Agoraphobia it’s the fear of being in a place or a situation where escape might be difficult (or embarrassing) or where help may not be available in case of felling ill. This fear usually appears after a panic attack, but it could also develop without it.
A panic attack, or anxiety crisis, it’s the sudden appearance of fear and intense indisposition plus one or more of these symptoms: palpitations, sweating, trembling, shaking, shortness of breath, nausea, weird perception of things etc. These symptoms come together with the thought of intense danger or an incoming death, and an extreme need of running away from the situation. During the crisis it’s common think that we are going to die, lose control, or lose the common sense.
What causes a panic attack? It appears when we make a dangerous interpretation after feeling, sensations, that usually are innocuous, but when we start to feel these symptoms we think that are the signal of the incoming of something terrible. That switches on our anxiety response, our fear raises and with it the symptoms, so we saw this as a proof that something’s wrong, and that causes more anxiety and more symptoms, and that’s what we called the vicious circle of panic.
After the first panic attack it’s common being afraid of going trough a similar situation, that’s because usually the person doesn’t understand what happened and what caused it. There’s the fear of have another crisis, but the person also starts to avoid the places or situations that might cause another attack. The problem is that as the situations aren’t the cause of the crisis, the anxiety usually reappears, and if the person keeps avoiding more and more situations, after a while there will be just a few “safe” places. Here is when the agoraphobia starts.
The person avoids being alone inside or outside home, crowed places, noisy places, supermarkets, malls, buses, subway, bridges, elevators etc. In case of confronting one of these situations there’s a lot of anxiety and usually they need to be accompanied by someone they trust. Depending of other people usually creates more tension in the relationship with friends and family. If there’s no intervention with the rights methods to help the person to recover and to lose the fear of panic attacks, this is one of the anxiety disorders that more disease can cause.
Cognitive-behavioral therapy has proven to be very effective in the agoraphobia. We work in different ways depending of the case, but usually we try to focus our work on the thoughts that switches on the anxiety response, we help to face the symptoms and teach the right strategies to start confronting the avoided situations step by step.