Phobias are a paradox in psychiatry: common but hidden, disabling yet illogical, curable but untreated. One of sixteen people has a phobia, but the figure is higher in women, young adults and the poor. Half of all cases suffer from agoraphobia, the most serious variety. Three out of four are receiving no specific help.
The essence of phobia is fear out of all proportion to any threat, which makes it ok to be afraid of snakes but not ok to freeze when they merely appear on television.
Sources of perceived threat are numerous - heights, hospitals, blood, open, closed and crowded spaces – but their effects are identical. They provoke apprehension, a pounding heart and trembling hands. The fear causes avoidance and the avoidance causes more fear. Steering clear of what terrifies you may sound like sense, but in phobias it makes the problem worse.
Agoraphobia – literally ‘fear of the market place’ – is the most debilitating and the one most likely to need treatment by a psychiatrist. Intense fear occurs in several situations that have in common a disruption of the surrounding space. You may be crossing a bridge, in a crowded shop, or travelling on a train when the anxiety hits – and escalates until you have to do something. The agoraphobic is the person who suddenly bolts off the underground train, who leaves the bus five minutes early and has to walk the rest, who cannot wait in a supermarket queue. Over a century after its name was coined, agoraphobia is still a fear of the market place.
This phobia is considered to be very serious because it saps the relation of the individual to the surrounding world and brings about social embarrassment. An agoraphobic can’t use the means of transport on a regular basis but he/she can’t use his own car in heavy traffic either. A severe case of agoraphobia will keep the ‘patient’ in his/her home.
There are a number of family, personality and biological actors that contribute to agoraphobia, among which: an anxious or over critical parent; high need for approval or oversensitivity to emotional or physical stimuli and even hormone changes.
