A Guide to Mental Disorders

Agoraphobia ✓

Agoraphobia is a type of anxiety disorder. A person with agoraphobia is afraid to leave environments they know or consider to be safe. In severe cases, a person with agoraphobia considers their home to be the only safe environment. They may avoid leaving their home for days, months or even years.

Translated, agoraphobia means 'fear of the marketplace'. Generally, busy public places (such as supermarkets, shopping centres, trams, trains, planes and airports) are feared the most. However, any public place – even a quiet church or an empty park – may seem threatening to a person suffering from agoraphobia.

Typically, agoraphobia often starts off as a mild anxiety about a particular event, place or situation that escalates over time into a generalised fear of being in public. Mental health experts believe that the root of agoraphobia is fear of the physical and mental sensations of anxiety and, often, of panic or of losing control or embarrassing oneself. A person with agoraphobia is unwilling to visit 'unsafe' places because they're afraid that doing so will trigger anxiety or a panic attack.

What are the symptoms of Agoraphobia?
The symptoms and signs of agoraphobia may include:
- anxiety in response to being away from an environment that feels 'safe'
- panic attack including symptoms such as breathlessness, sweating, dizziness, fast heart rate, choking sensations, nausea, and feelings of extreme fear or dread
- anticipation of anxiety if the person is required to leave their safe environment
- low self-esteem and loss of self-confidence
- reluctance to leave the house or venture beyond familiar surroundings
- depression, which can sometimes accompany the condition.

What causes Agoraphobia?
Agoraphobia usually begins with a stressful event – for example, a person loses a job or a relationship ends. They feel distressed and limit their contact with the outside world (this is called 'avoidance behavior'). As time passes, they may consider more and more public places as 'out of bounds' until they are eventually confined to their home.

In other cases, a stressful life event triggers a panic attack. Since panic attacks are so unpleasant, the person may avoid any situation or place that they think might trigger another attack until many situations and places are eventually feared and avoided.

Psychological factors that increase your risk of developing agoraphobia include:
- a traumatic childhood experience, such as the death of a parent or being sexually abused
- experiencing a stressful event, such as bereavement, divorce, or losing your job
- a previous history of mental illnesses, such as depression, anorexia nervosa or bulimia
- alcohol misuse or drug misuse
- being in an unhappy relationship, or in a relationship where your partner is very controlling

Occasionally, a person can develop symptoms of agoraphobia even though they don't have a history of panic disorder or panic attacks.

This type of agoraphobia can be triggered by a number of different irrational fears (phobias), such as the fear of:
- being a victim of violent crime or a terrorist attack if you leave your house
- becoming infected by a serious illness if you visit crowded places
- doing something by accident that will result in you embarrassing or humiliating yourself in front of others

What are the complications of Agoraphobia?
Untreated, agoraphobia can severely reduce a person's quality of life. For example:
- Activities outside of the home such as work, school, socializing, hobbies and many forms of exercise are out of reach.
- Financial hardship, isolation, loneliness and boredom may lead to greater feelings of distress and increase the risk of depression.
- The person may recognise that their fear is irrational, but feel powerless to do anything about it.
- They may feel angry and frustrated with themselves.
- These negative feelings damage self-esteem and contribute to depression, and other anxieties and fears.
- The person may try to cope using  unhealthy methods (such as comfort eating, drugs or alcohol), which in turn can cause or contribute to further health problems.