- Fear of Open Spaces

Fear of Open Spaces

Fear of open spaces (also know as agoraphobia) is a somewhat misleading description of a complex disorder that often develops out of an initial tendency toward anxiety and panic attacks.

This ‘fear of open spaces’ is not so much fear of the open space itself but rather fear of exposure during a panic attack, or fear that a panic attack will occur and the agoraphobic person will not be able to escape the situation. Usually by the time a person becomes agoraphobic, intense anxiety and regular but unpredictable panic attacks have been a problem for some time.

Some of the main symptoms of agoraphobia or ‘fear of open spaces’ are:

• Fear of crowds.
• Fear of public transport.
• Panic attacks.
• Restriction to one’s own neighborhood or familiar area.
• Restriction to ones’ home or inability to leave the house.
• Dependence on others due to an inability or refusal to leave the house.
• Social isolation.

Agoraphobia is an anxiety disorder that includes panic disorder. Agoraphobia can develop alone as an extreme form of panic disorder, or it can overlap with other emotional and/or mental illnesses like generalized anxiety disorder (GAD), clinical depression, post-traumatic stress syndrome (PTSD), obsessive-compulsive disorder, or social anxiety disorder.

Agoraphobia is one of a number of emotional and mental illnesses that fall under the general diagnostic category of anxiety disorders. Anxiety disorders are the most common mental health problems in the U.S. today, accounting for over 30% off all mental health expenses and costs.

Agoraphobia is one of the most crippling of the anxiety disorders. Persons who develop agoraphobia often become housebound and extremely dependent on others in order to live normally. A simple walk to the mailbox to bring in the mail can become unthinkable and overwhelming.

Agoraphobics most often start out with simple panic disorder, a condition marked by unpredictable attacks of intense fear coupled with physical symptoms such as shortness of breath, chest tightness or chest pain, dizziness, nausea, intense terror, confusion, a sense of unreality, and tingling or numbness in the hands, feet, and face.

Panic attacks look and feel very much like cardiac distress, and many panic attack sufferers make multiple trips to emergency rooms where even the doctors on hand have to run tests to make sure a heart attack is not in progress.

After one or more of these kinds of frightening experiences, some panic attack victims become so afraid of having another attack that they begin to voluntarily restrict their activities. When panic attacks begin to cause people to avoid public places for fear of another attack, agoraphobia begins to set in. If treatment is not sought, the person can end up housebound and unemployed, and primary relationships with partners and family will begin to suffer.

The good news is that agoraphobia is treatable and the prognosis for recovery is good. Treatment of agoraphobia usually involves both therapy and prescription medication.

Cognitive Behavioral Therapy (CBT) helps the agoraphobic see himself in a more realistic way, and helps ‘reframe’ the agoraphobic’s understanding of the world and the attacks so they decrease in frequency naturally.

Systematic desensitization is a therapeutic method in which the agoraphobic is exposed to very gradually increasing stressful stimuli. The exposure at each level is maintained until no fear is experienced before increasing the threat level.

The most common category of medications prescribed for agoraphobia is SSRI antidepressants. SSRI’s alleviate anxiety by increasing the amount of a naturally occurring chemical substance in the bloodstream called serotonin.

Serotonin is the body’s way of naturally maintaining a calm, stress-free state, but for reasons not yet fully understood, some people are unable to maintain healthy levels of this substance without medical help.