What is Agoraphobia and Is It the Cause of My Panic Attack?

In its literal Greek, agoraphobia means “fear of the marketplace.” From the literal definition you can see that the psychological definition of agoraphobia is an abnormal fear of public spaces and the crowds associated with those spaces. Indeed, agoraphobia often manifests itself as a literal fear of marketplaces and supermarkets. It can range from not being able to visit a moderately busy supermarket to not being able to stand on a street corner to not being able to attend a movie theater. A bustling public space, New York’s Times Square, for example, can trigger a severe agoraphobia panic attack.

Agoraphobia and its associated panic attacks are thought to be caused by the extreme sensitization that most agoraphobics have to their own bodily sensations. This high level of sensitivity causes agoraphobics to overreact to normal contact and stimuli. For example, when making your way along a busy sidewalk, your body releases adrenaline to keep you alert for obstacles like people and benches and for orientation markers like street signs or building addresses. Adrenaline causes an increase in your heart and respiration rates, which the normal person doesn’t even necessarily recognize. The agoraphobic, however, interprets these natural reactions as the start of a panic attack. This misplaced recognition of an agoraphobia panic attack can actually trigger such an attack.

As well, agoraphobia panic attacks could be triggered by general social anxiety. Social anxiety can cause discomfort – even fear – in public places, especially places that have a large gathering of people like street fairs and concerts.

Agoraphobia can often be treated with a combination of anti-anxiety or anti-depressant medication and cognitive behavior therapy. The medication is used to control the occurrence of panic attacks while the therapy, an ongoing process of graduated exposure, deals with the root cause of the phobia. Usually doctors prescribe benzodiazepines like Valium or Alprazolam or selective serotonin reuptake inhibitors (SSRIs) like Prozac, Paxil or Zoloft. Graduated exposure therapy works just like it sounds. During the course of the treatment, the patient is gradually exposed to more and more busy public spaces, slowly confronting and overcoming his fear. By setting small goals along the road to the larger goal of overcoming the phobia, agoraphobics may be able to live with their fears if not conquer them.

Treatment should be administered under the guidance of a licensed psychological professional and with the support of family and friends. Besides actually knowing how to properly administer treatment, medical professionals know when to terminate it. Usually, agoraphobia and the panic attacks associated with it can be completely cured, and the former sufferer can cease therapy and medication. However, termination of treatment, even when well, is best done under medical supervision because the anti-anxiety medications can have side effects including addiction and withdrawal. Familiar support networks help reassure the agoraphobic of her relative safety in situations she usually views as dangerous or threatening, giving her a better shot at success with the treatment.