- Panic Disorder
- Social Anxiety Disorder
Physical symptomsOftentimes people with agoraphobia avoid their triggers. Therefore they rarely get the signs of agoraphobia. Physical symptoms of agoraphobia are similar to a panic attack and can include:
- Increased heart rate and show shallow breaths
- Nausea, chest pain and feeling sweaty
- Dizziness and feeling faint
Behavioural signs and symptomsBeing stuck at home or avoiding being too far away from home are some of the limiting behaviours of agoraphobia. Also having someone you feel comfortable with or avoiding being in public altogether. In addition, doing your shopping online, exercising indoors or relying on others and sometimes even children to do tasks.
Thinking styles associated with AgoraphobiaThere are certain thinking styles or ways of seeing the world that is associated with agoraphobia. A view that having a panic attack may make you look silly in front of others. Secondly, that a panic attack could mean death. Fear of embarrassment around losing control or losing your sanity in front of others.Concerns that others are looking at you or noticing physical signs of your anxiety. For instance, sweating or shaking. Agoraphobia may also tie into views that the world is unsafe. Finally, self-views of not being good enough or not being capable.
Is there a specific age?Compared to other anxiety disorders in particular phobias and separation anxiety disorder, agoraphobia tends to appear at an older age. The 20s to mid-30s appears to be the peak age of onset. It is a chronic condition, with the intensity of symptoms fluctuating over time.
How to get help?Once it is identified that agoraphobia is driven by fears and worry; a psychologist or psychiatrist is well suited to complete a thorough mental health assessment. They may want to explore avoidant or dependent personality styles, past traumas or poor attachment patterns. Secondly, they will want to know how you cope, anyways other people enable agoraphobia. In addition, questions about past treatments, what has worked and what has not. Finally, what the goals of treatment are.
Learning about Agoraphobia
Firstly there are increasing amounts of high-quality educational material online about Agoraphobia. There is different audio, video and written content out there. In addition, therapists usually start treatment with an explanation of symptoms. Understanding allows for better engagement with therapy, ask questions and learning recommendations from your therapist.
Speaking with other people who face similar problems helps. Often it is these personal stories, insights that help the most. Also, agoraphobia is a lonely way to live. Connecting and sharing with others can help.
We will mention 4 self-help strategies below. It helps to be creative. Especially when tackling anxiety conditions. Agoraphobias as we wrote above is an anxiety condition.
- Slow down – People want to run and hide when they feel anxious. Instead, try to stay in the same place. If you are in an elevator, car or bus when it stops get down. Then slowly move to somewhere out of harm’s way.
- Mental pictures or using our imagination is a great way to challenge agoraphobia. For instance, picturing leaving home, stepping into a crowded space can form an exposure practice. Next, take some slow deep breaths. In addition, mental images can also help in a reverse instance when agoraphobia is triggered. For instance, thinking of a safe calm space during a panic attack can lessen arousal.
- Not fighting panic symptoms triggered by agoraphobia. Instead, focus on something else, distraction can help calm the body down. If feeling anxious in public, call a friend on your phone. Thereafter, watch a calming video on your phone.
- Internet-based apps or self-help books on agoraphobia. There are more and more apps to help people with anxiety. Similarly, self-help books on anxiety are a great tool.
There is a strong evidence base for talking therapies; they have some of the highest success rate and lowest dropout rates of all treatment options. Therapy works by stopping unhelpful thoughts. Firstly, some people with agoraphobia worry that if they have a panic attack outside the home. That they will die or not cope. Psychologists help replace those thoughts with more positive ways of thinking. Behavioural therapy plays an important role. Initially with agoraphobia therapists coach getting to the corner shop. Gradually as confidence builds, the next challenge can be getting to a supermarket and finally a mall.
Positive self-talk can also help. Be kind, caring and easy when you speak to yourself. We have a short youtube video on positive self-talk. Visit our channel’s page to learn more. There are also free online worksheets on positive self-talk.
The evidence to support the use of tablets in treating agoraphobia is limited. Selective serotonin reuptake inhibitors (SSRI) and tricyclic antidepressants (TCA) have limited and somewhat conflicting findings when used. There is a lack of scientific findings supporting their use long term. It is important to remain aware of antidepressants adverse and withdrawal effects.
Benzodiazepines are sometimes prescribed shorter terms. However, they too have side effects. Outcomes are best when used along with therapy.
- Avoid stimulants. Smoking nicotine, drinking coffee or sugar-rich drinks might worsen anxiety.
- Regular exercise can reduce muscle tension, force people to go outside and increase self-confidence. Invariable people with agoraphobia have low self-esteem. For instance, walking up and down the street is a great place to start.
- Long term use of alcohol can perpetuate negative self-views and get in the way of recovery.
Informal supports are equally and if not more important than professional supports. Ideally friends and family should be aware of the anxiety and supportive in recovery. It helps to have a person you trust. A support person can take you the first time. Help you build your confidence. Following this, you may be able to do the task alone.
Support can also come in the form of a pet. Talking your dog outside for a walk. Being outside with a trusted pet may be enough to drop down the anxiety. Plus its good exercise for you and the dog. Comfort animals are more and more been seen as a help for people anxious about being outside.
There are also online support groups; Australia based and overseas. People with agoraphobia feel alone, support groups challenge that view. A healthy support group provides tips, advice, provide emotional support and motivation. A quick search online can help find support groups.
At Epsychiatry we have clients with agoraphobia. In fact, people with agoraphobia often turn to online therapists to get their lives back on track. Send our friendly support team an email. Secondly, you can reach us by web inquiry or a phone call to learn more about how we can help. You will need a letter from your GP to see one of our doctors or psychologists.