What is Agoraphobia?

In the dictionary, agoraphobia is described as extreme or irrational fear of entering open or crowded places, of leaving one's own home, or of being in places from which escape is difficult. Agoraphobia is an anxiety disorder that often develops after one or more panic attacks, but can also be experienced without panic. Agoraphobia can be one of the most challenging parts of an anxiety disorder. It is important to say that not everyone with anxiety or a panic disorder experiences agoraphobia. Agoraphobia has many different emotional and mental symptoms, one of those symptoms is avoidance of specific situations , such as being alone. This is a common characteristic to most sufferers. Agoraphobia is an illness where avoidance dominates. Agoraphobia can develop slowly over time or it can develop immediately after a traumatic experience with panic. The complications of this illness only grows with each avoided situation.

For example: When a person is out in public (whether it be shopping, going to the doctors, driving, or anything else for that matter) and has a panic attack or intense anxiety, they are usually so scared by this experience that they leave the situation to find a safe place. This experience causes the one suffering to search themselves and try to make sense of what just happened to them. When no logical explanation can be found, the brain assumes that it must be the place and/or situation they were in that is dangerous and sends a signal to avoid it in the future. When the person tries to go back to that same place or situation, the mind tricks the person into thinking something is wrong by sending more anxiety and panic sensations. Instead of running from a real threat, the person then is running from their internal thoughts and feelings. True agoraphobia is avoidance due to their fear of panic/anxiety symptoms and sensations.

Lack of understanding about the prolonged effects of stress on the mind and body can lead to an increase of agoraphobic behavior. Those who do not understand what is happening to them have a huge tendency to avoid more and more as those symptoms present themselves in different places and/or situations. It is not uncommon to hear of agoraphobics who are unable to leave the comfort of their own home and have not done so in weeks, months or even years. It is extremely important for a person who has had a panic attack or is experiencing intense anxiety to learn about what is happening to them. Understanding body symptoms and even thought patterns that are common during prolonged stress helps to limit any unnecessary fears and concerns. Prompt education is a major factor in prompt recovery. The sooner a person understands what is happening to them the better. This does not mean that someone who has been suffering for years who has never understood their condition will never be able to recover. Although it may be true that it may be more challenging for them to recover, they can still recover no matter how long they have been dealing with their agoraphobia.

Phobias vs. Agoraphobia
What is the difference?

A simple phobia is when someone has an overwhelming fear of a specific object, specific situation or a specific circumstance. Whereas, agoraphobia is an overwhelming fear of having a panic attack, most often to the point of displaying avoidance behaviors.The sufferer avoids situations that might be difficult to escape a panic experience or any situation that may provoke panic in a public place.

Common Agoraphobia Symptoms

There are symptoms that are common to most agoraphobia sufferers. Many are physical and many are mental/emotional. Some symptoms may be more bothersome to the sufferer than others.

Physical Agoraphobia Symptoms

  • dizziness
  • breathing difficulty
  • hyperventilation
  • racing heartbeat
  • sweating
  • nausea
  • depersonalization
  • chest discomfort
  • jelly legs

  • Mental-Emotional Agoraphobia Symptoms

  • fear of having a panic attack
  • fear of being alone
  • fear of leaving home
  • fear of losing control
  • fear of losing your mind
  • fear of embarrassment
  • sense of helplessness
  • avoidance behavior
  • fear of crowds, elevators, or other situations where escape may be difficult

  • Each time the sufferer has a panic attack in public, the person with agoraphobia misinterprets the situation as being "dangerous" and and then begins to avoid these situations or circumstances in the future. This easily explains how the agoraphobic's world gets smaller and smaller as they avoid more and more. They avoid as an attempt to keep the panic sensations away, but what happens is they only end up increasing their fears and making them worse.

    It's not uncommon for one of the agoraphobia symptoms to cause a sufferer to become housebound. However, not all people who experience agoraphobia become housebound, but many have limited their lives to what they feel is safe and comfortable to them. These are usually called "safe people, safe places, safe situations" etc.

    You Can Overcome Agoraphobia

    Believe it or not, you can overcome agoraphobia. Some people describe agoraphobia as being a fear of open spaces or fear of being in a public place but although these may be symptoms of agoraphobia they are not necessarily agoraphobia itself. A more appropriate definition of agoraphobia would be the intense fear of anxiety and panic symptoms to the point where avoidance behavior begins to take over. Anyone can overcome agoraphobia regardless of how much hold it has on their life. Through education, baby steps in the right direction, and support; healing and recovery is a realistic goal that can be achieved providing the sufferer has a clear and determined attitude to recover. To overcome Agoraphobia, an individual must be willing to step out of their comfort zone to challenge misbeliefs and uncomfortable body symptoms and sensations. They must also be willing to break the habit of avoidance no matter how much of a habit it has become. As much as you want this part of an anxiety disorder to be gone in a flash, it will require much patience and determination to recover. There is no time limit to recovery with agoraphobia. Each individual is unique in his or her agoraphobia and the time it takes to overcome it varies from person to person. One thing is for sure though, you can overcome it as long as you persist and do not give up. To overcome agoraphobia it is important to educate yourself as much as possible. Cognitive behavioral therapy has been shown to be MOST EFFECTIVE for long term recovery, however, sometimes it is necessary for the sufferer to use other methods such as alternative medicine or conventional medications in conjunction with this type of therapy. If you feel you need extra help in dealing with agoraphobia symptoms, please do not hesitate to seek professional help. Your life is worth it.

    Tips for Overcoming Agoraphobia

    1. No matter how long you have been suffering with agoraphobia, you can overcome it! You must be willing to begin your journey with an attitude of persistence.

    2. Agoraphobia is a stubborn condition. The habit of avoidance is easily adopted but not easily removed. You must be willing to persist and not give up, no matter how difficult it may be or how long it seems to be taking.

    3. Practice is the biggest, most important thing you can do on your journey to recovery! You cannot recover without it.

    4. Remember, it is easy to get discouraged! The truth is that you will have good days and bad days. You cannot have one without the other. Be encouraged because by taking this journey and learning from someone who has been there, you are preparing for success!

    5. How you talk to yourself is also vital. You have the ability to either encourage yourself or sabotage your efforts by your fleeting thoughts and self-talk. It will benefit you greatly to have a good understanding of positive thinking. Learning how to use positive thoughts to encourage yourself is really important. If you do not have a good understanding on how to use positive thinking, I encourage you to practice this before stepping out and challenging your agoraphobia. For more information on how to do this, visit: How To Talk To Yourself. This will show you how to exercise this skill. Once you have a good understanding, you can then start practicing your steps to challenge your agoraphobia. Using your positive thinking along with stepping out in action, is the cognitive-behavioral approach that works.

    6. You cannot recover from agoraphobia without practice opportunities. Your total commitment is necessary. Overcome agoraphobia with practice.

    7. You cannot RUSH recovery! Recovery begins with one baby step at a time. It is through these small steps that will lead you to bigger steps, and then to leaps and bounds! Patience and perseverance is required.

    You Must Practice Overcoming Agoraphobia

    You must practice overcoming agoraphobia in order to find recovery. Practice, practice, practice! I cannot stress enough about the important of practice. I understand how dreadful this idea is to many of you. I wish I could tell you that there is an easier way. I know I wanted an easier answer, but I assure you, there isn't any. If there was, I would have found it! In order to recover, you must practice and there is no other way around it. But, just like anything else that you are trying to master, whether it be cooking, playing a musical instrument, or even a specific profession, you have to practice overcoming your agoraphobia. It is true that the more you practice the better you will become. You want to practice so much that the skills will become second nature to you. As long as you practice and practice often, you cannot lose the battle with agoraphobia. At first, you will make many mistakes when you practice, but you learn from those mistakes. The more you learn firsthand for yourself, the easier it will be for the skills to stick with you. Just like learning to ride a bike; it may be difficult at first, and you might even crash a few times; but if you persist, before long, you are riding with ease, crashing less and less. You have to think of overcoming agoraphobia the same way. Practice makes perfect... well, almost!

    So, how often should you practice?

    If you are serious about overcoming your agoraphobia, you will practice often. If you can practice four times a week, then you are heading in the right direction. For me, I found that there were certain things that I needed to face daily. Whatever your biggest avoidances are, these will take the most effort and need the most attention. There is no daily number of practice that is right for everyone. Practice overcoming agoraphobia at your own pace. We are all different and I believe we all know where we struggle the most. The stronger urge you have to avoid something is a good indication on how often you should approach it during practice.

    Its OKAY to take a break!

    Practice opportunities are exhausting! Mostly because when you practice, you are provoking anxiety symptoms. When you practice overcoming agoraphobia you are exposing yourself to feeling those sensations that you so desperately want to be over. So you definitely want to pace yourself in your practice. It's okay to take a break when practicing. When you practice overcoming agoraphobia it can be exhausting. So be sure to allow yourself a day off here and there, but be sure not to allow too much time in between practice sessions. The longer period you have between sessions, the harder it is to get back to work! So allow yourself a break but once that is over, get back to business.

    Ask for help if you need it!

    IMPORTANT: If you are severely agoraphobic and have a particularly hard time with the body symptoms associated with practicing, you might consider seeing your doctor about using a mild tranquilizer. However, if you don't like the idea of medications, there are natural alternatives that are non-addicting and have very few side effects. Just be sure to talk with your doctor or pharmacist before taking natural supplements. To learn which natural supplements work effectively for anxiety symptoms, be sure to visit natural stress relief. It's also very important that you understand that you will experience anxiety and perhaps panic sensations when you are practicing overcoming agoraphobia. This is normal and very acceptable. In order to conquer your agoraphobia, you need to work through those body symptoms. So even if you take a mild tranquilizer or a natural supplement to help with the body symptoms, you will still feel some anxiety. It is important to recognize that medications and supplements are meant to help lighten your symptoms, not take them away.

    Facing Your Fears When Challenging Your Agoraphobia

    Facing fear takes courage no matter what those fears may be. When you have a panic sensation, it is commonly followed by an intense urge to leave the situation. More than anything you long to escape and find a safe place. For many people this means going back home. Facing fear is one of the most powerful things you can do for yourself. For example, it is not uncommon for people who suffer panic with agoraphobia to leave full carts of groceries near the checkout line because their intense urge to run overwhelmed them. They have trouble facing fear due to the intense symptoms they feel. They mistake their symptoms are something more serious. Perhaps you do not have a problem with the grocery store or standing in line, but maybe it is something else. Either way, it is the racing thoughts that bring alarm and contribute to panic. They are so intrusive that they make facing fear difficult and contribute in a large way to your urge to run to back to your safe place.

    Your fearful thoughts might sound something like this:

    • I am going to lose my mind.
    • I am going to faint, pass out.
    • People will know I am anxious.
    • Something terrible is about to happen.
    • What if I embarrass myself?

    As common as these thoughts are for someone suffering with panic, many listen to the false internal message of the need to run. It is important to understand that not everyone with panic leaves their uncomfortable situations. There are a great many that stay and finish what they are doing. Although facing fear is difficult for them, they persevere through it. However, the ones that do leave their situation out of fear are only setting themselves up for more anxiety upon their next return. Every time you leave a situation out of fear, you train your mind to see your situation as dangerous. Your mind notices everything and makes a detailed record of things to avoid in the future.

    It is extremely important to resist running home or finding a safe place during panic. I know you might think that this is what you should be doing to feel better, but I assure you that the opposite is true. Staying and facing your fear is more important and beneficial to your mental health. Each time you resist the urge to leave a situation, you are training your brain to see things differently. Staying and waiting it out teaches your subconscious that there is nothing to fear. It is important to note that you will still feel all the unpleasant symptoms of panic as you did before. Panic will rise and fall as it does every other time. But the more you practice, the less and less anxiety you will feel over time. This is called desensitization.

    Next time you get the urge to run home to find your safe place, remember to accept your panic and ride it out. By facing your fear, and resisting the urge to run, you are making big progress in overcoming your agoraphobia. Remember, this too shall pass!

    Use Positive and Truthful Thinking for Agoraphobia

    Positive, truthful thinking for agoraphobia might take some time mastering, but, I want to encourage you to be patient with yourself as you learn, especially since negative thinking is usually automatic and extremely predominant in those suffering with agoraphobia. It is hard to know exactly what to say to yourself when you are challenging your agoraphobia. You may be wondering what you should be saying to yourself during your practice sessions. Many of you would agree that when challenging your agoraphobia and coming up against those dreadful physical panic sensations, that it is extremely difficult to have long, drawn out, logical, conversations with yourself.

    For the most part, learning how to have these conversations with yourself is good practice, however, during practice opportunities it is better to have quick, short, truthful, answers to the most common negative thoughts that you have. The purpose of doing the work as it is explained here is to get you into the habit of finding answers for yourself. It is important to understand that almost any answer you have when doing the work can be translated into a shorter response. By practicing those questions, you are preparing yourself ahead of time.

    What does your self talk sound like? It is very important to find out what your most common negative thoughts are when you are anxious. If you are not sure, it may help to take time each day to write down your random thoughts. By writing down your random thoughts, you may find specific thoughts that repeat themselves that you were not aware of before. Once you have a list of the most common negative, self-defeating thoughts are, you will be more able to find positive replacements. Do not be afraid to write them down. It helps to have a notebook when working through positive thinking.

    Examples of Positive, Truthful Thoughts for Agoraphobia

    These feelings will not hurt me.
    They are only anxiety symptoms and nothing more.
    These feelings are distressing but not dangerous.
    I can feel these feelings anywhere, nothing bad ever happens.
    It is not the place but how I am feeling inside that I do not like.
    I am in control.
    No matter where I am, I am my own safe person.
    I do not have to run home to feel better.
    I can stay still, allow the feelings to come and go on their own.
    Panic never lasts.
    I am strong, I am calm.
    I can resist the urge to leave. I will wait for the feeling to pass.
    I can relax and float through this.
    If I panic, it is okay.

    Your list might end up looking something like this or you might have different quick responses based on your particular negative thoughts. No matter what, your list will be customized to you and your needs. You can even write down these quick responses on an index card and take them with you wherever you go. It will take some time to adopt these new thoughts. You will want to repeat these new thoughts whenever possible. It is best to repeat them as soon as you get a negative thought, but even if you dont get that negative thought, repeating them to yourself is good practice and burns them into your memory.

    You Cannot Rush Recovery!

    The best treatment for agoraphobia is the process of taking baby steps towards your recovery. Little by little, by approaching feared situations one at a time until you can move forward to something else.

    However, it is recommended that before challenging your agoraphobia, you will want to get into the habit of recognizing and challenging your thinking. If you need help mastering your thinking, please visit How To Talk To Yourself to help you manage your panic and any other physical or emotional sensations. When you think you have a good understanding on how to replace your thoughts with healthy, more truthful thoughts, I would then suggest taking baby steps towards recovery so that you can put your skills to work.

    Remember, you learn by doing! So, I encourage you to practice as often as you can. The more you practice, the better you will get and the easier things will become. No matter how severe your agoraphobia is you can recover. It is really important that you understand that you cannot rush this process. By trying to rush recovery, you will actually sabotage it. You are encouraged to take your time and take those baby steps needed to recovery. The only agoraphobia treatment that works to help you recover from agoraphobia is by taking one small step at a time.

    I know you really want to get this over with and you want to hurry up, but a hurried attitude will only be self-defeating. The only way this agoraphobia treatment will work is through patience and determination. It is hard being patient when you are anxious but you do this by accepting your situation and adopting an attitude of persistence and perseverance. Remember you are human and good things are worth the time it takes.

    "But, how do I take these baby steps?"

    Here's a good example: Let's say your agoraphobia has stopped you from visiting the grocery store. You struggle with walking the isles, standing at the deli, and then standing in line at the checkout. You would approach this practice sessions by taking one small step at a time. It is through desensitizing yourself little by little that will bring you the most success. You can also call this approach exposure therapy.

    Recovery cannot happen without this form of agoraphobia treatment, so, please, take your time and pace yourself. Recovery is not about forcing yourself to suffer through it in a hurry. In fact, a successful practice session takes one thing at a time. Anyone can hurry into a store, get what they need and get out, but, if you go into that store with the intent of being quick, doing the job and then leaving, you are not making any progress at all. In fact, you could be sabotaging your own success.

    Successful agoraphobia treatment while using baby steps will look something like this:

  • First, adopt an attitude of acceptance. Accepting your symptoms for what they are and nothing more. Give yourself permission to feel whatever it is you are going to feel.

  • On the first day, practice entering the grocery store and just walking around near the door. Work through your anxious thoughts. If you get the urge to run, it is important that you stay and float through those feelings. I would recommend staying at least 10 minutes longer past the original urge to leave. If you feel you need to repeat what you did on the first day, then do it the following day. In fact, do it until you feel it is becoming easier. How many days this may take is up to you. Everyone is different and it is important to understand that. Be patient with yourself.

  • When you are ready to move ahead, you will go further into the store, perhaps this time walking the isles. If you experience dizzy spells or panic, stay still and do not move. Do not forget to use your positive affirmations and your breathing exercises. Again, allow these feelings to come, do not resist them, remember they will pass! Walk slowly if you must. It is okay to feel whatever it is you are going to feel. I would do this until you are ready to proceed to the next step which would be to get in line and purchase something.

  • When standing in line, you may start by picking a short line, or maybe a checkout that is open and ready for you. Then each time you visit the store, pick a longer and longer line. This will help you learn and build tolerance for your body symptoms and give you time to work on your self-talk.

  • It takes a long time before your body feels the effects of agoraphobia treatment through cognitive-behavioral therapy. Therefore it may take many attempts before you begin to feel less anxiety. Always know that your practice sessions are never a waste. Your mind is learning regardless of how "good" or "bad" your practice experience went. Practice, and practice a lot!

  • Remember, you are in control. You are in charge of your own recovery and how big these baby steps will be. You do not have to do anything that you do not want to do. So remind yourself that you want to do this, because you want to recover. We all have a tendency to feel more stress and anxiety if we feel we are being forced and have no choice.

  • The truth is, you do have a choice! Recovery is a choice! Please remember that you are always in control. Total commitment is necessary in order to achieve recovery!

  • Recommended Reading

  • One of the most helpful books, Hope and Help for Your Nerves by Dr. Claire Weekes, teaches you about agoraphobia and how to take steps to overcome it. This book is priceless! You can also use it as a handbook to take with you anywhere to help remind you of truth as you are practicing. The book is an older book but I can guarantee that there is no other book like it on the market. This book, along with Peace from Nervous Suffering has been used as the core teachings of many other anxiety, panic, agoraphobia programs on the market today. If you are interested in reading these books you can visit your local library but I truly recommend having personal copies for yourself because they will be used over and over again in your recovery.

  • Another really helpful book is Mastery of Your Anxiety and Panic: Workbook (Treatments That Work) by David H. Barlow and Michelle G. Craske.

  • The Agoraphobia Workbook: A Comprehensive Program to End Your Fear of Symptom Attacks by C. Alec Pollard Phd. This workbook deals with the many unique conflicts and fears specifically associated with agoraphobia.

  • Return from What is Agoraphobia to Self-Help for Anxiety
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