Agoraphobia goes well beyond “can’t leave the house”. In this episode, let’s examine the nature of agoraphobia. We’ll talk about:
- What agoraphobia really is
- What it isn’t
- How it develops
- The impacts of agoraphobia
- Recovering from agoraphobia
Most people will say that agoraphobia is that thing where you can’t leave your house. Others will say that agoraphobia is the fear of open spaces. Kinda. I mean, agoraphobia looks like that for sure, but that’s not really what defines this particular problem.
Agoraphobia is not a special disorder or a new kind of anxiety. Agoraphobia is simply what happens when your fear of panic and anxiety symptoms drives unchecked avoidance. That avoidance – designed to keep you away from the anxiety you fear – makes you shrink your life by bit so that the only “safe place” left is your house. So while an agoraphobic may indeed be afraid to leave the house, that is not what defines the disorder.
The important part is being afraid of panic and anxiety, and living a highly avoidant life as a result. THAT is agoraphobia!
Agoraphobia is most often the result of a common sequence of problems:
Panic attack –> Panic attacks –> Panic disorder –> Avoidance –> Agoraphobia
In the vast majority of cases, agoraphobia exists alongside and is born out of panic disorder. There is a reason why “panic disorder with agoraphobia” is a common diagnosis.
Nuances and Variances in Agoraphobia
Some agoraphobics can leave the house, but only if they remain in the car or within visual distance of the car. The car becomes an extension of their safe zone.
Many agoraphobics will leave the house – sometimes without much in the way of restriction – as long as they are with a designated “safe person”. These are people that we have decided can save us from panic and anxiety, or can talk us down when we need them to.
Some agoraphobics wind up not only stuck in the house, but stuck in one room in the house, or even on one piece of furniture in the house. For these people, a simple trip to the bathroom becomes an anxiety producing challenge.
Impacts of Agoraphobia
Social isolation. Agoraphobia results in isolation from friends, family and social support systems. While technology has made it easier to be agoraphobic, technology does not provide a long term substitute for actual human contact. The isolation that comes from agoraphobia is a real problem, even in the Zoom age.
Loss of independence. Agoraphobia will make you dependent on friends, partners, family members, and even strangers (i.e. the Door Dash driver) to handle simple life tasks. Ordering groceries online because it might be convenient is very different than ordering groceries online because you are terrified to go into a supermarket.
Strained relationships. Dependency on friends, family members and life partners can really place a strain on those relationships. Refusing to engage in the activities your loved ones want to participate in strains relationships. Being highly dependent and attached to loved ones based no on love, but on a drive for safety, can place burdens on loved ones that lead to relationship strain.
Complicating life. Trying to engineer the details of everyday life to avoid typical life tasks and/or anxiety makes life very complicated. “Normal” people do not have to engineer daily life the way an agoraphobic does.
Mental and emotional exhaustion. A complicated life full of complex logistical engineering i the name of avoiding anxiety and panic symptoms can wear you down. Agoraphobia will result in mental and emotional exhaustion. Retreating to a safe space and trying to never feel afraid is hard work, and it will fatigue you over time.
Are you afraid to be left alone? Not alone in a relationship sense. I mean literally alone. Like alone in your house, or alone in your office. Are you afraid of this? If so, you are not alone. Not by a long shot. Informally termed “monophobia”, being afraid to be physically alone for more than a few minutes is a VERY common component of the panic disorder/agoraphobia complex. Monophobia is simply another expression of your fear of panic and anxiety. It’s not a new or special problem. It’s just another manifestation of the same problem. Being left physically alone becomes unacceptable when you are sure that you need someone to “save you” from the symptoms, sensations, and thoughts that come with anxiety, fear, and panic.
Recovering From Agoraphobia
Good news! You can solve this problem.
Better news! You will also solve your panic disorder and monophobia problems at the same time.
Not so good news. The solution involves doing scary and difficult things on a regular basis. The solution is based on intentionally experiencing the anxiety and panic that you fear so much.
Recovery from agoraphobia (and therefore panic disorder and monophobia) requires learning a new non-reactive default response to anxiety, panic and fear, then using that new response while intentionally doing the things that trigger the anxiety you fear so much. Recovery does not happen in giant leaps forward. It happens in tiny steps taken repetitively and consistently while incrementally increasing the challenge level as you go.
Recovery from agoraphobia is based on one thing. Learning that you do not have to be afraid of panic, anxiety, and baseless fear. You’ve learned to fear your own body and thoughts. Now you will un-learn that fear. As a result, you will teach your brain to turn down the false alarms it has been sounding for so long. You are not learning to be in the supermarket of to drive on the motorway. You are learning how to tolerate and navigate anxiety and panic so you can learn experientially that you do not have to like them, but you do not have to fear them.
Recovery is hard!
This is true, and I will always acknowledge it. Intentionally being afraid and uncomfortable is not intuitive or instinctual. Being afraid requires courage. It is tiring. It is challenging.
Remember though, that difficult does not equal impossible. You are courageous. You are capable. You CAN tolerate fear and discomfort. Most things worth doing in life are challenging. Agoraphobia is no exception. This is hard, so be kind to yourself and acknowledge what you are doing along the way. But you CAN do hard things.
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Intro/Outro Music: "Afterglow" by Ben Drake (With Permission)
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