Fear of going outside: causes, signs, ways to combat it

Panic attacks

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

Proponents of this view think that agoraphobia has a primary fear of helplessness in the face of large spaces that causes attacks.
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.

Reasons for developing a fear of going outside

Heredity
. Quite a large number of specialists in the field of psychiatry are confident that all neuroses should be considered exclusively at the genetic level of manifestation of a certain pathology. Based on the results of their research, it can be concluded that a fifth of the population who are afraid to go outside borrowed a similar model of behavior from their parents. Sometimes a “gift of fate” can even be passed down from grandparents.
Increased anxiety
. People with an overly excitable psyche are afraid of everything, even their own shadow. For them, leaving the house is a feat that they are not going to accomplish. If we make an analogy with animals, then a person of this type automatically turns into a turtle, which is securely hidden in its shell.
Diffidence
. People whose complexes play a dominant role over other priorities try not to leave their native walls again. In every glance of a passerby, they see disapproval and even censure, which puts such poor fellows into a stupor and even depression. This is often encountered by young mothers after childbirth, and women in adulthood who find it difficult to control their weight. People with a pronounced defect in appearance (large birthmarks, growths on the body, etc.) are also susceptible to fear.
Disability
. People with disabilities often try to isolate themselves within four walls, because this is where they feel safe. For them, the street is a high-risk zone, even if they live in a quiet rural area.
Dysfunction of mental regulation
. In some anxious individuals, biological processes in the brain malfunction. In this case, there is an imbalance of reflex functions that must be controlled by consciousness.
Expansion of the stressful situation
. A child’s fear of entering a dark room can later develop into a much more serious phobia. The expression “my home is my castle” is also beginning to be perceived by some people as an unconditional verdict.
Low social status
. In this case, we are not talking about embarrassment and fear of becoming a laughing stock in the eyes of more successful people. A person who is afraid to leave home, in most cases, simply does not want to see a higher standard of living in the society that surrounds him. It’s easier for him to close himself in “his own box” so as not to correct anything and not fight to change the situation.
An accident that occurred
. If the poor fellow became a hostage in the past or observed some kind of disaster, then he will not have the desire to go out into the street again. After suffering stress, such people become hermit crabs who feel quite comfortable in such a situation.
Definite addiction
. In this case, we are not talking about alcoholics who, in the cold and cold, will leave the house in search of a strong drink. Those same computer gamers are so oblivious to reality that even a trip to the nearest bakery seems like a feat to them.
Accompanying effect
. Some phobias in humans tend to intertwine quite harmoniously with each other. Against the background of one mental pathology, another emotional anomaly is quite capable of developing, which leads to a fear of going out.
Fear of death
. Every adequate person does not want to say goodbye to his life before the scheduled date. However, in some cases, such a desire turns into a certain mania. People who fear death every second are simply trying to make a fortress out of their home. For them, going outside is equivalent to a death sentence for themselves.
Internal dictate
. Very often, parents prohibit young children from communicating with their peers outside the walls of the house, scaring them at the same time and inventing all sorts of horror stories. After personality maturation, mature adolescents may then perceive the street solely as a threatening factor.

Requests for help Write your story Hello. I really need help. I'm afraid to leave the house. When I go out I feel panic and fear. I am afraid of people and avoid communication, I don’t like when people pay attention to me. I was kicked out of school because I missed classes. I couldn’t sit through class because I felt terrible anxiety and fear, I wanted to run away to where I would be alone. And I ran away, and then stopped going to school altogether, blaming it on the fact that I was sick. I am constantly depressed because of this. I don’t see a way out and I feel very bad, I want to get rid of all the pain. I tried to kill myself, but they saved me. I believe in God and understand that this is a very big sin. Mom is very worried about me, and dad screams and this affects me even more. I'm afraid of him. And I'm afraid of everything and everyone. What should I do??? Now I need to go outside to run errands, but I can’t. I'm really scared.

worry, age: 17/11/12/2014

Responses:

Do your parents know about your fears? I think these are psychological problems. Parents should find a good therapist. If your mom is worried, talk to her about it. God help you)

Anna, age: 48 / 11/12/2014

Girl, have you told your parents about your condition? Do they know that you are experiencing all these anxieties, fears, panic? You need to see a doctor, a neurologist. Urgently. You will be prescribed medications, and everything will fall into place. And of course, you need to go to the temple. Repent and confess your suicide attempt. What a blessing that you are alive. You will be able to atone for your sin and save yourself for eternal life. And you still have a lot of good things ahead of you in this life. Believe it and ask the Lord for help.

Evgenia, age: 42 / 11/12/2014

Understand that suicide is not just a terrible sin, it is a grave sin, by committing which a person dooms himself to eternal torment, the severity of which is even scary to imagine, plus there is no time beyond the grave, there is eternity and the suffering of the soul lasts unimaginably, it is difficult for us to understand there are other categories, another, spiritual , a reality accessible only to the spiritual gaze. It is better to overcome any suffering here than there, because there the suffering is much worse. Believing in God is good, but faith must be based on knowledge, and knowledge must be true, because there is one truth and one truth, therefore there is one God. Unfortunately, many people have incorrect ideas about God and truth, on almost every corner they shout and call and offer their faith and their idea of God, and these ideas are oh so different, and it is not true that all faiths lead to one God, this is a lie because ideas about it vary greatly. I propose to turn your attention to Orthodoxy, and with reasoning try to figure out what it is, without fanaticism, I recommend the lectures of A.I. Osipov, you can find it in a search engine, there is a separate website on YouTube. He explains a lot, helps to understand, but of course it takes time, but if you show persistence and make an effort, it will help you understand life and its meaning. Your condition is understandable, because according to the teachings of the church, we are all in a fallen, unnatural state, in a spiritually sick state, so much so that God Jesus Christ himself had to come to save us, plus all spiritual damage is accompanied by spiritual blindness, we are sick and we don’t see it. An example is human history, the most intelligent being, man, how he behaves throughout history is simply like a savage, sometimes worse than an animal, what’s the matter, something is wrong in us and Orthodoxy explains what and how. Hold on, don’t despair, God help you!!!!

melches1974, age: 40 / 11/12/2014

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Manifestations of agoraphobia - fear of open places, fear of going outside

The main, leading symptom of agoraphobia is the fear of open spaces, the fear of going outside, the fear of entering large rooms (halls, recreation rooms, long corridors, rooms with high ceilings, etc.). Agoraphobia can manifest itself in the form of a variety of symptoms, which can manifest itself in the form of: - uncontrollable, unclear fear; - in the form of suffocation, palpitations, a lump in the throat and other somatic phenomena; - weakness in the legs or throughout the body; - internal trembling; - increased sweating, feeling hot, feeling cold

However, most often agoraphobia is accompanied by several symptoms at the same time, which can be combined into one well-known term - panic attack. Therefore, doctors most often treat agoraphobia with panic attacks.

Phobias are obsessive fears. Phobic anxiety Feelings of fear in open places or on the street Fear of leaving the house alone Fear of riding in public transport Need to avoid certain places or activities Fear of fainting

Methods to combat agoraphobia

Many VSDers withdraw into themselves, cherishing their fear and embarrassed to tell anyone about it. Indeed, it is not always pleasant to come to the doctor and say: “I’m afraid to leave the house, I’m afraid to go outside.” Dystonics subconsciously expect negativity and condemnation from any person who learns about their problem. And experts agree that the main barrier in the treatment of phobias - any phobias - is the relationship of the VSD person with his own family.

Everyone is familiar with phrases like this: “You’re overthinking a lot, relax!”, “Well, you’re so little, you’re scared of nonsense!”, “Don’t go there alone, otherwise you’ll have a heart attack!”, “It’s probably a premonition of trouble, Better stay at home!”

It is advisable to begin working with agoraphobia by correcting intrafamily relationships. It is important that the patient’s loved ones understand: what their loved one feels is not a joke, he really carries a mental disorder within himself, which progresses and over time can destroy the personality! There is no need to overprotect the VSD, scaring him even more, but you should not treat him like a spoiled child demanding attention. As soon as the psychiatrist begins working with his patient, it will be right if the family gets involved and follows the doctor’s recommendations.

Strengthening the nervous system greatly facilitates treatment. Yes, the fear of dying on a bus and proper nutrition seem to have little connection with each other, but extra physical and mental strength will be beneficial. Yoga and meditation also have beneficial effects. Some VSDers look for a partner with a similar mental illness and cope with the problem together. If there is a “mirror” nearby that fully understands and gives practical advice, the results will not be far off.

But still, the best way out of the situation would be a visit to a psychologist who can determine the roots of the problem and correct the patient’s attitude towards his fear of leaving the house. Medicines are included in treatment and have an auxiliary function - to normalize the current condition.

In the end, remember - you are far from alone with your misfortune, and it will not become a death sentence if your life is filled with interesting hobbies and the desire to improve yourself. Such famous people as Marilyn Monroe, Woody Allen and Macaulay Culkin also “had the honor” of becoming acquainted with agoraphobia, but, as you can see, they did not become its hostages.

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.

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.

Treatment of pathology

Before prescribing treatment, the patient must visit specialized specialists (general practitioner, cardiologist, psychiatrist, neurologist), who will rule out diseases with similar symptoms.

To get a complete picture of the disease, psychiatrists usually use a number of tests: anxiety scales and panic attack assessments, Beck Depression Test.

Drug treatment consists of selecting antidepressants, tranquilizers and antipsychotics that correspond to the severity of the disease. Along with medications, psychotherapeutic sessions are conducted with the patient (Ericksonian hypnosis, cognitive behavioral therapy, Gestalt therapy, etc.).

In addition, the patient is recommended to use relaxing techniques at home (breathing techniques, muscle relaxation exercises, meditative practices, art therapy, etc.), which can be studied in specialized literature or via the Internet, for example, in a video blog

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.

Manifestations of agoraphobia

The main symptom of fear of open space is attacks of severe anxiety (often reaching the level of panic) with vegetative and somatic manifestations. They absorb a person's attention and force him to avoid provoking situations. Some time after the first appearance of this disorder, fear of a repeat panic attack arises. Because of this, the symptoms of a phobia will increase in anticipation of leaving the house, with memories and images of dangerous places.

With agoraphobia, a person develops an individual comfort zone, the size of which is determined by the degree of severity of fear. Some people with a fear of open spaces may go to work, socialize with friends, and take walks, but avoid squares, crowded shopping centers, and deserted parks. Others find themselves unable to leave the house for several days, since even the thought of having to leave their safe home leads to severe anxiety.

An attack of fear is accompanied by palpitations, discomfort in the limbs, rapid breathing, spasmodic pain in the abdomen with the urge to urinate and defecate. A change in the productivity of gas exchange in the lungs leads to a violation of the ratio of carbon dioxide and oxygen in the blood. The brain reacts especially strongly to this, which leads to dizziness, disorientation, and increased feelings of danger and anxiety. The whole body tenses, sweat increases, and blood pressure may increase.

Often an attack of agoraphobia is significantly weakened in the presence of well-known people. For example, when accompanied by loved ones, a person with a fear of open space may be in an uncomfortable place and still experience only slight anxiety.

Self-help for agoraphobe

There are a number of simple exercises that you can do if the answer to the question “am I afraid to go outside because of panic attacks” is yes.

After taking the medicine prescribed by a specialist, you need to turn on calm music and try to relax as much as possible - after ten to fifteen minutes, you can start imagining with your eyes closed how you leave the threshold of the house. There is no need to rush: if there is any inconvenience within your visualization, you should immediately return home. With each repetition of the exercise, you need to gradually extend the time spent above the threshold, and then the distance. Once you get used to the sensations, you can experiment with distance from home and the time of imaginary walks.
It is necessary to find a point inside the house to which feelings of comfort are attached. This should not be some place, but a point - on the wall, chest of drawers or the back of a chair. In your imagination, you need to learn to materialize this point and move it in space (at the initial stage within the home), without losing the feeling of comfort and confidence in safety.

These exercises can help get rid of agoraphobia during panic attacks, but provided that the situation is not too advanced and the disease is not complicated by a number of concomitant phobias.

Treatment of agoraphobia with panic attacks

A feeling of fear in open places or on the street is a problem associated with a mental state disorder and cannot be controlled by the efforts of one’s own will; it requires the mandatory participation of a medical professional with higher medical education, a psychiatrist or psychotherapist.

Agoraphobia with panic attacks can be treated using complex techniques from a psychotherapist. Active neurometabolic therapy, psychotherapy are used, physiotherapeutic procedures are often prescribed, and a daily routine and diet are selected.

Treatment of agoraphobia with panic attacks is selected only individually, only after a thorough examination and identification of the true causes of the formation of a violation of the biological processes of the brain. It is not the symptoms that are felt by the person that are treated, but the cause that the person does not feel. The true reason is sometimes very well hidden from the eyes of non-specialists, and even more so from the person who suffers from it. Treatment of agoraphobia and panic attacks by psychologists or ordinary psychotherapists, without higher medical education and education in psychiatry, should be categorically excluded.

Prognosis for treatment of agoraphobia with panic attacks

Agoraphobia with panic attacks is treatable and the prognosis, as a rule, is favorable with proper treatment and following all the instructions of the attending physician.

If there is no treatment or incorrect treatment, the prognosis is usually not favorable.

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Causes

Scientists and psychiatrists have not agreed on what provokes the fear of open space. American luminaries claim that it begins with a panic attack, while in Europe it is generally accepted that it is agoraphobia that arises that causes the development of mental disorders and unreasonable fear, while several causes and factors are identified that can provoke it:

previously suffered traumatic situations and emotional shocks in crowded conditions or in open areas;
hereditary predisposition to mental illness;
weakness of the vestibular system, impairing the ability to navigate and see visually clearly in large spaces or in crowds of people;
developed imagination, which is why agoraphobia is more often diagnosed in women.

Thus, theoretically, the origin of agoraphobia can be biological, genetic or psychosocial.

What is agoraphobia

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.

Reasons for the development of the disorder

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.

The main signs of a person’s fear of going outside

Increased heart rate
. At any prospect of leaving their native walls, a person with the stated problem begins to beat actively. At the same time, the pulse goes off scale so much that in some cases you can call an ambulance.
Feeling hot
. We can all blush when we are given a well-placed compliment or simply flattered. However, for people with a fear of going outside, such a phobia takes on such global proportions that the poor fellow’s face turns purple in a matter of minutes.
Change in blood pressure
. Hypotonic and hypertensive patients with pronounced pathology react especially aggressively to the need to go outside against their wishes. However, people who do not suffer from unstable blood pressure may also experience similar problems in the early stages of agoraphobia.
Weakness in the legs
. They don’t hold us back not only during drunken fun, but also for other reasons. Beginning agoraphobes, even when leaving their home, understand that they simply are not able to take a step beyond the threshold of their home.
Loss of orientation
. Some people will look for a way in a labyrinth that consists of three pines if they had to leave their home walls. They literally will not be able to understand where to go and what is happening around them in this situation.
Refusal to communicate with friends
. In this case, we are not talking about alienating friends from oneself in the literal sense of the word. On his territory, such a person is ready to meet anyone, but you should forget about gatherings in any bar or restaurant in his company once and for all.
Panic attack
. When it comes to such a phenomenon, it is worth ringing all the bells when a problem arises. A person who is adequate in his actions should not be frightened by the prospect of leaving his home. Otherwise, a person who decides to live in an artificially created bunker should be treated by a psychotherapist.

Signs and symptoms of agoraphobia

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

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.
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.
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.
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.
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.
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.
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.
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.

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.