Coping With The Fear Of Leaving The House – Agoraphobia
By Nadia Khan
Updated February 09, 2020
Reviewer Richard Jackson
How many times a day do you step out of the house to run errands, to shop for groceries, to go to work, to visit friends, to pick up the toys lying in the backyard, or even to check the mailbox? We're constantly running in and out of our house without a second thought, never stopping to consider that this simple action we take entirely for granted is a near impossible task for some.
What Is Agoraphobia?
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 experience embarrassment 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. In the most extreme cases, those with agoraphobia will not even leave the house- finding a work from home job, getting all their food and supplies delivered to their house, and ensuring they do not have to interact with others outside their own home.
Panic attacks and agoraphobia almost go hand in hand, as it is incredibly rare for someone to suffer from agoraphobia without also suffering from panic attacks.
Females are twice as likely as men to develop agoraphobia. Hormones and the fact that women are more likely to seek help and therefore be diagnosed with the disorder may account for this. Societies tend to accept women expressing their emotions more than men. We tend to start telling boys at a young age, "Don't cry - be a man!" This is one reason men tend to stifle their emotions, whereas women are more likely to pay attention to their emotions and seek help if needed. It's extremely important for men to realize that this is one way society can damage individuals. Fortunately, we are shifting away from these more traditional ways of viewing gender, and men deserve mental health care just as much as women do.
What Causes Agoraphobia?
A person's genetics and overall health can play a part in whether he or she has agoraphobia. Chances of an individual developing the disorder are higher if they have a parent who suffered from agoraphobia. 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 fear that they could suffer another one. As a result, the sufferer avoids going to any place where they believe another panic attack could strike again. Some who suffer from agoraphobia find that when a friend or relative goes with them to a public place, they have an easier time leaving the house, and they feel less anxious. However, as mentioned above, some have a fear that is so overpowering 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 the phobia could pave the way for developing a panic disorder. What is panic disorder? It's a condition wherein a person often suffers recurring panic attacks or episodes of extreme fear. These come on suddenly and without warning. A panic attack usually lasts only a few minutes, but it can be incredibly painful, is sometimes confused with a heart attack, and can cause distressing physical effects, in addition to mental distress.
Those who suffer from panic attacks are fearful of losing control of the situation. They may also worry they are about to have a heart attack and die. Panic attacks can completely disable a person, and the fear of suffering another one can cause the individual to do everything possible to avoid another attack. For instance, if a few panic attacks occurred at work, the person may quit his or her job to avoid having to go back there for fear of potentially triggering another episode.
Risks Of Developing Agoraphobia
Who is at risk for developing the disorder? Almost anyone, including 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 brought on by outside influences, such as environmental stressors and learning experiences. Those who have a nervous temperament may be more likely to suffer from agoraphobia. 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.
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. If you're thinking you're the only one who lives in constant fear, think again. Approximately 1.8 million adults in the United States are currently suffering from the phobia.
Why should it be taken seriously? Aside from the obvious impracticality and inconvenience of never being able to step out of the house, agoraphobia can lead to clinical depression and substance abuse. The longer one suffers, the more likely they are to develop additional mental disorders or health problems, so it should be treated as soon as symptoms begin to appear.
Symptoms of Agoraphobia
Physical symptoms of a panic attack can include:
- Having a rapid heart rate;
- Difficulty breathing;
- Feeling lightheaded and dizzy;
- Feeling shaky or numb;
- Breaking out in sweat;
- Suddenly feeling flushed or, conversely, getting chills;
- 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 have to wait in a 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 become incapacitated for other reasons.
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. Many simply remain at home, seeking out all possible options, which 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, 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 taking out the garbage. As a result, sufferers often become dependent on others for daily help and simply stop living life.
Unfortunately, there is no one way of overcoming agoraphobia. Agoraphobia and panic disorder are best resolved with treatment. Treatments for conditions like these include cognitive behavioral therapy (CBT) and medication.
Face Your Fears
The tricky thing with anxiety is that the less you face your fears, the more they fester and get worse. So sometimes, the best way of overcoming your fears or anxieties is to face them head on. If you're scared of taking the bus, ride the bus for a full day; if being in a line at the grocery stores worries you, grab a friend and stand in the longest line you can find! But truly the best way of getting over your phobia is to seek treatment, as soon as you can. Like most mental illnesses and disorders, the sooner you get help, the more effective the treatment.
Cognitive Behavior Therapy
CBT is one of the most effective forms of therapy for anxiety disorders, and it works by teaching you the specific skills you need in order to cope with anxiety, face your fears head-on, and gradually return to the normal life you previously enjoyed. Symptoms will improve gradually over time.
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 to help you challenge your fears and differentiate between rational and irrational thoughts.
CBT can help you understand that your anxiety will gradually decrease, if you remain present in the situation- no matter how scared you may feel. The therapist will also arm you with coping mechanisms for managing your symptoms.
Antidepressants and Anti-Anxiety Medication
Your therapist will likely prescribe medication such as Prozac and Zoloft to go with your psychotherapy sessions. Interestingly, antidepressants have been found to be more effective at treating agoraphobia than 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 habit-forming tendencies. Furthermore, chronic usage of benzos can induce agoraphobia in someone who has no history of anxiety disorder. It is important to remember that medication is not a "quick fix." It can take weeks for you to feel the effects, and you may have to try several different medications before finding the one that works for you.
Keep in mind, 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 closely with your doctor on the best course of treatment, rather than opting to go "cold turkey," which can lead to you potentially feeling worse.
Remember, getting help early can prevent your symptoms from worsening.
Treating agoraphobia can be difficult, since you would usually have to work up the courage to leave the house to meet with a counselor. This seems like a near impossible thing, since the reason for seeking help is precisely your inability to leave the house.
Thankfully, as you prepare to take the initial steps to getting help, you do not have to leave the house (until you are ready and capable of doing so) and can get help online through BetterHelp. You can access our licensed professionals from the comfort and safety of your own home. This site, dedicated to mental health, has counselors and therapists who are available around the clock, and they are ready to support you in whatever way you need.
This is an ideal option for someone suffering agoraphobia since they can meet with a counselor from their home computer or cell phone. Others who have been where you are, took the step to get help through BetterHelp, and they were able to put their fears and anxieties to rest and regain their life. Read below for some reviews of BetterHelp counselors, from people experiencing similar issues.
"It's amazing how beneficial therapy is. The EMDR sessions with Keith have enabled me to reclaim my power and control over my own life. As a result of my work with Keith I went from too scared and anxious to leave the house with crippling panic, to being able to enjoy walks with my husband in the park, garden and we have even traveled by plane, and train. I've been able to leave some toxic relationships that weren't serving me, and now feel equipped to not only face life but to enjoy the richness and fullness of it. I highly recommend Keith as a counselor and the EMDR sessions."
"I want to say a Big Thank You to betterhelp.com for assigning Noami Kim to me...I don't know if I'd have gotten a better session like hers. My 2 weeks alone with her has recorded some noticeable progress on coping with my frequent panic attacks/disorder. My experience so far with her has been very relaxing and conversational even when at times it was difficult for me to express myself. I feel very positive that'll come out better and more focused in fighting this PAD. Thank You Noami Kim."
It's easy to get swept up in your phobias and have them slowly overtake your life- until you wake up one day and realize the life you knew and loved is gone. But this doesn't have to be the case, and it is never too late to get help or get your life back on track.
Don't let your fears take control of your life. Remember, you control your life! Take heart from the knowledge that millions of people have faced the same crippling fears as you, and they are actively working at getting help, even as you read this. You can be one of those people too. Take the first step today.