Less Common Mental Disorders: Agoraphobia

May 27, 2023

Like many mental illnesses, agoraphobia has a definition—the fear of open spaces—that isn’t remotely sufficient to encompass the entirety of what it entails. Less than a fear of open spaces, agoraphobia is a severe anxiety disorder that has more to do with fear of the outside world. People, places, public transport, essentially anything outside of the person’s comfort zone—generally one’s own house—have the possibility of being a source of fear and stress in someone with agoraphobia.

Agoraphobia is more than just fear, though, because like most anxiety disorders, it comes with an array of physical symptoms that get more or less extreme depending on the person’s proximity to the situations that make them uncomfortable. Agoraphobia’s physical symptoms, at their worst, are probably most like the symptoms of panic disorder: heart palpitations, hyperventilation, tingling, numbing hands and feet, nausea, and shaking are common (when combined, these symptoms usually qualify as what’s called a panic attack, which is the main criterion for panic disorder).

Because of its similarity to panic disorder, the two are occasionally mistaken for each other if careful diligence isn’t applied during diagnosis. While both disorders often include frequent panic attacks, those of panic disorder often occur without warning or reason, and then include associated feelings of fear related to having more attacks. Panic attacks that come from agoraphobia are often situational and result more frequently in fear related to being in the triggering situation again.

If you’ve ever loved someone through addiction or insecurity, you might understand a fraction of what it’s like to love someone with agoraphobia. It’s similar in that it can seem endless, and it’s often difficult to assist with; as the adage goes, you can lead a horse to water, but you can’t make it drink. The same goes for helping people with agoraphobia escape their house or other comfort zone. While the condition is only considered this severe in about 40% of cases and therefore doesn’t usually leave people housebound, it’s worth remembering that avoidance is a key component of agoraphobia and it’s almost always present, just in different ways.

Patience is paramount when dealing with someone with agoraphobia. It may seem like a simple solution to us, but, like all the others, agoraphobia is a disorder that individuals can’t control. The fear they feel is real and difficult to combat; they may logically know that the situation they’re scared of is unlikely to actually harm them, but without the proper coping mechanisms, it sometimes doesn’t matter. Even with the right coping skills, the stress and panic that agoraphobia induce are, again, difficult to argue with; almost like schizophrenic delusions, the anxious mind can tell us things like “You can’t leave, it isn’t safe” or “People will laugh at you if you get on that train” and have us unwillingly believe them.

This is also important to keep in mind when talking to anxious people in general. Since mental illnesses like agoraphobia are rare, you’re much more likely to come in contact with a generally or socially anxious person, where the same tenets—patience, compassion, appreciation for the person’s resilience—can come in handy. Remember that it’s not always just as simple as “getting better” or “getting over it,” and try to have sympathy for the things you don’t understand, especially when they cause someone else suffering. You have the power to make the difference with your kindness—why not take advantage of that?

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