Housebound: A Closer Look at Agoraphobia
What is Agoraphobia?
For some, there is nothing more natural than going to the grocery store. Those people might also make a trip to the mall without a problem, or navigate a crowded hallway without a second thought. For others, such commonly used places are as frightening as a minefield, and every bit as dangerous. For them, leaving their own homes is a huge issue. These unfortunate few suffer from a type of anxiety disorder known as agoraphobia.
Agoraphobia is widely known as the fear of public places, which only somewhat scratches the surface of this disorder. The fear doesn’t stem from the fear of many people in one place, exactly, but instead a fear of being in a place that would be difficult or embarrassing to escape from should they suffer a panic attack. “Agora” is a Greek word referring to the marketplace, the central public location of a standard ancient Greek town; in other words, a common area. Likewise, such places are the ones most commonly avoided by the victims of agoraphobia, as well as sporting events, airplanes, crowded hallways, lines formed to wait for something, and even bridges. The resulting fear is to the extent that, though the main concern is not being able to escape should a panic attack occur, the victim is so caught up in that anxiety that the fear itself causes a nervous meltdown.
Agoraphobia symptoms are comprised of, basically, more phobias. These include the fear of being alone and the fear of losing control in a public place. Other symptoms include an over-dependence on others, a sense that their body is “unreal,” and, predictably, the inability to leave the home for long periods of time. In addition, those suffering from agoraphobia may worry themselves to the point that the symptoms of a panic attack occurs. These symptoms include everything from increased heart rate to dizziness, and trouble swallowing to trouble breathing. These physical effects not only add to the fear of going out into the public places that trigger them, but also, such as the inability to leave home, prevent them from facing their fears. This inability, known as “housebound” plagues the lives of the more serious cases of agoraphobia, and is truly difficult to overcome. One victim of the disorder, a woman named Jeina, struggled greatly with the housebound side effect. “I had once been a “go everywhere” woman,” she says, “I took my children to amusement parks, attended teachers conferences and Sunday school. Now, I was suddenly afraid to walk into a grocery store. I would become overwhelmed by a feeling of panic and doom which I simply could not explain. So, I lived quietly inside the walls of my little house, afraid to venture out into the world.” Jeina missed her son’s soccer games, her daughter’s high school graduation, and both of her parent’s funerals. She gave birth to her third child at home. Her distress led her to self-medicate with alcohol, which she came to refer to as her “can of courage,” and became an alcoholic in the process. Only by the constant urging of her loved ones did she seek help, and, even then, she had to reschedule her appointment twice, as she was afraid to venture out of her house. Now, aware of her condition, she is making great progress in conquering it, and has been sober for two years. She ended her interview saying, “My next venture outdoors is long overdue. I am taking flowers to a grave which I have never seen... my father’s.”
Many have agoraphobic tendencies, such as becoming nervous when speaking to someone over the phone, or becoming flustered in a crowd. Others simply have less severe forms of agoraphobia, and have “safe zones.” These are specific places that the agoraphobic can go without feeling exceptionally worried, such as a certain grocery store that they feel comfortable with, or a wide-open park where they can interact with others without feeling trapped. These people are often able to get up the courage to venture out into other public places, but they are often still horribly uncomfortable. These are forms of agoraphobia that do not severely affect the lives of its victims. Help should be sought, however, in the cases where the victim loses the ability to attend important events, work, socialize in a normal environment, and even care for themselves.
Causes, Risk Factors and Complications
While experts are completely certain of the cause of agoraphobia, they have connected it in most cases to panic disorders. Often, the victim experiences a panic attack, or a moment of extreme nervousness, and begins to associate that feeling to a certain place, eventually avoiding that place altogether.
This phobia is relatively rare, only one to five percent of people in America will develop it in their lifetime. The disorder usually begins to develop between late adolescence and early adulthood, and is most common in women. The risk factors for agoraphobia include having a panic disorder or being a nervous person in general, having experienced traumatic childhood events- such as sexual or physical abuse- and having a substance abuse problem. However, these are risk factors for countless other problems or disorders as well.
Complications concerning agoraphobia are moderate to severe, the worst cases not being able to go past the doors of their homes or rooms without suffering immense panic attacks. The symptoms limit their everyday activities and increase their dependence on others to do things such as grocery shopping, and other activities that require them to exit their house. As in the case of Jeina, many agoraphobics suffering severe cases develop a dependency on drugs and other substances. This dependency will most likely lead to other health problems later on in life, which will be hard to cope with, as they will find it difficult to venture from their “safety zones” to seek medical aid.
As many people have agoraphobic tendencies, it is often hard to tell whether or not a person has a true case of agoraphobia. For example, someone may be afraid of elevators, but that can be derived from claustrophobia. Likewise, a person who is uncomfortable around people may simply have a social phobia. To be diagnosed with agoraphobia, however, the person has to meet two criteria. First off, the person must have acute anxiety about being in situations that would be difficult or embarrassing to escape from in the event of a panic attack. Secondly, the person must be in the habit of going out of their way to avoid such places or situations.
Treating this disorder has been attempted through the use of anti-depressants and anti-anxiety medications, though psychotherapy has proved much more effective. This approach uses cognitive behavioral therapy, which is divided up into two parts. The first part is the cognitive portion. In this half of the therapy, the victim learns about the causes of their phobia. They learn what triggers and worsens the panic attacks they fear, and also how to control them. The patients often learn relaxation exercises such as deep breathing and visualization to control their anxiety. The behavioral portion, which is also called exposure therapy. This involves the therapist taking the phobic to public places for small portions of time, desensitizing them to their fear until they are able to conquer their anxiety. The therapist may take them on walks through the mall, or drive around with them in a car for awhile. This works wonders, as the main cure for any phobia is facing the fear.
Because most agoraphobia patients have trouble seeking help in their homebound state, specialized therapists often offer to perform house calls for the first few appointments. They also offer therapy help over the phone and even through email.
In most cases of physical diseases, prevention is the cure. For phobias such as agoraphobia, however, there is no tried-and-true method of prevention. Therapists do advise those fearful of developing the disorder, however, to do one not-so-simple thing: to face their fears. If a person begins to have mild fears about going to a place that is safe, that person should practice going to that place as much as possible before the fear become overwhelming. Also, as panic attacks and agoraphobia are closely related, those with anxiety disorders should not hesitate to seek treatment to get their nerves under control.
Agoraphobia is not commonly known, and is difficult to treat. The reality is, however, that a small percentage of Americans are living in fear this very moment of all that lies beyond their front door. The more this phobia is studied, the sooner this unfortunate disorder will be eradicated.
- "Agoraphobia Symptoms."Psych Central. N.p., 17 July 2016. Web. 01 Aug. 2017. <https://psychcentral.com/disorders/agoraphobia-symptoms/>.
- "Agoraphobia."Mayo Clinic. Mayo Foundation for Medical Education and Research, 22 Mar. 2017. Web. 01 Aug. 2017. <http://www.mayoclinic.org/diseases-conditions/agoraphobia/home/ovc-20311918>.
- Jeina's Story. N.p., n.d. Web. 01 Aug. 2017. <http://www.paniccure.com/Stories_of_Healing/Jeina.htm>.
- Tracy, Natasha. "What are Phobias? - Phobias - Anxiety Panic."HealthyPlace. N.p., n.d. Web. 01 Aug. 2017. <https://www.healthyplace.com/anxiety-panic/phobias/what-are-phobias/>.
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This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
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© 2017 Elyse Maupin-Thomas