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Agoraphobia, a fear of open spaces and/or social interactions, is one of the most common panic disorders. It is a complex disease, but some simple measures usually make it a lot easier to control.

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.

Face your fear of fear.

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.

  • Dratcu L. Panic, hyperventilation and perpetuation of anxiety. Prog Neuropsychopharmacol Biol Psychiatry. Oct 2000. 24(7):1069-89.
  • Fleet RP, Martel JP, Lavoie KL, Dupuis G, Beitman BD. Non-fearful panic disorder: a variant of panic in medical patients?. Psychosomatics. Jul-Aug 2000.41(4):311-20.'Photo courtesy of Hunter McGinnis via Flickr: www.flickr.com/photos/vaenator_irae/13986155103
  • Photo courtesy of Michael Elleray via Flickr: www.flickr.com/photos/mike_elleray/6816422817

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