I'm afraid to go outside, or agoraphobia - how to overcome fear?

Fear experienced in open places or when going outside is experienced emotionally by a person. Agoraphobia with panic attacks is treatable.

The fear of going outside is often accompanied by symptoms such as a panic attack, which is in one way or another associated with direct changes in the nervous system. Therefore, when determining the correct direction of treatment for anxiety conditions, high-quality differential diagnosis comes to the fore.

Brain Clinic specialists have extensive experience in treating agoraphobia and various disorders of nervous activity that cause fear and panic attacks. Our doctors will be able to correctly and safely restore the body’s functioning without any side or negative effects on it.

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We help in the most severe cases, even if previous treatment did not help.

Fear of going outside - what is the name of the phobia?

This phenomenon was first mentioned by Karl Westphal at the end of the 19th century. A German psychiatrist described the state as panic when required to contact a crowd or be in an open, uncontrolled space. The word agoraphobia comes from the Greek "agora" and "phobia", which means public place and fear.

In fact, the fear of leaving the house is an unconscious defense mechanism formed in front of unfamiliar places and people. The symptom has a basis - emotional trauma. The panic type occurs when the client gets to the place where he previously experienced an attack.

By the way, until the end of the 20th century, most psychiatrists were sure that the fear of going outside was only a symptom of anxiety. But gradually the phenomenon was identified as a separate disease.

The first fear is the main anchor

The complexity of a phobia is that even an experienced psychotherapist is not always able to discern where the roots of the problem lead. But when it comes to VSD sufferers, then in the overwhelming majority of cases the trigger is the most common panic attack, which for certain reasons did not occur at home at the usual time, but in public. And it was a real nightmare: there were no household members or a life-saving first aid kit nearby, everything around was unusual, and most importantly, there was a clear realization - this is how I will die among these strangers, no one will help me, they will only discuss and laugh.

The subconscious mind remembered this panicky conclusion and decided that a public place or just a street was a deadly place. This is how the main anchor appeared. As soon as you move it, the clear bottom of the soul becomes cloudy and frightening. Having returned to this place again, the VSD student will subconsciously understand: death is somewhere nearby. And nature, which protects its creatures, will never allow this stupid death. Adrenaline will immediately begin to release, the heart will pound furiously, and the person will feel the rush of insane panic. It’s as if the body itself is screaming at him: run away, run before it’s too late!

Having succumbed to his fear several times, the VSD worker tightens his anchor more and more, and one day he realizes: the fear of leaving the house has become so strong that, perhaps, it will soon leave him without friends, travel and a job.

There are other causes of agoraphobia that do not depend on whether a person has VSD. These include hereditary factors, childhood psychological trauma, the effects of taking certain medications, and even a person’s specific personality type. But whatever the reason, is there a chance to independently eradicate this terrible phobia that has narrowed your life to the size of an apartment?

Where does fear and fear of the street manifest itself?

Most often, agoraphobia occurs:

• at a bus stop when there are a lot of people;
• near train stations, airports;
• if necessary, leave the house alone, on a deserted street;
• in public, before or during a performance;
• if there are unpleasant personalities around who can negatively evaluate the client’s actions;
• when there is no way to defend yourself, leave the unfavorable area quickly.

If a loved one is close to the person, then panic attacks do not occur.

Causes of fear

When there is a fear of leaving the house, the main reasons for this are:

• Alcohol abuse, drug use. They destroy the brain and psyche.
• Psychological trauma. In this state, all fears, doubts, and complexes increase, provoking an attack. The client's own insecurity distorts the client's reality.
• Genetics. A fifth of people suffering from agoraphobia have a characteristic heredity.
• Increased mental excitability. People prone to fear experience not only fear of crowds, but also other phobias.
• Uncertainty. Many complexes force people to hide from reprehensible glances and words from the crowd. The phrase “I’m afraid to leave the house” speaks of an unwillingness to overcome one’s complexes.
• Disability. For such persons, the home acts as protection against danger outside it.
• Childhood fears. Impressionable kids cultivate fears and transform them into phobias. One of these is the fear of the dark. Against the background of the existing condition, fears and phobias grow.
• Failure of biological processes in the brain. Increased anxiety disrupts mental regulation, there is an imbalance in reflex activity, consciousness loses control, the client develops fear of crowds, and is afraid to go out.
• Existing similar emotional anomaly. If a client has acquired a similar pathology, then others develop against its background.
• Fear of death. Being fixated on not dying prematurely makes you see the outside world as a potential threat.
• Exhaustion of the nervous system. It occurs during a protracted conflict at school or at home, when the nervous system is constantly tense.
• Constitutional factors. When an unpleasant incident occurs, for example, a traffic accident, one person forgets about it over time, another begins to be panicky afraid of such places and transport.
• Intrapersonal conflict. In childhood, traumatic situations do not disappear; they gradually develop into dialogues with one’s self. Subconsciously, the client tries to protect himself by replaying different scenes, plots, exhausting the nervous system, acquiring fear of going out.
• Skull injuries.

Diagnosis of agoraphobia

The feeling of fear experienced by a person in open places or when going outside is defined in medicine as a phobia and is one of the signs of a violation of the biological processes of the brain, a violation of mental regulation. Today, it is not uncommon to hear or read on the Internet:

"Help! I'm afraid to go outside! When going outside, panic begins. I literally start shaking. I wanted to go to a psychologist but I’m afraid to go out. I'm afraid to tell my boyfriend. He will laugh. I'm already tired. I don’t even want to live.”

For a person, going outside into a large and open space from a protected space (my home is my fortress), the absence of “protective means” nearby, from birth is a stressful situation, which he gradually expands over time. The first stress is the moment of birth. Then the child is afraid to go alone into another room, then from the apartment onto the street, then into the neighboring yard, into another district, into another city, country, etc. It is for these reasons that the child reflexively hides under the blanket or under the bed, climbs into the closet out of fear, thereby, as it were, trying to return as close as possible to the safest space around him - “in his mother’s tummy.” Whenever a person expands his security space, he always learns to control his own security reflex. The first step is always accompanied by a feeling of fear, to one degree or another, from slight excitement to minor worries - this is normal.

In people with increased anxiety, this fear of open, large places, unfamiliar streets, is expressed more emotionally. But in the absence of violations of the biological processes of the brain, a person is able to independently, with the help of the efforts of his own will, cope with the feeling of fear of unfamiliar open places or streets, thereby expanding his own space of safety. When biological processes in the brain are disrupted, the balance of consciously controlled reflex functions is disrupted, and previously acquired skills in overcoming the feeling of fear of unfamiliar open places and streets are lost. Most often, this fear is accompanied by an imbalance of higher nervous activity with the peripheral nervous system, which is expressed in a variety of manifestations and sensations, such as: increased pulse (heartbeat) and blood pressure, feeling of heat, weakness in the legs, loss of orientation, etc., which is very often qualified by various people as VSD (vegetative-vascular dystonia). A feeling of fear in open places and on the street can often turn into panic, which is popularly called a “panic attack.”

Manifestations of agoraphobia with panic attacks

Patient: Male, 27 years old, unmarried, no bad habits, does not work, vocational education, lives with parents. I turned to a psychiatrist, psychotherapist (psychotherapist) on my own, after a correspondence consultation on the Internet. He described his condition as follows:

“At the time of leaving school, after final exams, I was 16 years old, I had

Various fears began to arise when going outside. At first it was a fear that I could overcome and struggled with it myself. But I was advised to see a psychologist, who talked to me, but nothing changed from that. Time passed, and this fear began to bother me, I decided to turn to another psychologist, then to another one. They began to give me different diagnoses - “panic attacks”, “anxiety disorder” and something else, I don’t remember exactly, everyone gave their own diagnosis. But no one really helped. More and more often, panic attacks began to occur when going outside, which were accompanied by fear of going crazy, fear of death, fear of dying from the fact that the heart would stop during an attack, lack of air, increased blood pressure, weakness, chills, “hot flashes” or sudden cold. In a state without attacks, I felt very lethargic, overwhelmed, and lost all interest in anything.

I became afraid to go out and go to the store. Before, before I was 16, I never had this. I have been playing football for myself since childhood. In life, I am a very emotional and impressionable person. During panic attacks, an ambulance was called for me on the street 2 times. I'm afraid I might lose consciousness and die. As a result, I ended up in the hospital with a diagnosis of “VSD of the hypertensive type.”

Four long months of examinations by a neurologist led to nothing. Blood tests were normal, an ultrasound of the heart showed mitral valve prolapse, but according to the doctor, it could not cause such conditions. Ultrasound of the abdominal cavity: kidneys and other organs are healthy. The neurologist advised me to take a picture of the cervical vertebrae. It turned out that I have early stage cervical osteochondrosis and there are vertebral displacements. He recommended a number of medications and referred him to a chiropractor, who said that in addition to his treatment, he needed to see a psychologist.

I went to another psychologist, with a referral from a neurologist. After listening to all my complaints, the psychologist said that it was “Panic Disorder” and I needed to take 20 classes with it. Despite the fact that I feel a sense of fear on the street, I agreed to come to a psychologist, since he said that it is necessary to overcome my fears and train my nervous reactions. I went to all 20 sessions with a psychologist, completed the prescribed course of treatment with a chiropractor, but nothing helped. The neurologist again suggested that I go to the hospital, but I refused because... I no longer saw the point in these endless treatments that did not help me. During all these treatments, on the contrary, I became even worse, and in an unfamiliar place I began to feel 10 times worse than at home.

I have added a fear of open spaces - “agoraphobia”; I practically haven’t left the house for a long time, because... On the street every now and then I was overtaken by panic. I had to quit my job and now I can’t play football either, because... With any physical activity, the head begins to feel very dizzy, a state of lightheadedness and stunned consciousness arises. I don't work because... I feel very bad. I can leave the house, for example, I can freely go to a neighbor’s house, or go by car to visit someone. I’m afraid of being on the street or in large open spaces. Afobazole was recommended on one forum. I took it for a month, it got better, but it didn’t go away completely. Perhaps the fear becomes a little less, but the nausea and dizziness do not disappear. I had to take more Afobazole for it to work. Then I read that afobazole is addictive and stopped taking it. After that it got even worse.

Now there is a fear of going outside, a fear of open spaces, anxiety, panic, and nervousness, the joy in life has disappeared, and I have begun to find less positivity in everything.

I have been undergoing treatment for more than 11 years, and still without results, I am so tired of living in this nightmare. Every night I wake up, go to the window, and it seems to me that I’m going to die soon, I’ve lost interest in life, I don’t want to do anything for myself.”

Based on the results of a pathopsychological examination, a psychotherapist identified a manifestation of anxiety-depressive syndrome, complicated by autonomic dysfunction.

It was proposed to undergo an outpatient course of intensive complex therapy according to an individual scheme with daily visits to the day hospital. But at the patient’s insistence, due to the difficulty of going outside and the fear of large spaces, he was hospitalized to avoid forced movements around the city and going outside. After 7 days he was discharged from the hospital in satisfactory condition. Agoraphobia with panic attacks was not pronounced and the patient could cope with it independently.

He was transferred to a day hospital, where he continued the complex therapy he had begun under the supervision of a psychotherapist. I visited the clinic every day for a month. During this period, I was able to find work and moved freely around the city. Treatment continued on an outpatient basis, with visits to a psychotherapist once a week.

Treatment continued for a year. During this period, the patient fully recovered and his quality of life significantly improved, and he changed his job to a more attractive one. Observed for three years. During this period, no deterioration of the condition was observed.

Most people, unfortunately, believe that the manifestation of agoraphobia is fiction, and panic attacks are whims or a manifestation of bad character that needs to be educated and overcome, sometimes by violent means. Others, who believe that this is a psychological problem and can be solved by educational measures, turn to psychologists.

Panic attacks

Based on the theory of the development of fear of going outside on your own, there are two directions:

1. Proponents of this view think that agoraphobia has a primary fear of helplessness in the face of large spaces that causes attacks.
2. Followers of the second idea are confident that the basis of the pathology is a panic attack, formed into a phobia. The fears experienced reinforce and strengthen the primary branch, paralyzing the will, and provoking attacks.

Panic attacks occur spontaneously, a person is afraid to go outside, he does not understand what to do, reinforcing the real danger many times over with the subconscious. Fear of death or madness occurs. A type of attack similar to a vegetative crisis is characterized by the appearance of anxiety and pain of a different nature.

If reality becomes blurred, the client panics, becomes hysterical, screams, and asks for help. In severe cases, seizures occur. The duration of the unconscious process is about 15 minutes, less often half an hour. Attacks are more typical for suspicious people.

How to get rid of agoraphobia

The use of drug therapy alone to treat fear of open space is unpromising, although in the initial stages, the doctor may prescribe sedatives (calming agents) and certain antidepressants to alleviate the condition. They help reduce overall anxiety levels. But if you limit yourself to only this method of treatment, soon after stopping the drugs, attacks of fear will resume with the same force, which is explained by the preservation of the internal mechanisms of phobia formation. It is possible to free yourself from fear with the help of psychotherapy.

Treatment of agoraphobia may require the use of several psychotherapeutic techniques. A competent and experienced doctor combines them, helping to control panic attacks and gradually eliminating the cause of anxiety. Specialists use exactly this approach and individually select a psychotherapy regimen.

The treatment of agoraphobia is usually based on rational and cognitive-behavioral psychotherapy, supplemented by various relaxation techniques. A person with a fear of open space is taught controlled breathing, special exercises to relax the body, auto-training and visualization. In some cases, the doctor uses classical or Ericksonian hypnosis to quickly reduce the severity of panic attacks. And long-term therapy can be supplemented with psychoanalysis and other psychotherapeutic techniques.

To make an appointment with a psychotherapeutic specialist, you can use a special form or contact the administrator yourself using the phone numbers provided at the top of the page.

Main signs of street fear

The fear of going outside is reflected by the following signs:

• Anxiety. As the disease progresses, fears take on new colors; the client is even afraid of what is happening in his thoughts. He invents many scenarios and plots of events for himself, driving himself deeper into his own cage of hopelessness.
• Cardiopalmus. A panic attack feels like a claustrophobic attack. The client panics, loses his bearings, sweats, his heart rate increases, and it becomes difficult to breathe. This condition occurs when the home is abandoned and there is unprotected space around.
• Difficulty breathing. Characteristic of panic attacks. Violation of the correct rhythm leads to panic of a hypochondriacal nature. The person is afraid of suffocating and loses control.
• Weakness of muscle structures. Occurs during prolonged emotional stress. Apathy begins, the person loses strength, he ceases to be interested in what is happening around him.
• Nausea. This symptom clearly shows disgust, rejection of life. Tablets are powerless. The condition normalizes on its own after treatment of the underlying cause.
• Obsession. The slightest problem becomes an insoluble tragedy. The client considers himself a failure, a leper.
• Feeling hot. At the moment of panic, the face turns purple, a surge of warmth is felt, blood pressure and pulse rise. Against this background, noise is heard, ringing in the ears, sweat appears.
• Pre-fainting state. Severe dizziness can cause fainting.
• Cramps. When there is strong fear and panic, a person begins to shake when going outside, and short-term convulsions occur.
• Losing your bearings. The client does not remember where he came from, does not understand which direction to move in order to find protection.
• Stomach upset. It may manifest as diarrhea or, conversely, constipation. It occurs due to stress.

The fear of going out is psychologically manifested by the fear of having an attack in public, losing your mind, losing control, depression, constant obsessive anxiety, and low self-esteem.

Treatment of agoraphobia

When there is a fear of leaving the house, each case requires an individual approach, drawing up a treatment regimen. Apply:

• Drug treatment. Helps to temporarily stabilize the emotional state so that he can overcome the disease.
• Psychotherapy. It can be individual or group. Helps to stabilize the mental background, identify the problem, and learn to look at the current situation from the other side.
• Hypnosis. Used to identify the cause of the development of a phobia, if this cannot be done by other methods. Also, with the help of hypnosis, a specialist can give the necessary commands to correct the client’s behavior.

Ways to cope with fear on your own

Most often, clients ask the psychologist the following questions: why they are afraid to go out, what is the name of the disease, are there ways to solve the problem on their own. Better at the time of attack:

• Calm down, look at the potential threat as an outside spectator.
• Be close to your loved one. This will help you gain confidence.
• Try to get distracted and talk to people.
• Normalize breathing. Taking a deep breath and exhaling the same way relaxes the muscles and calms you down.

When the fear of leaving the house is strong, then training begins in a comfortable place. Having taken the necessary medications, you should mentally leave your home step by step. When you feel an attack approaching, you should calmly return home. Daily activities gradually expand the permissible territory, the person decides to take a real action.

Symptoms - how does fear manifest itself?

The manifestation of the disorder is characterized by the emergence of an incomprehensible, previously unexperienced fear at the moment of leaving one’s home. A person is seized by severe inexplicable anxiety, which is accompanied by intense autonomic failures. As soon as the person goes outside, she feels a trembling in her body. Her legs give way, her limbs get cold. She finds it difficult to take a full breath. He feels a squeezing headache and a feeling of heaviness in his chest. The heart rate increases. There is a urge to urinate. The body becomes covered with cold, sticky sweat. There may be a feeling of unreality of what is happening. The person loses touch with reality, does not understand where he is, what time it is.

These unfamiliar, extremely unpleasant sensations are alarming and frightening. Unable to give a correct interpretation of what is happening and attaching enormous importance to symptoms that arise unexpectedly, a person becomes convinced that “it is not safe to be outside the home.” Such a stereotype is firmly fixed in the subconscious and begins to control the behavior of the individual. These attitudes work proactively, trying to protect a person from repeating a painful episode. A warning mechanism is activated: the individual stops going outside his home.

At the same time, the person is seized with real horror only at the mere thought of being outside the apartment. Symptoms of panic arise already when anticipating leaving the house. To be in a comfortable living space, a person takes decisive steps. For example, he gives up a prestigious position and starts working from home. Making ridiculous arguments, he negotiates with his relatives to supply him with food and medicine.

Voluntary seclusion negatively affects the social sphere. The person stops communicating with friends and does not make new acquaintances. Refuses to attend sports clubs. Doesn't go to cultural events. Doesn't go outdoors, doesn't travel. The outcome of such isolation is an even greater aggravation of anxiety and the emergence of fears with a new plot.

Methods to combat phobias

The phrase I'm afraid to go outside speaks of an internal personality conflict. To get rid of this condition, you should distract yourself:

• shopping. Purchasing things relaxes and gives a lot of positive emotions;
• buying a dog. You need to walk the animal, which will force you to leave your home;
• chat with friends. A meeting of relatives is arranged near any convenient area except home;
• picnic. Fresh air, loved ones, relatives will help you cope with the problem;
• child therapy. Little toddlers are full of energy and cheerfulness. Therefore, communication brings pleasure and helps to find meaning in life.

Recommendations from psychologists for eliminating fear

Experts in this industry advise those who say “I’m afraid to go outside” to a number of methods to solve the problem:

• Autotraining. A sensible analyst can easily assess the usefulness of a walk. A mental comparative table of the advantages and disadvantages of the action is compiled, and the correctness of the actions is assessed.
• Method of rejection. This is a workable solution. The main thing is to remove the “stop” within yourself, stepping over panic and anxiety.
• Yoga. Helps you find inner strength, learn to control your actions, thoughts, and relax.
• Visiting a psychotherapist. When the disease is advanced, it is difficult to find a way out on your own. Visiting a specialist will help.

Many people wonder what the fear of leaving the house is, what the disease is called, do people really experience panic attacks? This is a serious mental disorder that requires treatment. With delayed help, complete isolation from society and degradation occurs. The right solution is to contact the psychologist-hypnologist Nikita Valeryevich Baturin. By writing on the official VKontakte page, the client will be able to return to normal life, freed from fear.

Risk group

Studies have shown that the fear of open doors, whose name is agoraphobia, is more often found among residents of urbanized cities and big cities than among residents of quiet, calm rural areas. Women are also more prone to this disease than men. This is explained by the fact that they are more susceptible to scrutiny and condemnation from society. Moreover, ladies prefer to see a doctor, while men, not knowing how to get rid of agoraphobia, try to drown their problem in alcohol.

People who are psychologically and somatically weakened are more prone to agoraphobia. And also those who have arrhythmia, asthma, epilepsy, hyperthyroidism or hypothyroidism. What is noteworthy is that almost all patients with agoraphobia have problems with orientation in space. Perhaps dysfunction of the vestibular apparatus is also a cause of agoraphobia. Loss of orientation in space appears due to an unclear perception of the environment (large area, crowd).