The dictionary definition of agoraphobia is ‘an abnormal fear of open spaces or public places’. But most agoraphobics will tell you they aren’t afraid of open spaces. Agoraphobia is actually a fear of having a panic attack in a public place where you cannot escape from quickly.
The use of the term agoraphobia dates back to 1871, where a German psychiatrist Karl Otto Westphal used it to describe the anxiety three of his patients had when walking through streets and squares.
Agoraphobia is a recognised medical disorder. The Diagnostic and Statistical Manual of Mental Disorders is a widely used manual published by the American Psychiatric Association. The manual lists all the different categories of mental illness and the criteria for diagnosing them. In the 1994 version, the title of which is shortened to DSM-IV, agoraphobia is recognised as either being ‘Panic Disorder with agoraphobia’ or ‘Agoraphobia without history of panic disorder’. Panic Disorder with Agoraphobia is diagnosed when anxiety about panic symptoms occurs when in a situation where escape might be difficult, when the person avoids these situations and when another disorder, such as social phobia, doesn’t better describe the person’s difficulties.
How can you tell if you have agoraphobia? Answer these two questions:
• Do you experience psychological and physical anxiety when you are in at least two of the following situations: crowds, public places, travelling away from home or travelling alone?
• Are you are also avoiding the situations you fear?
If you’ve answered yes to both, then it’s likely you have agoraphobia but remember your doctor must make a formal diagnosis.
Agoraphobia is a complex phobia and can involve a series of inter-linked phobias. For example, some agoraphobics may have an illness or health phobia which comes out during a panic attack, others may be afraid to be left on their own (monophobia), some may be afraid of any situation where they feel trapped, a work meeting for example, showing similarities to claustrophobia. Many agoraphobics worry about what other people think of them or of humiliating themselves in public which are signs of social phobia. It’s likely you’re only too familiar with the situations which make you panic.
You may have been agoraphobic for so long that you cannot remember living any other way – it is now the norm for you. But no matter how long you have been agoraphobic, one month or ten years, there is always hope and always the possibility of recovering fully.
The journey may not be an easy one and in order to start it you need to be prepared to stop running away from your fears and begin to face them. This may mean an increase in the levels of anxiety you experience until you have learnt how to remain in the situations you are frightened of without panicking. My book and this accompanying blog aims to arm you with the knowledge you need to start taking those first steps.
