Fear of Open or Crowded Spaces Phobia – Agoraphobia

Agoraphobia is the irrational fear of having a panic (or anxiety) attack in a place that may be difficult to escape from. Before we learn about the causes, symptoms and treatment of this phobia, let us first see a few myths associated with it and the actual facts.

Myths about Agoraphobia

• People with the fear of open spaces always remain housebound– Many sufferers of Agoraphobia actually prefer crowded spaces than being left alone at home. A majority of these patients may have milder symptoms of Agoraphobia. If one is housebound for months or years, then his/her Agoraphobia can be classified as being extreme.
• Agoraphobia is only the fear of crowded spaces– As mentioned above; some individuals are known to fear crowds while others to prefer them.
• Fear of enclosed spaces in not Agoraphobia, only claustrophobia (the fear of enclosed spaces)– Many individuals with Agoraphobia are also known to fear enclosed spaces but they might have other fear symptoms as well.
• Agoraphobia is the fear of open spaces and public places– More than the fear of being in an open space; the phobic tends to fear a “symptom-attack”- a rush of symptoms and sensations that s/he is unable to deal with.
• Agoraphobia is always a fear of panic attack– In Agoraphobia, it is not just ‘panic’ that one fears but several other symptoms. For example, a person might feel nauseated in a crowded space and fear not being able to reach the bathroom on time to throw up. Thus, the sufferer might “learn to feel or expect to feel something disturbing” in a particular situation and hence try to avoid the situations as much as possible.

Causes of Agoraphobia or the fear of open/crowded spaces

There is no single cause for the fear of open or crowded spaces. Researchers believe that a number of physical and psychological factors may be responsible for this phobia.

• In the majority of cases, an underlying ‘panic disorder’ may be responsible for Agoraphobia. A panic disorder is characterized by an intense and irrational fear that can cause the sufferer to lose control, cry, shake and have thoughts about dying. In his/her mind, the sufferer then links the attack to situations and then tries to avoid those situations completely.
• A research is also suggesting a possible link between long term tranquilizer or sleeping pill usage with Agoraphobia.
• Individuals with difficulty of spatial orientation and balance (or those with weaker vestibular functions) are also known to experience the extreme fear of crowded or open spaces.
• A history of alcohol or drug abuse, traumatic childhood experiences, recent life changes such as death, divorce, relationship difficulties, war, explosion, earthquakes etc can bring on the fear of open or crowded spaces.

Symptoms of Agoraphobia

The symptoms of this phobia can be classified into physical and psychological symptoms.

Physical symptoms:

• Hyperventilating or rapid/shallow breathing
• Feeling of choking or difficulty swallowing
• Sweating
• Shaking and trembling
• Nausea and other gastrointestinal distress
• Dizziness or lightheadedness
• Ringing or buzzing in the ears

Psychological symptoms

• Fear of losing control or going crazy
• Fear of dying
• Feeling ‘unreal’ or detached from oneself
• Feelings of depression, dread or anxiety
• Having low self esteem or low confidence

Treatment for Agoraphobia

It is essential to treat Agoraphobia early on, since, left untreated, it may take a more serious form and even make the sufferer depressed or suicidal.

There are several treatment options for dealing with the fear of open or crowded spaces. Of these, it is best to rely on the self help techniques rather than taking medications as the latter can have withdrawal symptoms and other side effects.

Self help techniques for dealing with panic symptoms

• Breathing slowly and counting to ten while repeating the word ‘relax’ in calm and soothing manner. This is one of the expert recommended self help techniques that have been proven highly effective in managing panic symptoms.
• Slowly exposing oneself to one’s fears and also writing down things that make one feels fearful. This might turn out to be difficult in the beginning but gradually one can overcome the fear of crowded or open spaces.
• Educating self – There are many books and case studies available online and offline that can inspire one to fight their Agoraphobia.

Other than these self help methods, one can also opt for CBT/cognitive behavior or behavior therapy, guided imagery, counseling, talk therapy and group therapy. Taking baby steps is the key to overcoming Agoraphobia.