Agoraphobia is a marked fear of being in a situation or environment that is a crowded or public setting where perceived escape is difficult or unlikely. Individuals may experience overwhelming anxiety and panic attack-like symptoms when faced with such a situation.
People struggling with agoraphobia may avoid social situations and, in extreme cases, may avoid leaving their homes altogether. This phobia is debilitating and can significantly affect daily functioning without the appropriate help and treatment.
How Does Agoraphobia Develop
Approximately 1.7% of the population struggle with agoraphobia, and symptoms are first presented in the early to mid-twenties, although symptoms can present themselves as early as age 17.
Differences between males and females are minimal, with 0.8% incidence rates for males and 0.9% for females. Agoraphobia has not been found to be attributed to a specific cause; however, overprotectiveness during childhood or traumatic events could influence the development of the phobia.
Individuals with a highly neurotic personality deposition may also be at risk. Agoraphobia is often seen as a co-occurring disorder with obsessive-compulsive disorder, panic disorder, or post-traumatic stress disorder.
Some may have a genetic predisposition to developing the phobia; however, there have not been concrete findings on the genetic markers that point to it.
Signs and Triggers of Agoraphobia
The signs of agoraphobia manifest themselves similarly to that of an anxiety/panic attack when an individual feels they have been exposed to a threatening stimulus. The general signs, according to the Diagnostic and Statistical Manual of Mental Disorders, include four (or more) of the following:
- Palpitations, pounding heart, or accelerated heart rate
- Trembling or shaking
- Sensations of shortness of breath or smothering
- Feeling of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, lightheaded, or faint
- Derealization (feelings of unreality) or depersonalization (being detached from oneself)
- Fear of losing control or “going crazy”
- Fear of dying
- Paresthesias (numbness or tingling sensation)
- Chills or hot flushes.
Individuals will also have a marked fear of two or more of the following situations;
- Public transportation
- Open or enclosed spaces
- Being in crowds
- Being outside their home alone
These situations are avoided or restricted to reduce symptoms of distress that impairs daily functioning.
Agoraphobia and Air Travel
Agoraphobia is a restrictive and debilitating phobia that affects an individual’s ability to experience life for all it has to offer. Symptoms make traveling particularly grueling as individuals dread the possible scenarios of what could go wrong being on a flight several thousand feet in the air.
Since symptoms are so intense, individuals feel anxiety and fear at even the thought of being in a ‘threatening situation.’ Below are some ways that explore symptom management and treatment for those struggling with agoraphobia.
Cognitive Behavior Therapy and Medication
Cognitive Behavioral Therapy (CBT) is an effective solution-focused therapeutic approach used to treat different phobias. Particularly, exposure therapy has been found to have long-lasting curative effects in maintaining progress.
As you anticipate an upcoming flight, engaging in exposure therapy with professional help or self-learning may help you better prepare for your journey. Exposure therapy consists of skills designed to gradually desensitize your fears and anxieties toward a trigger, which would be, in this case, being in an airplane.
Another consideration could be to talk to your doctor about anti-anxiety medications. Particularly beta-blockers and selective serotonin reuptake inhibitors (SSRIs) that treat the symptoms of OCD.
A long-lasting cure for agoraphobia and other phobias is a combination of medication and therapy. The recommendation to engage in this combination of treatments is due to the independent skills you would acquire to eventually manage distressing symptoms without dependence on medication.
It is important to manage your daily habits outside of treatment. After all, the way you feel physically affects how you feel mentally. Therapeutic lifestyle changes are effective in maintaining the progress you gain through therapy and medication.
Reducing or even avoiding alcohol and caffeine, along with a nutritious and well-balanced diet and routine exercise, has been found to have people feeling better almost instantly. Another important aspect of being mindful is getting adequate sleep.
Taking care of your physical needs lowers general levels of anxiety and enables your body to perform at an optimal level to enhance psychological functioning.
Agoraphobia, like many other phobias, takes time, patience, and persistence to overcome and manage. There is a light at the end of the tunnel, and finding the resources that work for you will enable you to experience all life has to offer.
1. Anxiety and Depression Association of America. (n.d.). How can I overcome my fear of flying? Anxiety Disorders and Depression Research & Treatment | Anxiety and Depression Association of America, ADAA. Retrieved December 8, 2022, from https://adaa.org/living-with-anxiety/ask-and-learn/ask-expert/how-can-i-overcome-my-fear-of-flying
2. APA. (2017, July 31). What is exposure therapy? https://www.apa.org. Retrieved December 8, 2022, from https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy
3. APA. (n.d.). Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). American Psychiatric Association. Retrieved December 8, 2022, from https://psychiatry.org/psychiatrists/practice/dsm
4. Cleveland Clinic. (n.d.). Agoraphobia: Symptoms, causes & treatments. Retrieved December 8, 2022, from https://my.clevelandclinic.org/health/diseases/15769-agoraphobia
5. Schindler, B. (n.d.). CME: Fear of Flying and Flying Phobia. National Library of Medicine. Retrieved December 8, 2022, from https://pubmed.ncbi.nlm.nih.gov/29871581/
6. Substance Abuse and Mental Health Services Administration. (2016, June). Table 3.10, panic disorder and agoraphobia criteria changes from DSM-IV to DSM-5 - Impact of the DSM-IV to DSM-5 changes on the national survey on drug use and health - NCBI bookshelf. National Center for Biotechnology Information. Retrieved December 8, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t10/