What is Agoraphobia?

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Agoraphobia is an anxiety disorder characterised by an uneasiness, fear or dread about leaving familiar surroundings. This may include a reluctance to travel, particularly on public transport, or to be in crowded places.

It is associated with severe physical symptoms of anxiety and panic attacks. It is a condition related to anxiety, depression, panic and other phobias.

The word agoraphobia is derived from the Greek “agora” which means “market place” and “phobia” meaning “fear of”. It was first considered to be simply a fear of being in a public place (e.g. the market place).

However the fear and dread about leaving home (or other O.K. place) is considered not to be associated with fear of the public place in itself, nor of lots of people, but actually the learnt fear from a previous experience of a panic attack in such a location.

First, a person may have a panic attack (for any number of reasons, including stress). Then a real fear develops that it may happen again, and situations are avoided which remind a person of the previous panic attacks. Panic attacks are frightening and embarrassing, so it is a natural reaction to do things to avoid what is perceived to have caused the panic attack.

A fear can be developed for almost anywhere. It can be open public places such as shopping centres, railway stations, airports or closed places like churches, theatres, buses, trains, aircraft or quiet places such as empty streets or a store at closing time.

The situation can become very generalised from a fear of one place to the point where a person cannot leave home at all.

The onset of agoraphobia can be sudden and unexpected or it can take months or years for the condition to develop - from a mild phobic anxiety to a feeling of dread of many public situations. The fear of leaving the house may literally extend even to collecting the milk, mail or newspaper from the front step or gate.

There may be many factors playing a part in the development of agoraphobia - such as loss, separation or the death of a family member or close friend. Sudden life changes may bring emotional stress. Long-term emotional stress, which builds up gradually, often without its seriousness being recognised, can trigger panic attacks, which can gradually develop into agoraphobia.

Once a person develops agoraphobia, it is further reinforced by feelings of hopelessness, anger, frustration and guilt about the agoraphobia itself.

While the symptoms of agoraphobia may fluctuate, they may include:

• Feelings of depression

• Abuse of tranquillising drugs and alcohol for relief of symptoms

• Fear of loss of control

• Other phobias

• Loss of self-esteem and self- confidence

• Frustration and anger with oneself

• Anxiety and panic attacks

• Confusion

The physical symptoms of anxiety and panic attacks may include:

• Feeling of light-headedness

• Feeling of being detached or distant from surroundings or even from one’s own body

• Buzzing in the ears, blurred vision, a dry mouth, tingling in the face and arms

• Difficulty in breathing - perhaps breathlessness without apparent cause

• Sudden feeling of extreme panic

• Heart palpitations

• Indigestion

• Dizziness

• Severe backache without apparent cause

• Headaches and other muscle aches and pains

• Weakness of the legs

• Sweating

• Nausea

• Hands which shake

• Fear of fainting

• Fear of heart attack.

Generalised Anxiety Disorder (GAD)

You may worry constantly about being harmed, about financial disaster, your health, work and/or personal relationships. General anxiety disorder is marked by unrealistic and excessive worry, accompanied by constant and often unnecessary concern about anything or everything.

People with Generalised Anxiety Disorder are excessively worried about two or more life situations most of the time. This may be extreme concern about their health and perhaps their finances, despite both being in reasonable condition.

Generalised Anxiety Disorder is one of the anxiety disorders. A person with GAD is in a state of constant anxiety over many aspects of their life – relationships, work, health, family and/or finances.

Just about anything that a person can think about – they worry about. The concerns are ongoing, extreme and unrealistic.

The person feels worried and anxious most of the time.

Symptoms associated with generalised anxiety disorder include:

• Mind becomes alert

• Heart rate increases, blood pressure rises

• Sweating increases

• Muscles tense

• Mouth gets dry, increased thirst

• Breathing rate increases

• Immune response decreases

• Feelings of fear and apprehension

• Restlessness

• Feeling sick or nauseous

• Trembling and shaking

• Butterflies in the stomach

• Startling easily

• Frequent urination

• Irritability

• Sleeping difficulties

• Feeling out of control

• Feeling as if you are going ”crazy’

It is difficult coping with constant anxiety – some people smoke, drink or use other recreational or non-prescription drugs – however these drugs only exacerbate the problem.

Cigarettes, coffee, modern energy drinks and other stimulants decrease the anxiety for short periods, but the stimulant nature of these drugs actually puts more strain on the nervous system as it increases the alert mode.

Alcohol and other depressants are other short-term fixes – anxiety often couples with depression – so alcohol only leads a person to increased anxiety when they are not drinking, and depression when they are.

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