Overcoming Agoraphobia: How To Say Goodbye To Your Fear Of Open Spaces

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.

See Also: Is Obsessive Compulsive Disorder A Risk Factor For Schizophrenia?

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.

What Can You Do To Overcome Agoraphobia?

Everything about agoraphobia probably is not bad. "Primary" agoraphobia, like the experiences of the author described above, may be part of the way human beings are "hard wired" for their own protection. Before modern times, going out into the open without cover was often dangerous. Wild animals, enemies of the tribe, or bad weather could pose a real threat to life. A panic reaction requiring a conscious decision to leave a protected place could have resulted in greater survival.

People who overcome agoraphobia on their own are brave individuals who do things despite their fears and discomfort. While agoraphobia is not entirely a psychological condition in all cases, the psychological component is sufficiently strong that "facing fears" usually makes a huge difference in how well people do with the disease. Here are some of the behaviors that lessen the symptoms of the condition in most people who have it:

Never let your "safe zone" shrink.

People who become crippled by agoraphobia typically manage to continue their jobs and their lives with difficulty and discomfort, but slowly take the easy way out by going to fewer and fewer places and doing fewer and fewer things. Eventually, they may restrict themselves to their homes, or even to just part of their homes. It is essential to keep going new places and trying new things, even when they are uncomfortable, to avoid becoming, to whatever degree, shut in and dependent on others. The way to choose new places to go and new things to do is "just different enough" to be "just a little" uncomfortable. Well-meaning friends and family members have to avoid pushing so hard that the agoraphobic shuts down.

Don't protect yourself against things that can't hurt you.

Many agoraphobics harbor fears that would be rational for someone else but that are irrational for themselves. For instance, Ebola is a deadly disease, but if you live in Kansas, chances are extremely remote that anyone will ever pass it on to you. Storm surge from hurricanes can result in drowning, but this does not mean you need to stay in a third-story apartment in Las Vegas. No one's life is utterly safe, but life is wasted in avoiding events that will not happen.

Identify your fears, and then intentionally expose yourself to them.

"Exposure therapy" loosens the grip of agoraphobia. If you are afraid of driving across high bridges, practice driving across low bridges. If you are afraid of large crowds of strangers, go somewhere there are small crowds of strangers. If you are afraid of taking a flight over an ocean, take a flight over a lake. Work up to confronting your worst irrational fears, and you will gradually — or sometimes immediately — feel better.

See Also: Phobias: How to Overcome Fears

Don't avoid panic attacks. Learn how to deal with them. Face your fears so often that they become boring—and usually your fears will go away.

Completely overcoming agoraphobia may require getting help with vision or balance disturbances, and breaking caffeine, nicotine, drinking, or pill habits. The more you confront your fears on your own terms, however, the milder your symptoms will become.