I'm afraid to go outside due to panic attacks

“I’m not against shopping and meeting friends, but lately I hardly leave the house. I prefer to get to work by taxi - it’s faster and safer. Minibuses, metro and noisy crowds - all this is a thing of the past and, apparently, forever. I won’t be able to become a normal person anymore.”

Interestingly, there are more and more similar messages on forums. Why, living in such a civilized century with high technology and excellent doctors, are people increasingly afraid of each other and seriously experience suffocation and tachycardia in public places? The most frequent victims and hostages of their fear are, of course, VSD soldiers. After all, they are endowed with a special nervous system in which phobias feel comfortable, like fish in a pond. Is the situation really hopeless?

What is the fear of going outside called?

The word “Agoraphobia” itself means “fear of open space ,” that is, fear of leaving the house. Fear that people cannot control. When behaving adequately indoors or in an open space, a person suddenly begins to get lost and panic. Such a pathology can put an end to public and private life, which is why it is worth studying the origins of its occurrence, trying to overcome the phobia.

Agoraphobia in psychology

The term "Agoraphobia" comes from Greek literally translated as fear of the place where the market is located . Psychologists interpret this phobia as a fear of open doors, fear of open space and crowds. This is a neurological disorder that appears in an individual as a result of certain childhood traumas, central nervous system disorders, stress, due to the participation of other people. Agoraphobia is a subconscious defensive reaction of an individual to walking through a spacious square or street with a huge concentration of people.

A person suffering from this disease may be afraid of unforeseen actions due to the presence of a crowd around. For the first time, German neuropathologist and psychiatrist Karl Westphal spoke about what agoraphobia is. He described this disease in detail and clearly in his general scientific work “Agoraphobia, a neuropathic phenomenon.” For this experiment, Westphal observed three men who had the fear of agoraphobia, although it later turned out that it was women aged 15-35 years who suffered more from this illness . And especially if the person is overly sensual and perceives everything closely.

What is agoraphobia - obsessive fear or neurological pathology? The issue remains controversial . There is an opinion that one of the primary human instincts is fear, but it is just a function for self-preservation, embedded in the subconscious. Pathology is something else associated with a deviation or dysfunction of the nervous system. A phobia is an obsessive state of an individual caused by fear of something that, in principle, is not dangerous.

Fear of large spaces is no less common than claustrophobia.

Some are able to control themselves more, engage in their profession, communicate with other people and generally function as a full-fledged person. But at the sight of a new area and a huge expanse, uncontrollable people, signs of agoraphobia appear from the subconscious . Others see problems even in mundane things like going to the store or walking down a busy street. Most often, agoraphobes lock themselves in their “cage” and thus run away from the external environment.

Agoraphobia in psychiatry

What is agoraphobia in psychiatry? Modern doctors attribute to the concept of agoraphobia not only the fear of open, spacious places and crowds. This pathology most often covers other fears, for example, fear of performing, panic attacks, and social phobia. Some psychologists argue that a phobia of open doors can arise in a person since childhood due to excessive family protection. In such cases, it is hammered into children’s heads that potential danger awaits them outside the home.

In adult life, such upbringing entails a list of mental and neuropathic problems, including agoraphobia. For example, when an elderly person suffers a heart attack or stroke, he is always overcome by the fear of not being rescued in a timely manner and being left without medical care outside the home. Neurologists define agoraphobia according to ICD-10; these are criteria that serve for correct diagnosis.

General information

Agoraphobia is a persistent, inexplicable fear of being in a crowd, in open space and in other places that cannot be left unnoticed when a panic attack develops, a manifestation of helplessness or “loss of face”, supposedly confirming the patient’s unforgivable weakness or his failure to meet standards of behavior in public.
Can be observed with panic attacks, panic disorder, generalized anxiety disorder, social phobia, other mental illnesses, neurotic and borderline disorders. Patients suffering from agoraphobia cannot use public transport, cannot get to their place of work, and in severe cases cannot leave the house at all. This severely limits their professional and social opportunities, as well as their personal relationships with others. Agoraphobia is one of the most severe phobias and often leads to disability. Treatment of agoraphobia is carried out by specialists in the field of psychology, psychotherapy and psychiatry.

Agoraphobia

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).

Is there a treatment?

Due to the fact that phobias are purely psychological in nature (i.e., they are not associated with brain dysfunction or other physiological reasons), they can be treated with psychotherapy. However, if panic attacks are too severe, additional measures may be required (in particular, taking medications in the early stages of treatment).

To heal from the fear of large spaces, a specialist must establish the true cause of its occurrence - this could be a traumatic situation experienced in the past, or a hidden manifestation of social phobia, or a symptom for obtaining secondary benefit (an excuse not to go to work, not to take responsibility, etc.). d.). One way or another, in getting rid of the fear of open spaces, the main task for a specialist is to isolate the essence of fear.

Of course, as in any psychotherapy, giving a guarantee of cure may be too presumptuous and hasty. It all depends on the depth of the particular case. However, we should not forget that the success of any work with a psychotherapist is determined precisely by the work - that is, by the joint efforts of the client and the specialist, and not only by the efforts of the latter. The desire to get rid of fear, openness and faith in your own healing are the key to successful recovery.

One of the specialists who can help in a situation of phobia is psychologist-hypnologist Nikita Valerievich Baturin. Thanks to psychological in-depth study, in 5 sessions you will completely get rid of your problem.

Reasons for fear of leaving home

The fear of leaving the house can only be overcome if you know the nature of its formation, otherwise all the efforts made will be in vain.

Numerous studies confirm that fear of going outside is caused by the following factors:

1. Genetic - a significant number of specialists in mental disorders are confident that a large number of neurotic disorders are hereditary in nature, which manifests itself in the presence of certain pathological genes. Based on the results of their research, we can conclude that 20% of those who suffer from agoraphobia received this problem from their immediate family - parents, grandparents.
2. Increased anxiety - there are people who worry about any reason, for them going outside is already a feat. They create a kind of “world” around themselves, which they categorically refuse to leave, hiding in it, like a snail in a house.
3. Uncertainty. Most people are subject to one or another complex, but if self-doubt “takes precedence” over other priorities, then patients suffering from agoraphobia try not to go out at all. Those who still decide to leave their native walls see condemnation at their own expense in every passerby. This phenomenon is usually encountered by young mothers after childbirth, as well as women who find it difficult to control their weight.
4. Disability. People with physical disabilities often close themselves within four walls because this is how they feel safe. For them, the street is a “territory of increased danger,” both physically and morally.
5. With the deepening of stress - the banal fears of children, for example, the fear of a dark room, as a result of the stress suffered in adulthood, develop into phobias, as a result of which the expression: “my home is my fortress” takes on a literal meaning.
6. Low socio-economic status. In this case, a person is afraid of becoming a laughing stock in the eyes of more successful people. The fear of leaving the house is primarily due to the reluctance to see a higher standard of living around oneself. And instead of trying to improve his financial situation, he will most likely lock himself in his “house”.
7. Experienced man-made accidents or disasters. If in the past a person was a participant or witness to any accident or disaster, he may no longer want to go outside. After suffering stress, such people often become hermits, and this is the only way they feel comfortable
8. Addiction. We are not talking about alcohol or drug addiction, these vices, on the contrary, push people into the bitter cold at -25 and in the heat of + 45 degrees to look for alcohol or drugs, but about the game of mania, in which contact with reality is often lost.
9. Collateral effect. Some of the phobias are intertwined and the resulting fear leads to a fear of leaving the house.
10. Fear of death. No mentally healthy person wants to say goodbye to life ahead of time. However, sometimes the fear of death becomes an obsession. People who fear death every second are simply trying to build a fortress in their home. For them, leaving home is equivalent to losing their life.
11. Intimidation. Let’s exclude real threats from third parties, since in this development of events the fear of going out is considered completely justified and is not considered a pathology, an individual is simply afraid for his life and health. This refers to cases where parents outside the home forbid their children to communicate with their peers and intimidate them by inventing various terrible stories. In adolescence, and even in adulthood, such people consider the street a threat.

There are many other reasons behind the fear of leaving the house. With this phobia, a person deprives himself of the possibility of contact with the outside world, including self-realization.

There are a number of obvious reasons why there is a fear of open space, which is called agoraphobia. Namely, long-term use of tranquilizers, antidepressants, sleeping pills, excessive addiction to alcoholic beverages, drug-containing substances, war, health problems.

Many neurologists argue that it is a panic attack that entails agoraphobia and is its root cause. During a panic attack, a person can lose their mind and find themselves in a very frightening situation. Panic appears suddenly and can last about 10 minutes, less often up to half an hour. At the time of an attack, the patient’s body produces a huge release of adrenaline into the blood. The more often such relapses occur, the more difficult it is for the patient to cope with his problem.

Features of the violation

People suffering from agoraphobia are terrified of going outside.
Agoraphobia describes several situations in which a person experiences pathological fear. This is a serious disorder, which is identified in the ICD as an independent disease. Agoraphobia is accompanied by severe panic disorder, but can manifest itself with varying intensity. In this case, the disease code is F40.1. If the patient does not experience panic attacks, the disease is designated by code F40.0.

Agoraphobia manifests itself:

• fear of open space;
• panic attacks in public places;
• fear of crowds;
• fear of open windows and doors;
• fear of going out.

The fear of open space is characterized by panic attacks in situations where a person is forced to leave the safe walls of his home and cannot return home at the first need. This can manifest itself when traveling on public transport, when visiting shops, markets, squares and any places with large crowds of people. Some cases of agoraphobia are manifested simply by intolerance to open doors.

As a rule, a person feels safe only at home. The “comfort zone” is very clearly defined, but can expand or contract depending on the circumstances. In fact, agoraphobia is very closely intertwined with social phobia, as it is characterized by the fear of making a mistake in front of a large number of witnesses.

At the same time, agoraphobes are often afraid to go out alone. For example, visiting large crowds of people near a loved one may be asymptomatic and not cause concern, while traveling alone or even driving alone to the other side of the city can cause a panic attack.

Almost all forms of fear of open space are classified as “adult” phobias. They appear over the age of 20, and can progress with age, forcing a person to lead a reclusive lifestyle.

Interestingly, agoraphobes quickly learn to live with their fear. Thus, with a fear of open space, a person consciously chooses professions that allow him to minimize contact with strangers and frequent movements along the streets.

If you are afraid of open space, an important place is given to your own “comfort zone”. It is not necessarily limited to the agoraphobic's home. Since with agoraphobia panic attacks occur only in certain unfamiliar situations, a person can feel quite confident in the office where he has worked for many years, visiting an old friend or in a familiar supermarket.

The main feature of the fear of open space is a panic attack in a situation that a person cannot control. Horror sets in if the patient feels trapped, for example, in a close crowd of people or in an open area far from home.

If a child was humiliated on the street by his peers as a child, in the future this may lead to the development of a phobia of fear of the street.

The causes of agoraphobia have not yet been precisely identified. According to many experts, agoraphobia is not a disease, but part of a syndrome that covers a number of mental disorders. The causes of agoraphobia in this case are:

• panic attacks;
• mental disorders (bulimia, anorexia, depression, neurosis);
• childhood psychological trauma;
• strong emotional experiences.

Agoraphobia and anxiety attacks (panic attacks) are closely related. According to one version, this phobia is a direct consequence of panic attacks; according to another version, attacks stem from fear of a crush, crowds or open space.

Agoraphobia very often accompanies other mental disorders. It often goes “hand in hand” with social phobia. Often, a fear of open space is detected in people with neurosis. Fear of leaving one's home is typical for people with depression, and fear of crowds and social judgment is observed in eating disorders.

Depression can be both a cause and a consequence of agoraphobia. According to statistics, 70% of patients with agoraphobia eventually acquire a depressive disorder, but only 27% of patients with depression experience pathological fear.

Agoraphobia can develop due to mental trauma. For example, the loss of a loved one in an accident can cause fear of the streets, which is one of the signs of agoraphobia.

Signs and symptoms of agoraphobia

Signs of the disease in the initial stages of agoraphobia appear quite clearly; let’s consider the most typical:

1. Increased heart rate. At any mention of the need to leave the house or apartment, the heart rate gradually increases, the heart beats wildly, even to the point where you have to call an ambulance.
2. Feeling hot. Most people, when receiving a flattering, successful compliment, often blush. For people afraid to leave the house - similar symptoms occur globally, within minutes the person's face becomes very red.
3. Change in pressure. Patients with hypotension and hypertension often have obvious pathological reactions. However, people who do not suffer from blood pressure will experience similar problems in the early stages of the phobia.
4. Indigestion, nausea - stress caused by the need to go outside can provoke nervous (stress) dysbiosis - a disorder of the digestive system, this happens because under stress, a significant amount of a person’s blood rushes to the extremities, causing disruptions in the digestive system. In order to get rid of unpleasant symptoms, you should lie down and relax, allowing the blood to flow to the stomach.
5. Weakness in the body. In the initial stages of agoraphobia, many people feel a “stiffness in the body”; it gets to the point that some cannot cross the threshold of their own home.
6. Inability to navigate the terrain. People suffering from agoraphobia can get lost even in familiar areas. Having left the house, they will not be able to understand where to go or what is happening around them.
7. Refusal to communicate with loved ones. Now we are not talking about literally abandoning loved ones and friends. On its territory, the patient is ready to meet with anyone, but it is unlikely that he will be able to drag the agoraphobe out for a walk or to a cafe.
8. Panic attack. If the disorder acquires such serious symptoms, it is no longer possible to do without psychotherapeutic help, since a mentally healthy person should not be tormented by the fear of leaving the house.

Whatever of the listed symptoms you find in yourself or your loved ones, remember that in the early stages any disease can be defeated.

Principles of treatment

The tablets are taken regardless of meals, washed down with a sufficient amount of drinking water; the duration of therapy and dose are determined by the doctor individually for each patient
. How to treat agoraphobia depends on the specific symptoms observed in each case. Your doctor may suggest drug therapy or behavioral intervention, or a combination of both. Drug treatment is prescribed only if the phobia manifests itself as severe panic attacks.

If agoraphobia is manifested by a desire to quickly leave a place in which a person feels uncomfortable, severe discomfort when being in unfamiliar places, as well as the need to stay in a “comfort zone,” drug therapy is not needed.

How you can get rid of agoraphobia in each specific case is decided by the doctor after a conversation with the patient. Therapy and treatment of agoraphobia complicated by panic attacks begins with drug correction. For this purpose, tranquilizers (Diazepam), antipsychotics, drugs for the treatment of neurosis, and antidepressants are prescribed.

After reducing general nervousness, they move on to behavioral therapy. Methods are selected individually for each person. For agoraphobia use:

• cognitive psychotherapy;
• implosion therapy;
• hypnosis.

Cognitive psychotherapy helps both overcome agoraphobia and learn to control your thinking in general. It involves eliminating inappropriate thoughts and misperceptions of situations in which the phobia worsens.

Implosive therapy involves identifying all existing fears and gradually working through them. The doctor and the patient make a list of situations in which an attack begins, ranking them in order of decreasing symptoms. So, for example, if being in the square causes a panic attack and loss of control, this item is first on the list.

Open doors and windows, which only cause irritation and a desire to close them as quickly as possible, will then be at the bottom of the list. Then the patient, alone or together with the doctor, begins to consciously seek encounters with frightening situations, starting from the end of the list. So, in this example, the first thing the patient will face is an open door, but will refrain from immediate action. So, gradually moving through the list, a person gets used to fighting his fears.

Implosive therapy is very effective for agoraphobia, but it cannot be carried out without preparation; first it is necessary to normalize the psycho-emotional state of the patient.

Hypnosis can help, but a long course of such procedures is required to achieve results.

Self help

Agoraphobia can be successfully treated if a person consults a specialist in a timely manner

Having figured out how to cure agoraphobia with the help of a doctor, you should know how you can treat the disorder yourself. Self-medication is permissible only in cases of moderate anxiety and the absence of panic attacks. Otherwise, special medications are needed that are not available without a prescription.

You can deal with the problem yourself using implosive psychotherapy. Here it is recommended to enlist the help of a loved one who will help you quickly leave the place that provokes the onset of the attack.

In general, phobia of unfamiliar places, or fear of open space, can be successfully treated if a person consults a specialist in a timely manner. In advanced cases, such a phobic disorder leads to severe neurosis and depression.

Ways to deal with the fear of going outside

The fear of leaving the house usually affects those who cannot cope with their inner fears and emotions. However, if such a person firmly decides to live a full life, he will cope with any difficulties. A person should approach the question of how to get rid of the fear of going out with all seriousness, trying to solve the problem as quickly as possible.

Methods for the early stages of agoraphobia

In the initial stages of agoraphobia, the following measures can be taken to restore mental health:

1. Refusal of stereotypes. Don't try on yourself with labels that someone else puts on you. Remember, each person is a separately formed personality, with his own successes and failures. When you are alone, try to figure out why you don’t dare leave the house.
2. Receiving positive emotions. Try to get as many positive emotions as possible outside the home. As a rule, small children or animals give us their positive energy. In order to recharge, it is worth visiting recreation areas for small children.
3. Shopping. If you enjoy shopping and your finances allow it, shopping can be an excellent reason to leave the house.
4. Meeting with family and friends. Some people find it relaxing to communicate with loved ones and friends, for example, in the park. They feel safe on neutral territory.
5. Get a pet. It’s best if it’s a dog, and it doesn’t matter what breed. Because, regardless of the owner’s wishes, she needs to be walked several times a day, fighting the fear of going outside.
6. A trip to the countryside. In the warm season, it’s worth going out for a picnic or even going on a visit to another city, this can significantly improve the situation.

Psychotherapeutic methods of struggle

Experts generally recommend the following methods to solve the problem:

1. Auto-training - any sane person, if desired, can convince himself that he needs to go out into the fresh air. It is worth concentrating on the positive aspects of the upcoming walk, and they will definitely outweigh all the negative emotions that may arise after its completion.
2. Rejection Method - This method is not suitable for everyone. The bottom line is that if the patient says: “I can’t” and “I don’t want to do this,” in this case, to leave the house, this must be done.
3. Yoga - Some people think that this hobby is a waste of time. However, for agoraphobia, many psychologists recommend using this method. Thanks to such exercises, everyone will be able to control their internal state and adjust their behavior patterns.
4. Going to a psychotherapist. If a person feels that he cannot overcome his fear on his own, he needs to turn to an expert. A specialist will help you understand the cause of the problem and give recommendations for solving it.
5. Hypnotherapy - more and more studies conducted all over the world prove the effectiveness of hypnosis in the fight against various phobias, including the fear of going outside. The method reduces anxiety, which helps people make positive changes in their lives.

Regarding the question of how to overcome the fear of leaving the house, you need to calm down and try to follow the suggestions given in the article. If you don’t fight, then you can spend your whole life within “four walls,” instead of trying to be happy: by building personal relationships, realizing yourself professionally.

How to recognize a fear of open space?

The difficulty of making a diagnosis is that the symptoms of mental disorders often “flow” into one another, masking each other. In this regard, the main criterion for diagnosing agoraphobia is the presence of phobic symptoms, i.e. the experience of fear (or panic attacks) in certain situations.

It may be that in addition to the fear of going out, the client also expresses delusional ideas: for example, he is afraid of crowds of people because they can infect him with a dangerous virus, or he is afraid that foreign spies will kidnap him on the street. Or he is hallucinating: for example, he explains his fear of large spaces by the fact that he sees witchcraft circles, or that passers-by have distorted faces - then it makes sense to suspect another mental disorder, the symptoms of which include a phobia (primarily paranoid schizophrenia).

In addition, it matters in what situations the client experiences fear. For agoraphobia, characteristic situations of fear are being in a crowd, outside the home, in public places (and, as a rule, alone). Fear can also arise from “triggers” - conversations about an upcoming trip outside, photographs of crowds, etc.

Another compelling reason for making a diagnosis is the regular avoidance of a collision with a frightening object - in particular, reclusiveness, preferential travel in a taxi or in personal transport, visiting public places during the hours of minimum attendance, fear of large rooms and moving “along the walls,” etc. d.

Fear of large spaces occurs at different ages under completely different circumstances. The largest category of the population suffering from a phobia are young people (20–25 years old), mostly girls, living in large populated areas.

Treatment of agoraphobia

The most effective treatment for agoraphobia is cognitive behavioral therapy. This is a short-term psychotherapy in which the doctor, together with the patient, identifies thoughts and beliefs that provoke the development of anxiety when visiting unsafe places. Then the patient begins to gradually immerse himself in frightening situations, first with the support of a specialist, and then independently. Psychological desensitization occurs, the patient gets used to frightening situations, and his anxiety level decreases.

In the presence of concomitant depression, panic disorder and other similar diseases, psychotherapeutic treatment is carried out against the background of drug therapy using antidepressants and tranquilizers. It should be borne in mind that substances that depress the central nervous system may interfere with cognitive behavioral therapy, therefore, during treatment, alcohol consumption should be avoided, and tranquilizers should be taken strictly as prescribed by the doctor (usually these drugs are prescribed for a short period of time to alleviate the patient’s condition before the onset of antidepressants ).

In the presence of severe psychological trauma and internal conflicts, long-term psychotherapy using Gestalt therapy, psychoanalytic therapy, psychodrama, existential therapy and other methods may be required. All of these methods do not aim to get rid of agoraphobia, but to eliminate psychological attitudes, self-images and characteristics of perception that contribute to the emergence and maintenance of fears - without working with these psychological mechanisms after cognitive behavioral therapy, agoraphobia may return or transform after some time to another phobia.

The prognosis for agoraphobia depends on the depth and severity of the psychological problems that cause the development of the disease, the personality characteristics of the patient, and the presence of concomitant mental and somatic pathologies. The chances of recovery increase with clear motivation, conscious cooperation with a psychologist, psychotherapist or psychiatrist, and strict adherence to all specialist recommendations.

When a patient turns to a specialist with the problem “I’m afraid to go outside because of panic attacks,” we can talk about the development of agoraphobia.

Agoraphobia is essentially a term that unites specific isolated fears that are interconnected in essence. Thus, denoting a fear of open space, agoraphobia can often coexist with a fear of public speaking, and sometimes with social phobia.

Agoraphobia is usually called fear that appears accompanied by vivid clinical manifestations of a somatic nature that arise in certain places or circumstances:

• in open areas;
• in public areas, in places with large concentrations of people (cafes, shopping centers, metro);
• at large-scale cultural events (concerts, fairs, sports competitions);
• when there is a likelihood of attracting the focused attention of strangers;
• if the door and window openings in the room are open;
• in deserted places where there is no opportunity to seek help;
• when moving alone;
• in the absence of an accessible opportunity to return to a comfortable place at any time, which most often is home for the patient.

Agoraphobia can also arise as a defense mechanism against the present fear of encountering aggressive behavior from others, fear of public shame and criticism from strangers, as well as uncertainty about the compliance of one’s own behavior with the norms of public morality.

One of the first goals of psychotherapy for agoraphobia is to relieve the client's symptoms associated with severe physical manifestations of panic. A big challenge that agoraphobes face is experiencing fear of death, increased heart rate, nausea, and other unpleasant physical symptoms.

The next stage of therapy is to search for the causes of the phobia. At the same time, the therapist gives the client tasks that expand his “comfort zone.” For example, you may receive an order to leave the house and walk around the yard in the morning, then go to the shopping center, then go to an event, etc. The pace of complication of tasks should be selected individually, in accordance with the pace of recovery and readiness of a particular client.

Contrary to the popular recommendation that “they fight each other,” psychotherapists avoid making violent demands on agoraphobes, such as abruptly “pushing” them into a stressful situation: into a crowded subway lobby or into a crowded square. Given the intensity of physical symptoms, such methods can harm the client and aggravate the situation, permanently turning him away from professional help. Although in cases with hysterical “pseudo-patients” this method can work if you tactfully bring the client to him.

One way or another, there is no one-size-fits-all recommendation that can quickly and permanently rid a person of fear. Specific methods are chosen by the specialist depending on the severity of the case, the client’s character traits, and even taking into account his gender and age. In this regard, a professional approach to the problem of agoraphobia is necessary, since inept “brute force” methods can cause harm and aggravate the case.

Development mechanism

As a rule, it all begins with a panic attack that appears in a characteristic situation, and therefore the connection “leaving the house – danger” is formed in the subconscious. As a result, fearing that panic attacks will overtake him again on the street, a person tries to eliminate risk situations from life: limiting himself in movement and communication.

At moments when the patient is forced to leave a comfortable environment, he involuntarily exhibits somatic signs of anxiety:

• cold sweat;
• increased heart rate;
• severe nausea;
• dry mouth;
• lack of air;
• pain in the heart area;
• weakness and trembling in the limbs;
• general pre-fainting state.

Falling into panic, a person asks those nearby to take him to a place where he could feel out of danger. In crowded places (transport, cafes), the agoraphobe tries to stay as close to the exit as possible or at least keep the doors in sight. Often, a person suffering from agoraphobia creates for himself certain routes that are the safest in his opinion.

The clinical picture may contain anticipatory anxiety, avoidant behavior, and depressive symptoms.