What is it?
Agoraphobia is a fear of being in situations from which the person sees that escape may be difficult or embarrassing. A person with agoraphobia may avoid a range of situations, e.g. queues, public transport, large crowded shops, supermarkets, shopping centres.
In these situations, the person can feel anxious, panicky (butterflies in the stomach, palpitations, increased heart rate, hyperventilation etc) like something ‘bad’ will happen.
Often, these fears relate to illness and harm (e.g. having a heart attack, dying, stopping breathing) or a fear of public scrutiny and embarrassment (e.g. falling down and making a fool of oneself).
Why does it happen?
Researchers believe that panic is the result of our body and mind going into “fight, flight or freeze” mode. This is a stress response that our ancestors developed to keep themselves safe from harm in a world where there were many dangers, such as predators or enemy tribes. Most people live in a very different type of world today, but we’re still hard-wired with the same stress response. Panic attacks can be the result of this response becoming over-sensitive. This can happen when we’ve been through difficult experiences, or when we have a lot of stress in our lives.
What causes it?
There are many different explanations of why people develop worries about going out:
- Having a panic attack in a public place can lead to associating fear of this happening again being away from our home
- Having panic disorder (recurrent panic attacks)
- Traumatic events or bereavements
- Previous experience of mental health difficulties
- Alcohol or drug misuse
- Being in an unhappy relationship
Often if may not just be one of these but a combination of these and other factors. Agoraphobia very often occurs along with panic attacks, and can sometimes go together with other difficulties, such as depression or post-traumatic stress disorder (PTSD).
Research has helped us understand the important role that thoughts can play in the development of these fears. These thoughts can be about yourself, other people, the future and the world around you. You may recognise the following negative thoughts:
Thoughts about yourself
- “I’ll make a fool of myself”
- “I’m going mad”
- “I’m going to die”
- “I need to keep myself safe”
- “I could become infected by a serious illness if I visit crowded places (this is much more likely to be a fear in the time during and after the COVID-19 pandemic)
Thoughts about other people
- People can see how anxious I am
- “Other people will think I’m ill and call an ambulance – I’ll be so embarrassed”
- I need someone with me if I’m going to go outside, in case I panic”
Thoughts about the future
“I need to stay away from there”
“things will never get better”
Thoughts about the world
- “It’s dangerous to go out when I might have a panic attack”
- “I should stay inside where it’s safe”
- “The world is dangerous – there could be a terrorist attack, or I could be attacked”
How common are these kind of worries?
About 3% of people experience ongoing fears of going out for a prolonged period of their lives.