Agoraphobia

What is agoraphobia?

Agoraphobia is an anxiety disorder; in the public mind this is thought to be the opposite of claustrophobia and so should be a fear of open spaces. But this isn't quite right. Agoraphobia is the fear of crowds of people. The word comes from agora which is the Latin for marketplace, and it is the bustling crowds that we see when out shopping or travelling that are scary.

There seem to be two underlying beliefs that cause agoraphobia:

• the world is an unsafe place and that you won't be able to cope out there, that if something were to go wrong you would be lost and alone and no-one would come to your assistance, and you feel isolated and alone when you are away from home.

• the world is a hostile place full of judgemental people who will laugh or mock or point at you, and you feel watched when you are away from your place of safety.

Agoraphobia can be accompanied by panic attacks which are a sensation of fear, a feeling of loss of control and a desire to escape. If you become panicky at the thought of having another panic attack then this might be panic disorder which is the unpleasant fear of having another panic attack. These feed into each other - if you were to have a panic attack when out by yourself then you are going to scared that people will either not help you or will laugh at you, which makes the thought of risking going out more scary which in turn makes panic attack more likely. This sort of vicious circle, with self-fulfilling prophecies are common when suffering from anxiety.

Special considerations for getting treatment

Getting treatment for agoraphobia can be scary as it means leaving your safe place, and putting yourself in the gaze of someone you believe might be unsupportive or judgemental; we can do whatever we need to get you going, including a home visit or two. And if you have Skype, then online counselling is possible (but it's not as good).