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Agoraphobia is one of the most common panic disorders, in which the sufferer experiences extreme anxiety in situations in which he or she has little control. Not just a fear of open spaces, agoraphobia can also involve fear of crowds, fear of traveling even short distances, or fear of new places and social situations. Some people who have agoraphobia are unable to leave their homes, but most people who have the condition are capable of going out in public but harbor irrational, strongly held fears of embarrassing themselves in front of other people.
Agoraphobia As Snowballing Anxiety
Agoraphobia usually begins with a panic attack. Fearing another panic attack, the victim refuses to return the site of the first. "Fear of being fearful" can build to the point that the individual who has this condition is unable to work, carry on normal relations with friends and family, meet new people, or participate in activities outside a very limited routine. Not every panic attack in large open places or during interactions with groups of people, however, results in the development of a phobia.
Unusual surroundings, visiting a huge city train station for the first time, for example, may be extremely stressful. The farm-bred author of this article suffered a mild panic attack the first time he caught a train out of Grand Central Station in New York City. Whether a panic attack becomes agoraphobia, however, depends on whether the person who has the attack is able to overcome his or her fears and return to the site of the distress to pursue normal activites. The second time the writer of this article visited Grand Central Station, he did not experience any kind of panic.
Other Causes Of Agoraphobia
Telling an agoraphobic to "snap out of it" never works. This is because this panic disorder is not entirely of psychological origins, or they may have physical characteristics that interact with the psychological dimensions of their experiences.
In some, but not all, cases of agoraphobia, part of the underlying problem lies in the inner ear, in the vestibular system. Some people have to maintain their balance with the help of visual cues, looking at objects around them. These people may experience severe discomfort in large open spaces because (1) their inner ear canals don't function in ways that keep them from becoming dizzy and (2) landmarks for standing up or sitting up can be hard to find in a large open space.
In some, but not all, cases of agoraphobia, part of the underlying problem is substance abuse. Agoraphobics who are addicted to benzodiazepine tranquilizers, for example, usually improve when they come off the medication. Both smoking and alcohol use are also associated with the development of this panic disorder. Surprisingly, smoking marijuana tends to make the panic attacks worse, rather than better.