Coping With The Fear Of Leaving The House – Agoraphobia
Updated November 08, 2019
Reviewer Richard Jackson
If you often experience a fear of leaving the house or a fear of going outside in general, then you may have agoraphobia. Agoraphobia is the extreme fear of leaving home, which results in the sufferer avoiding places or situations that could cause him or her to panic, feel trapped and helpless, or embarrassed for any reason. Someone with agoraphobia may avoid sharing enclosed spaces like subways or elevators with other people, or they may even fear standing in line at the grocery store, or being part of a crowd at a concert.
Panic disorder, with or without accompanying agoraphobia, affects about five percent of the American population at some point in their lives, with about one-third of these people who have agoraphobia in addition to panic disorder. It is incredibly rare for someone to suffer from agoraphobia without also suffering from panic attacks - specifically, about 0.17 percent of the population.
Agoraphobia is found about twice as often in females as it is in males. This may be due to several factors, such as Premenstrual hormonal fluctuations. Women are also more likely to seek help and are therefore more likely to be diagnosed with the disorder.
What Causes Agoraphobia?
A person's genetics and overall health can play a part in whether he or she has agoraphobia. Chances are that if a person's mother or father is a sufferer, then he or she is more likely to come down with the condition, too.
The root of agoraphobia is the fear that there is no way for the sufferer to escape the situation easily, or that no one will be able to help them if they succumb to an anxiety attack. Most people who are living with agoraphobia developed it after experiencing panic attacks. One panic attack may be all it takes to make someone fearful that s/he could suffer another one, and so the sufferer avoids going to all places where the attack could strike again.
Some who suffer from agoraphobia find that when a friend or relative accompanies them to a public place, then it is easier for them to leave the house. However, for some, the fear is so strong that they eventually avoid leaving the house altogether.
Panic Disorder And Agoraphobia
Because someone suffering from agoraphobia lives in fear all the time, it is easy to understand why a panic disorder can develop from such a phobia. Panic disorder is a condition wherein a person often suffers episodes of extreme fear that come on suddenly or a panic attack. A panic attack usually lasts only a few minutes, but it can be incredibly uncomfortable and can cause potentially embarrassing physical effects in addition to mental distress.
Those who suffer from panic attacks fear they are losing control of the situation. They may also worry that they are about to suffer a heart attack and die. Panic attacks can thoroughly disable a person, and the fear of suffering another one can cause the person to do everything possible to avoid being put into such a situation again. For instance, if the panic attack occurred at work, the person may quit his or her job to avoid having to go back there and potentially trigger another episode.
Risks Of Developing Agoraphobia
Children can have agoraphobia, but it typically presents during a person's late teen or early adult years, usually before they reach the age of 35. Agoraphobia can also be affected by such outside influences as environmental stressors and learning experiences.
Those who have a nervous temperament may be more likely to suffer from agoraphobia, as might those who respond to having a panic attack with obsessive fear and the avoidance of potential triggers. A traumatic life event can also cause someone to develop the condition, such as physical or emotional abuse, or experiencing the death of someone close, such as a parent. Agoraphobia can lead to clinical depression and substance abuse, and the longer one suffers, the more likely he or she is to develop additional mental disorders.
Symptoms Of Agoraphobia
Physical symptoms of a panic attack can include a rapid heart rate; difficulty breathing; feeling lightheaded, dizzy, shaky, or numb; breaking out into a flop sweat; feeling suddenly flushed or, conversely, getting chills; and experiencing an upset stomach and diarrhea.
Someone who has agoraphobia will exhibit fear and anxiety when confronted with the option to leave home alone, use public transportation (such as a plane, train, or bus), or wait in line or a crowd. They may also fear being in open spaces, like parking lots or malls. This is because they are terrified of being unable to escape or seek help if they suffer a panic attack or some such other incapacitation or embarrassing condition.
While some phobias are dormant, agoraphobia is almost always activated from being exposed to the situation in question. In other words, to avoid the fear, sufferers avoid the situation. They don't take public transportation. They don't go to the mall. They stop going to work. They opt for having their groceries delivered, rather than waiting in line at the store. Many simply remain at home, seeking out all options possible that will allow them to get what they need without having to leave the home to get it.
As with most phobias, though, the fear of the situation is infinitely larger than the dangers of the actual situation itself. While some are brave enough to leave home in spite of their fears, even if they bring a friend or relative along, they may often feel extreme distress in doing otherwise mundane chores, like going to work, sitting in traffic, or going grocery shopping.
Agoraphobia can disable someone to the point where he or she can no longer find the strength to leave home. Without treatment, some sufferers remain homebound for years, and their quality of life is severely impacted. They stop seeing friends and relatives. They drop out of school and quit their jobs. They send someone else to run errands for them. In the most extreme cases, they abstain from participating in otherwise normal activities, like going outside to get the mail or take out the garbage. As a result, sufferers often become dependent on others for daily help.
Unfortunately, there's no one tried and true method for overcoming agoraphobia. The tricky thing with anxiety is that it tends to get worse the less you face your fears. If there is a place you go to that makes you feel mildly uneasy, the best thing for you to do is to continue to go to that place over and over again until you stamp out the fear. Avoiding the place will only make the fear worse until you find yourself refraining from ever going there again. If you find this too difficult to do, ask someone to go with you or consider seeking professional help.
If you feel anxious or experience panic attacks about going to a particular place, it is important to seek treatment as soon as you can. Getting help early can prevent your symptoms from getting worse. The longer you wait, the harder anxiety is to treat.
Agoraphobia and panic disorder typically do not resolve without treatment. Treatments for conditions like these include cognitive behavioral therapy (CBT) and medication. CBT is one of the most effective forms of therapy for anxiety disorders, and it works by teaching you the specific skills you need to be able to cope with anxiety, face your fears head-on, and gradually return to the normal life you have not been living because of anxiety taking over. Symptoms will improve gradually over time as you rebuild.
For instance, CBT can help you recognize the triggers and symptoms of a panic attack and what makes them worse. It can also provide you with different thought patterns that help you challenge your fears and recognize irrationality, such as understanding the likelihood that the things you fear will happen to you while in a social situation.
CBT can also help you understand that your anxiety will gradually decrease if you remain present in the situation that is scaring you, and it can give you coping mechanisms for managing your symptoms until they subside. You can also learn to desensitize yourself to behavior that is unhealthy through a process called "exposure therapy.""
Antidepressants And Anti-Anxiety Medication
Antidepressants like Prozac and Zoloft can also be taken in conjunction with therapy. Interestingly, antidepressants have been found to be more effective at treating agoraphobia than are anti-anxiety medications. This is because the most commonly prescribed anti-anxiety drug - benzodiazepines (or "benzos") - are more ideal for resolving short-term issues.
Those suffering with long-term anxiety should refrain from taking benzos due to their tendency to be habit-forming. Further, chronic usage of benzos can induce agoraphobia in someone who has no history of anxiety disorder. Alcohol use and tobacco have also been linked to the development of agoraphobia, though the connection between smoking and anxiety and panic disorder remains unclear. Some theories include nicotine dependence and the effects of smoking on a person's breathing as possible causes.
It is important to remember that even medication is not a "quick fix." It can take weeks for you to feel the effects and, since everyone's body is different, you may have to try several different medications before finding the one that works for you.
Additionally, the window between ending one medication and starting another can come with some unwanted side effects, some of which may even lead to panic attacks. This is why you should work with your doctor on the best course of treatment, rather than opting to go "cold turkey," which can lead to your potentially feeling worse.
Seeking Professional Help
Treating agoraphobia can be difficult, as the sufferer must first confront the fact that they have a problem, then work up the courage to leave the house to meet with a counselor to resolve it. If you have agoraphobia, consider reaching out to one of our counselors at BetterHelp.com, who are available 24/7 to assist you. Our treatment methods are ideal for conditions like agoraphobia, as you can meet with our counselors right from the comfort of your own home without needing to leave the house. All you need is a reliable internet connection.