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Cause of panic: Why are some people afraid of crowded places?
Among people, some people feel extremely anxious, which may stem from a psychological state called agoraphobia. Agoraphobia is an anxiety disorder that causes intense anxiety when an individual believes that their environment is unsafe and that escape is difficult. This is often seen in busy public transportation, shopping malls, crowded places, or even when alone at home. Affected people may experience panic attacks that cause them to avoid entering these environments at all costs, and in some cases may even prevent them from leaving their homes at all.
The root cause of agoraphobia may be related to a combination of genetic and environmental factors.
Causes of agoraphobia
Research shows that agoraphobia often runs in families and may be driven by stressful or traumatic events, such as the death of a parent or an assault. According to the DSM-5 classification, agoraphobia is classified as a phobia along with other specific phobias and social phobia. In some cases, patients with agoraphobia are often accompanied by problems such as depression, substance abuse, and suicidal ideation. If left untreated, the chance of healing from agoraphobia is extremely low.
Symptoms and signs
Individuals with agoraphobia develop anxiety in situations that are unfamiliar or where they feel they have less control. Triggers for anxiety may be wide open spaces, crowds (social anxiety) or travel, even short distances. Patients often avoid these environments and choose to stay in familiar and controllable spaces, often their own homes. Additionally, patients who have experienced a panic attack in the past may develop a fear of that location because they fear experiencing a panic attack again in public.
When faced with a panic attack, patients may experience physiological reactions such as rapid heartbeat, sweating, and trembling, as well as a fear of death or loss of control.
Diagnostic criteria
In diagnosing agoraphobia, a medical professional will look for symptoms that are more serious than panic disorder. Some patients may develop agoraphobia without a history of panic disorder. People with agoraphobia often quickly avoid places where they feel unsafe and may gradually develop severe social withdrawal, eventually leading to a complete reluctance to go out.
Treatment methods
The most commonly used method to treat agoraphobia is cognitive behavioral therapy (CBT), which produces good results for about half of patients. Additionally, medication is an adjunctive option and often includes antidepressants and anti-anxiety medications. In some cases, patients may use positive coping strategies to cope with anxiety, such as gradually confronting their panic triggering situations through exposure therapy. More recently, virtual reality technology has been used to help patients face real-world challenges in a safe environment.
Social Impact
The impact of agoraphobia goes beyond the individual level and causes widespread social problems. Many patients isolate themselves because of their fear of going out, leaving them unable to function socially and professionally for the rest of their lives. This also forces us to reflect on the importance modern society attaches to mental health and how to help those who suffer from it. While attention to mental health issues continues to grow, many people still face barriers to accessing treatment, especially those who are completely unable to leave their homes.
In the face of agoraphobia and other anxiety disorders, could cultural and social support be the key to breaking isolation?
