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Coping with Agoraphobia


In his recent memoir, Prince Harry revealed that he has struggled with agoraphobia over the years. 

Prince Harry

In his recent memoir, Prince Harry revealed that he has struggled with agoraphobia over the years. According to the American Psychiatric Association (APA), agoraphobia is the fear of being in situations where escape may be difficult or embarrassing – or the fear that help might not be available in the event of panic symptoms.

Many people think of agoraphobia as a fear of being in large crowds or being in public, but it is actually much more complex.

“The name kind of means ‘fear of open spaces’ but it is not that. It is this fear of having a physical reaction in a certain situation or a certain environment. It is possible to be agoraphobic and the fear is being afraid to be home alone because XYZ might happen, so you always need to have someone there with you,” says Joseph Siegel, an OSF HealthCare licensed clinical social worker.

As opposed to the type of anxiety people tend to feel when facing a known fear that is specific to them, agoraphobia is instead when someone actively avoids something in particular that will lead to that anxiety. And since it is specific to the individual, agoraphobia can occur for a variety of reasons. One person may experience agoraphobia when they are in enclosed spaces like elevators, while another may experience it in open spaces like parks or concerts. Some people may have agoraphobia that occurs when they are around other people, while other people may have it when they are alone – and the list goes on.

Although agoraphobia tends to happen in individuals who have experienced a panic attack at some point in their life, Siegel explains that the symptoms are not the same as a typical panic attack.

People who have experienced a panic attack typically describe it feeling as though their heart is racing or like they are having chest pain or trouble breathing. The symptoms of agoraphobia, however, may include dizziness, confusion, or a fog-like feeling while you are experiencing it. According to the Anxiety and Depression Association of America (ADAA), someone with agoraphobia might feel constantly on guard, waiting for the next panic attack – rather than as they might feel when they are actually having one.

Agoraphobia is complex and can be hard to fully understand, especially for someone who has not experienced it. Many times if somebody has a loved one who experiences agoraphobia, they may try to convince their loved one to just “face their fears” and if they simply do that, nothing will go wrong and there is nothing to be afraid of. Siegel says this mindset is not helpful for someone with agoraphobia and it may even add to their anxiety.

“One of the dilemmas – especially early on when people are first experiencing this – is that even if they would be happy to face their fear, they don’t know what it is. They don’t actually know what’s causing this thing. They don’t know what causes it the first time, and there is a bit of confusion about what is causing it now,” Siegel explains.

Because it is hard to pinpoint the root cause of the agoraphobia, it can be difficult to try to describe it to someone else. Some individuals are even able to hide their agoraphobia, which is why people are surprised to learn that someone they love or even a celebrity in the spotlight has struggled with it. If you or someone you know experiences agoraphobia, the good news is there are ways to cope with it.

“People who have it manage it in all kinds of ways,” says Siegel. “Celebrities who reportedly have this probably manage it just like anyone else would manage it. They kind of set themselves up for success. They also may avoid those things that they know are going to cause them to possibly have a reaction.”

Siegel advises individuals with agoraphobia to try methods like deep breathing, some sort of muscle relaxation technique, or other cognitive approaches that help with mindfulness or focusing.

“Sometimes people do subtraction problems in their head. I like to have people say the alphabet backwards, which is another thing you kind of have to focus on because it is hard to do. It’s all about trying to get your brain to reset on something else other than the fact that this thing is happening that you may not be able to control,” Siegel says. “The thoughts kind of drive it forward, so refocusing the thoughts it super important. At the same time, you try to regulate your body a little bit.”

Having a companion who is aware of the agoraphobia is also important – someone you can trust, share your feelings with, and lean on for support.

If not managed properly, agoraphobia can significantly impact someone’s ability to function on a day-to-day basis. In some cases, medication can be recommended to take in combination with a mindfulness technique.

If you or a loved one experiences agoraphobia and you think you might need help coping with it, talk to your healthcare provider or a mental health professional.

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