You must have had these reactions for at least 6 months to be diagnosed with agoraphobia.
Some people also experience panic attacks or symptoms in situations that trigger anxiety. During a panic attack you can experience a variety of contemporary discomforts, such as chest pains, numbness, dizziness, tremor, sweating, shortness of breath, nausea, unreal feelings or feelings of lack of self-perception, feelings of loss of control or madness, death, cold or heat
Step 2. Find out the situations that make you feel fear
For those with agoraphobia, the fears that are felt are quite specific. To diagnose this condition, the fifth version of the DSM (Diagnostic and Statistical Manual of Mental Disorders) indicates that the patient must feel fear in two or more of the following circumstances:
- being in a large gathering of people or in a waiting queue;
- being in an open space, such as a market or parking lot;
- being in an enclosed space, such as a bar or a cinema;
- use a means of public transport, such as bus, train, plane or ferry;
- leaving home alone.
Step 3. Realize when you are afraid of being alone
You may be agoraphobic if you don't like being alone because you may experience panic and difficulty breathing, rapid heartbeat, and the confused thoughts characteristic of the disorder. Take note of the increase in feelings of fear that can occur when you are alone.
There are two characteristic types of fears under these circumstances. The first is related to agoraphobia, the second is what occurs because the person is alone and feels vulnerable to attacks from any aggressors. The latter is not a symptom of the pathology. Finding out precisely your reactions is essential to understand if you have a specific disorder
Step 4. Consider your risk factors
Women and people under the age of 35 have a high risk of developing agoraphobia. Other risk factors include:
- having another form of comorbidity, such as a panic disorder or another type of phobia;
- feeling nervous or anxious most of the time;
- having undergone traumatic experiences, such as losing a parent, having suffered an attack or abuse;
- having a family history of agoraphobia (e.g. a relative);
- being depressed;
- have a substance abuse problem.
Part 3 of 3: Finding Help for Agoraphobia
Step 1. Ask your doctor about the medications you can take
Agoraphobia should not be treated only with medicines, but these can help if taken as an accompaniment to therapy. Commonly used drugs are:
- Antidepressants. Serotonin reuptake inhibitors (SSRIs), such as paroxetine and fluoxetine, may be helpful in panic attacks due to agoraphobia. Other options include tricyclic antidepressants and MAO inhibitors (monoamine oxidase inhibitors).
- Anxiolytic drugs. Medicines such as benzodiazepines can provide an immediate sense of tranquility, but they can be addictive, so it is advisable to limit their use for emergency situations, such as in the midst of a panic attack.
Step 2. Follow the therapy
Cognitive-behavioral therapy (CBT) is the most effective form of treatment for agoraphobia. This technique combines cognitive therapy (which emphasizes that certain thought patterns lead to certain mental disorders) with behavioral therapy (which emphasizes people's ability to change behaviors that create harm to themselves).
- Effective CBT therapy will take several weeks and will be administered in sessions of approximately 50 minutes. The specialist who follows you will talk with you about what you have been feeling in a given week and will ask you to analyze your thought and action patterns.
- In the end, you will be asked to progressively expose yourself to more demanding situations of social relationships in order to put an end to the emotions and thoughts that feed agoraphobia. You may initially go to the market for 15 minutes, then for 30 minutes, then for an hour and so on until you get used to social relationships.
Step 3. Train your mind
Agoraphobia arises from untruthful messages transmitted by the mind, such as: "You are trapped", "Here you are in danger" or "You must not trust anyone". By changing all this and taking the initiative to reject the wrong messages, you can learn to fight with agoraphobia. The first step to achieving this is to admit that your mind is troubled and that the thoughts or signals you are receiving are false.
For example, when your brain tells you to go crazy because there is a danger nearby, you gather more information. Think about previous panic attacks you have had and remember that you survived and endured them without suffering permanent injury and without dying (a common fear among people with agoraphobia)
Step 4. Use non-avoidance coping strategies
They expose you by forcing you to confront situations that you perceive as threatening. To free yourself from fear in situations that currently give you anxiety, you will need to experience them firsthand. Only after passing through the flames of fears can you be reborn, like the phoenix, with a whole and renewed mind.
- For example, if you feel or fear a wave of panic when you go to the stadium, try watching a local amateur or minor league game for about 15-20 minutes. Increase progressively, watching the next game for 30-40 minutes, then for 60-70 minutes and so on. In the end, you go to see a half of a Serie A match and finally go to see it all.
- Be fair to yourself about your comfort level. Your goal shouldn't be to induce an agoraphobic panic attack, but to find out the cause that brings about the attacks without actually there being any threat. Do not rush the process of exposure to triggers that are too demanding or too early. Set yourself a pace that works well and keep a journal of how you feel after each exposure to check your progress.
