What is agoraphobia or fear of open space?

Fear experienced in open places or when going outside is experienced emotionally by a person. Agoraphobia with panic attacks is treatable.

The fear of going outside is often accompanied by symptoms such as a panic attack, which is in one way or another associated with direct changes in the nervous system. Therefore, when determining the correct direction of treatment for anxiety conditions, high-quality differential diagnosis comes to the fore.

Brain Clinic specialists have extensive experience in treating agoraphobia and various disorders of nervous activity that cause fear and panic attacks. Our doctors will be able to correctly and safely restore the body’s functioning without any side or negative effects on it.

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What is the fear of going outside called?

The word “Agoraphobia” itself means “fear of open space ,” that is, fear of leaving the house. Fear that people cannot control. When behaving adequately indoors or in an open space, a person suddenly begins to get lost and panic. Such a pathology can put an end to public and private life, which is why it is worth studying the origins of its occurrence, trying to overcome the phobia.

Agoraphobia in psychology

The term "Agoraphobia" comes from Greek literally translated as fear of the place where the market is located . Psychologists interpret this phobia as a fear of open doors, fear of open space and crowds. This is a neurological disorder that appears in an individual as a result of certain childhood traumas, central nervous system disorders, stress, due to the participation of other people. Agoraphobia is a subconscious defensive reaction of an individual to walking through a spacious square or street with a huge concentration of people.

A person suffering from this disease may be afraid of unforeseen actions due to the presence of a crowd around. For the first time, German neuropathologist and psychiatrist Karl Westphal spoke about what agoraphobia is. He described this disease in detail and clearly in his general scientific work “Agoraphobia, a neuropathic phenomenon.” For this experiment, Westphal observed three men who had the fear of agoraphobia, although it later turned out that it was women aged 15-35 years who suffered more from this illness . And especially if the person is overly sensual and perceives everything closely.

What is agoraphobia - obsessive fear or neurological pathology? The issue remains controversial . There is an opinion that one of the primary human instincts is fear, but it is just a function for self-preservation, embedded in the subconscious. Pathology is something else associated with a deviation or dysfunction of the nervous system. A phobia is an obsessive state of an individual caused by fear of something that, in principle, is not dangerous.

Fear of large spaces is no less common than claustrophobia.

Some are able to control themselves more, engage in their profession, communicate with other people and generally function as a full-fledged person. But at the sight of a new area and a huge expanse, uncontrollable people, signs of agoraphobia appear from the subconscious . Others see problems even in mundane things like going to the store or walking down a busy street. Most often, agoraphobes lock themselves in their “cage” and thus run away from the external environment.

Agoraphobia in psychiatry

What is agoraphobia in psychiatry? Modern doctors attribute to the concept of agoraphobia not only the fear of open, spacious places and crowds. This pathology most often covers other fears, for example, fear of performing, panic attacks, and social phobia. Some psychologists argue that a phobia of open doors can arise in a person since childhood due to excessive family protection. In such cases, it is hammered into children’s heads that potential danger awaits them outside the home.

In adult life, such upbringing entails a list of mental and neuropathic problems, including agoraphobia. For example, when an elderly person suffers a heart attack or stroke, he is always overcome by the fear of not being rescued in a timely manner and being left without medical care outside the home. Neurologists define agoraphobia according to ICD-10; these are criteria that serve for correct diagnosis.

Consequences of the disorder

The agoraphobe first realizes the absurdity of his fears, and short remissions persist between attacks. The patient adapts his behavior to the circumstances: he does not go outside, rarely visits shops and other public places. A person chooses safe routes and sits closer to the exit.

Over time, there is less and less reasoning, and more anxiety appears in all areas of everyday life. The harder the patient tries to avoid fear, the more susceptible he is to it. Gradually, the disease changes relationships with others, and a phobia of large crowds of people arises.

Often anticipatory agoraphobia causes misunderstandings and ridicule even among loved ones. Conflicts may arise at work or in the family. If this disorder is not treated, the patient risks spending all days at home and not going out.

Risk group

Studies have shown that the fear of open doors, whose name is agoraphobia, is more often found among residents of urbanized cities and big cities than among residents of quiet, calm rural areas. Women are also more prone to this disease than men. This is explained by the fact that they are more susceptible to scrutiny and condemnation from society. Moreover, ladies prefer to see a doctor, while men, not knowing how to get rid of agoraphobia, try to drown their problem in alcohol.

People who are psychologically and somatically weakened are more prone to agoraphobia. And also those who have arrhythmia, asthma, epilepsy, hyperthyroidism or hypothyroidism. What is noteworthy is that almost all patients with agoraphobia have problems with orientation in space. Perhaps dysfunction of the vestibular apparatus is also a cause of agoraphobia. Loss of orientation in space appears due to an unclear perception of the environment (large area, crowd).

Causes of claustrophobia

In each specific case of claustrophobia, it is difficult to say what caused it. However, fear of confined spaces is almost always associated with mental trauma experienced in childhood. Perhaps the parents were overzealous with the punishment - they locked him in the pantry or in a dark and cramped closet. Perhaps the roots should be sought in the loss of parents and a long stay in a crowded place without them - in the child’s psyche such an experience is imprinted for life, in some cases resulting in the development of claustrophobia. Falling into a pool or pond without the ability to swim is another common cause of the disease.

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Children copy the behavior of their parents, and it happens that imitation leads to the child reflecting the mental disorders of the mother and father. If the latter suffered from claustrophobia, it is quite possible for it to appear in children. According to one theory, copying is not the only way to “transfer” a phobia from parents (or more distant relatives) to children. According to this theory, claustrophobia can be inherited.

Another theory says that the cause of fear is the presence of the fetus in the womb. Well, given the prevalence of the disease, such an assumption has a right to exist. Perhaps during pregnancy a situation occurred that threatened the life of the unborn child. This could be reflected in the subconscious and subsequently result in claustrophobia.

Reasons for fear of leaving home

The fear of leaving the house can only be overcome if you know the nature of its formation, otherwise all the efforts made will be in vain.

Numerous studies confirm that fear of going outside is caused by the following factors:

1. Genetic - a significant number of specialists in mental disorders are confident that a large number of neurotic disorders are hereditary in nature, which manifests itself in the presence of certain pathological genes. Based on the results of their research, we can conclude that 20% of those who suffer from agoraphobia received this problem from their immediate family - parents, grandparents.
2. Increased anxiety - there are people who worry about any reason, for them going outside is already a feat. They create a kind of “world” around themselves, which they categorically refuse to leave, hiding in it, like a snail in a house.
3. Uncertainty. Most people are subject to one or another complex, but if self-doubt “takes precedence” over other priorities, then patients suffering from agoraphobia try not to go out at all. Those who still decide to leave their native walls see condemnation at their own expense in every passerby. This phenomenon is usually encountered by young mothers after childbirth, as well as women who find it difficult to control their weight.
4. Disability. People with physical disabilities often close themselves within four walls because this is how they feel safe. For them, the street is a “territory of increased danger,” both physically and morally.
5. With the deepening of stress - the banal fears of children, for example, the fear of a dark room, as a result of the stress suffered in adulthood, develop into phobias, as a result of which the expression: “my home is my fortress” takes on a literal meaning.
6. Low socio-economic status. In this case, a person is afraid of becoming a laughing stock in the eyes of more successful people. The fear of leaving the house is primarily due to the reluctance to see a higher standard of living around oneself. And instead of trying to improve his financial situation, he will most likely lock himself in his “house”.
7. Experienced man-made accidents or disasters. If in the past a person was a participant or witness to any accident or disaster, he may no longer want to go outside. After suffering stress, such people often become hermits, and this is the only way they feel comfortable
8. Addiction. We are not talking about alcohol or drug addiction, these vices, on the contrary, push people into the bitter cold at -25 and in the heat of + 45 degrees to look for alcohol or drugs, but about the game of mania, in which contact with reality is often lost.
9. Collateral effect. Some of the phobias are intertwined and the resulting fear leads to a fear of leaving the house.
10. Fear of death. No mentally healthy person wants to say goodbye to life ahead of time. However, sometimes the fear of death becomes an obsession. People who fear death every second are simply trying to build a fortress in their home. For them, leaving home is equivalent to losing their life.
11. Intimidation. Let’s exclude real threats from third parties, since in this development of events the fear of going out is considered completely justified and is not considered a pathology, an individual is simply afraid for his life and health. This refers to cases where parents outside the home forbid their children to communicate with their peers and intimidate them by inventing various terrible stories. In adolescence, and even in adulthood, such people consider the street a threat.

There are many other reasons behind the fear of leaving the house. With this phobia, a person deprives himself of the possibility of contact with the outside world, including self-realization.

There are a number of obvious reasons why there is a fear of open space, which is called agoraphobia. Namely, long-term use of tranquilizers, antidepressants, sleeping pills, excessive addiction to alcoholic beverages, drug-containing substances, war, health problems.

Many neurologists argue that it is a panic attack that entails agoraphobia and is its root cause. During a panic attack, a person can lose their mind and find themselves in a very frightening situation. Panic appears suddenly and can last about 10 minutes, less often up to half an hour. At the time of an attack, the patient’s body produces a huge release of adrenaline into the blood. The more often such relapses occur, the more difficult it is for the patient to cope with his problem.

Symptoms of agoraphobia

The disease is manifested by anxiety attacks that develop in certain situations. Three components are necessarily present: anticipatory anxiety, the anxiety reaction itself, and avoidance behavior to reduce fear and anxiety.

List of possible symptoms.

1. Dizziness, loss of balance.
2. Tremor (trembling of limbs).
3. Unreasonable fear of death.
4. Hot flashes, feeling of heat.
5. Labored breathing.
6. Severe tachycardia.
7. Feeling of suffocation.

Anxiety reactions may be short-lived and less intense. Two or three signs predominate. Most often the following symptoms appear: dizziness, severe tachycardia, tremor, feeling of suffocation.

Signs and symptoms of agoraphobia

Signs of the disease in the initial stages of agoraphobia appear quite clearly; let’s consider the most typical:

1. Increased heart rate. At any mention of the need to leave the house or apartment, the heart rate gradually increases, the heart beats wildly, even to the point where you have to call an ambulance.
2. Feeling hot. Most people, when receiving a flattering, successful compliment, often blush. For people afraid to leave the house - similar symptoms occur globally, within minutes the person's face becomes very red.
3. Change in pressure. Patients with hypotension and hypertension often have obvious pathological reactions. However, people who do not suffer from blood pressure will experience similar problems in the early stages of the phobia.
4. Indigestion, nausea - stress caused by the need to go outside can provoke nervous (stress) dysbiosis - a disorder of the digestive system, this happens because under stress, a significant amount of a person’s blood rushes to the extremities, causing disruptions in the digestive system. In order to get rid of unpleasant symptoms, you should lie down and relax, allowing the blood to flow to the stomach.
5. Weakness in the body. In the initial stages of agoraphobia, many people feel a “stiffness in the body”; it gets to the point that some cannot cross the threshold of their own home.
6. Inability to navigate the terrain. People suffering from agoraphobia can get lost even in familiar areas. Having left the house, they will not be able to understand where to go or what is happening around them.
7. Refusal to communicate with loved ones. Now we are not talking about literally abandoning loved ones and friends. On its territory, the patient is ready to meet with anyone, but it is unlikely that he will be able to drag the agoraphobe out for a walk or to a cafe.
8. Panic attack. If the disorder acquires such serious symptoms, it is no longer possible to do without psychotherapeutic help, since a mentally healthy person should not be tormented by the fear of leaving the house.

Whatever of the listed symptoms you find in yourself or your loved ones, remember that in the early stages any disease can be defeated.

Treatment of agoraphobia with panic attacks

A feeling of fear in open places or on the street is a problem associated with a mental state disorder and cannot be controlled by the efforts of one’s own will; it requires the mandatory participation of a medical professional with higher medical education, a psychiatrist or psychotherapist.

Agoraphobia with panic attacks can be treated using complex techniques from a psychotherapist. Active neurometabolic therapy, psychotherapy are used, physiotherapeutic procedures are often prescribed, and a daily routine and diet are selected.

Treatment of agoraphobia with panic attacks is selected only individually, only after a thorough examination and identification of the true causes of the formation of a violation of the biological processes of the brain. It is not the symptoms that are felt by the person that are treated, but the cause that the person does not feel. The true reason is sometimes very well hidden from the eyes of non-specialists, and even more so from the person who suffers from it. Treatment of agoraphobia and panic attacks by psychologists or ordinary psychotherapists, without higher medical education and education in psychiatry, should be categorically excluded.

Ways to deal with the fear of going outside

The fear of leaving the house usually affects those who cannot cope with their inner fears and emotions. However, if such a person firmly decides to live a full life, he will cope with any difficulties. A person should approach the question of how to get rid of the fear of going out with all seriousness, trying to solve the problem as quickly as possible.

Methods for the early stages of agoraphobia

In the initial stages of agoraphobia, the following measures can be taken to restore mental health:

1. Refusal of stereotypes. Don't try on yourself with labels that someone else puts on you. Remember, each person is a separately formed personality, with his own successes and failures. When you are alone, try to figure out why you don’t dare leave the house.
2. Receiving positive emotions. Try to get as many positive emotions as possible outside the home. As a rule, small children or animals give us their positive energy. In order to recharge, it is worth visiting recreation areas for small children.
3. Shopping. If you enjoy shopping and your finances allow it, shopping can be an excellent reason to leave the house.
4. Meeting with family and friends. Some people find it relaxing to communicate with loved ones and friends, for example, in the park. They feel safe on neutral territory.
5. Get a pet. It’s best if it’s a dog, and it doesn’t matter what breed. Because, regardless of the owner’s wishes, she needs to be walked several times a day, fighting the fear of going outside.
6. A trip to the countryside. In the warm season, it’s worth going out for a picnic or even going on a visit to another city, this can significantly improve the situation.

Psychotherapeutic methods of struggle

Experts generally recommend the following methods to solve the problem:

1. Auto-training - any sane person, if desired, can convince himself that he needs to go out into the fresh air. It is worth concentrating on the positive aspects of the upcoming walk, and they will definitely outweigh all the negative emotions that may arise after its completion.
2. Rejection Method - This method is not suitable for everyone. The bottom line is that if the patient says: “I can’t” and “I don’t want to do this,” in this case, to leave the house, this must be done.
3. Yoga - Some people think that this hobby is a waste of time. However, for agoraphobia, many psychologists recommend using this method. Thanks to such exercises, everyone will be able to control their internal state and adjust their behavior patterns.
4. Going to a psychotherapist. If a person feels that he cannot overcome his fear on his own, he needs to turn to an expert. A specialist will help you understand the cause of the problem and give recommendations for solving it.
5. Hypnotherapy - more and more studies conducted all over the world prove the effectiveness of hypnosis in the fight against various phobias, including the fear of going outside. The method reduces anxiety, which helps people make positive changes in their lives.

Regarding the question of how to overcome the fear of leaving the house, you need to calm down and try to follow the suggestions given in the article. If you don’t fight, then you can spend your whole life within “four walls,” instead of trying to be happy: by building personal relationships, realizing yourself professionally.

How is the treatment carried out?

There are several ways to overcome your fear of crossing the street. Phobias are treated with medicinal and non-medicinal methods. The treatment regimen depends on the severity of the patient's condition. To reduce anxiety symptoms, medications are prescribed. Medicines are also needed for patients with complicated phobias, against which depression and other disorders develop.

The most effective way to combat agyrophobia remains cognitive behavioral therapy. Another effective method of dealing with irrational fear is a gradual rapprochement with the subject of fear under the supervision of an experienced psychotherapist.

Professional help

To combat a phobia, a doctor can use a method of gradually approaching the object of fear.

Medications are used to reduce symptoms of anxiety in patients with severe types of phobic disorders. Tranquilizers are usually prescribed to help reduce psycho-emotional stress. The choice of drug is made only by a doctor, depending on the severity of symptoms.

Note! Tranquilizers do not cure a phobia, but only reduce the feeling of anxiety and panic when confronted with an object of fear.

If a person is diagnosed with concomitant neuropsychiatric disorders, medications are used to reduce their severity, for example, antidepressants, antipsychotics, etc.

To effectively combat a phobia, the method of gradually approaching the object of fear is used. Thus, treatment of fear of crossing the street consists of several stages:

• determining the cause of the development of fear;
• working through fear in conversations with a doctor;
• going outside with a doctor.

After accepting his fear as a result of working with a psychotherapist, the patient should begin to gradually get closer to the subject of fear. If it is fear of crossing the street, first the person begins to approach the end of the sidewalk, then crosses to the other side through an underground passage, and after some time, crosses the road at a pedestrian crossing.

After completing each stage, the patient tells the doctor in detail about his emotions and experiences. The process is quite lengthy, but gives a guaranteed result. Dromophobia is completely surmountable.

The cost of treatment depends on the pricing policy of the clinic where the person is undergoing therapy. As a rule, one session of psychotherapy will cost 500-1000 rubles.