Agoraphobia

Management and Resources

At home

Although people with Agoraphobia usually require professional treatment, there are steps one can take at home to improve their overall functioning and hopefully decrease their symptoms of agoraphobia. These include meditation, deep breathing, movement, nutrition, and sleep.

Meditation

The practice of meditation has been around for thousands of years. What was first a way for individuals to find spiritual connection is now widely used as a means of reducing stress and anxiety. Meditation, and specifically mindfulness meditation, involves setting aside time during one's day to focus on the present, and not their broad stream of thoughts. During this designated time, individuals try to keep their thoughts centered around this very moment: their sensations, an object, or a sound. When the thoughts stray, as they naturally do, meditation teaches people to acknowledge the distraction without judgement, and come back to the present. The repeated practice of meditation can be calming in the moment, but can also “build the muscle” that re-centers a person through life’s ups and downs, even when they're not meditating.

Deep breathing

Learning to control one's breathing can be extremely helpful during a panic attack. When having a panic attack, an individual may notice having a harder time breathing or that they just can’t catch their breath. Higher levels of anxiety can cause shallow breathing that often gives us less oxygen and requires us to breathe faster to get the oxygen our body needs. This is a common symptom of panic disorder and can make people feel uncomfortable and unwell.

When we breathe deeply and through our diaphragm, specifically, we may feel calmer and more at ease. We call this technique deep breathing or diaphragmatic breathing. It is a simple technique that can be hard at first or uncomfortable, but with practice, it can become second nature. Deep breathing is easier to learn when one practices the skill at times when anxiety is low. As an individual becomes more skilled and can deep breathe when calm, they will be able to use this skill even when they are feeling a panic attack coming on.

Movement

Research shows that 30 minutes of walking per day can decrease overall anxiety. The proven benefits of exercise are vast. Exercise is one of the most effective ways to manage stress and anxiety. Some people who experience panic attacks find exercise challenging at first because the feelings one can get while exercising may mimic a panic attack.

Individuals may start small by beginning a walking routine, taking the stairs, or doing gentle movement like yoga. These are just a few examples of low impact exercises that increase the heart rate safely, in turn releasing serotonin and other brain chemicals that reduce anxiety. The anti-anxiety effects of exercise are both immediate and long term. Movement and exercise can be a great complement to one's treatment plan and can even be social if bringing a friend along.

Nutrition

Serotonin is a brain chemical that is involved in anxiety. 95% of serotonin is produced in the stomach, which communicates information to the brain to influence emotion. Nourishing one's body with fruits, vegetables, nuts, eggs, grains, and legumes may help to reduce anxiety. Similarly important is the frequency at which one eats. Eating regular, well-balanced meals, helps to maintain a steady blood sugar, which can create a feeling of calm and may reduce anxiety symptoms.

Sleep

Individuals with agoraphobia have intense periods of times where they feel like they are in overdrive, also known as the fight or flight response. This means that the body is always ready to escape danger, even if it may not actually exist. A full night of sleep, approximately 8 hours for most adults, helps the body control the fight or flight response associated with panic. Creating a consistent and calming bedtime routine, avoiding blue light (that light from our phones and screens) one hour prior to bedtime, abstaining from daytime naps, and refraining from caffeine after noon all promote restful and continuous sleep.

In relationships

An individual's agoraphobia symptoms may affect them and the significant people in their life unintentionally, usually due to the symptoms stopping them from doing what they would normally do if they didn’t live with this anxiety. For example, if they haven’t visited their mother who lives in a major city for years -- because cities terrify them -- they may feel more distant from her or potentially their mother may feel hurt.

Others in the lives of those with agoraphobia may notice their symptoms and have a hard time understanding why the individual is experiencing them, or think they can reason them out of feeling anxious.

In reality, most people with agoraphobia realize that their thoughts and actions surrounding this anxiety disorder are not entirely logical, and it usually doesn’t help when others try to talk them out of these symptoms. Instead, the person with agoraphobia can explain to their friends, relatives, and neighbors that they have an illness that causes them to behave this way; that the individual knows their behavior is not rational, and that they are working on resolving the problem.

Explaining this to others can help others understand, at least somewhat, what the person is going through. Once explained, the individual with agoraphobia may also be less likely to constantly be given the same unhelpful comments or advice that aren’t helpful to them after all. Most people with agoraphobia who seek treatment usually see major improvements in their relationships.

At work

Agoraphobia can affect people differently at work. Many people with agoraphobia have found themselves at one point or another feeling unable to work, feeling unwell at work, or fearing going to work. However, with treatment, most people with agoraphobia feel more functional at work and if they do have anxiety the symptoms can only be a temporary challenge at work.

When at work, it can be helpful for individuals with agoraphobia to keep a few tips in mind:

Identifying a safe space: Many individuals with agoraphobia fear having anxiety at work. People who have a plan on how they are going to manage their anxiety usually feel some relief knowing they have a safe place to go to. Individuals may identify a location at their place of work that they could go to for 15 minutes to breathe, reset, and feel less overwhelmed (like a break room, bathroom, or sitting area). Knowing they have a place they can go in the event they do experience bouts of intense anxiety can make all the difference.
Identifying a coping plan: When in a state of panic or intense anxiety, individuals may find themselves forgetting the things that help them cope. A reminder can make it much easier to cope. Writing down three things they can do to relax safely at the workplace like deep breathing, listening to music, talking to a supportive person, or meditating can be helpful to the individual with agoraphobia symptoms.
Starting the day right: Having a morning routine can help start the day right, and help prepare a person for work. Individuals with agoraphobia can try identifying what makes mornings easier start a new morning schedule out to see what works for them. Having the time to wake up, get ready, and take care of their needs may help individuals reduce stress and make them less vulnerable to intense anxiety at work.
Giving oneself grace: If an individual does have panic attacks or intense anxiety frequently at work and in front of others, they may try to remember that this is not their fault. They are not crazy or “going crazy.” With time and treatment, their symptoms will improve and their current struggles will become temporary.

Others may find that workplace accommodations are necessary. For example, agoraphobia might make it hard to be one's best self at work. Individuals might be able to request accommodations such as working from home if applicable, or having a desk in a certain location. Under the Americans with Disabilities Act (ADA), certain individuals with agoraphobia, but not all, may qualify for reasonable accommodations at work. Vital considerations involved with qualifying include (1) Their employer’s type of business and operations, (2) how agoraphobia is affecting their ability to carry out essential job functions, and (3) whether or not an accommodation would cause their employer an undue hardship.

A note from a prescribing physician should serve as a record of agoraphobia, however, not all employers are required by law to offer accommodations. Effectively acquiring workplace accommodations often requires collaborating with the employer’s HR department to institute a plan that satisfies all involved.

Keep in mind, people with agoraphobia do not ever need to tell anyone at work about having the condition, nor do they need to keep it a secret. The amount they share is their choice, though some people find it useful to share this information with a manager or colleague to help others understand that their brain might operate a little bit different.

At school

Agoraphobia can affect people differently at school. Many people with agoraphobia have found themselves at one point or another feeling unable to do school work, feeling unwell at school, or fear going to school. However, with treatment, most people with agoraphobia feel more functional at school and if they do experience panic or intense fear, the symptoms can only be a temporary challenge. When at school, it can be helpful to keep a few tips in mind:

Identifying a safe space: Many fear having a panic attack or intense anxiety at school. People who have a plan on how they are going to manage their anxiety in the moment usually feel some relief knowing they have a safe place to go to. Those with agoraphobia may identify a location at school they could go to for 15 minutes to breathe, reset, and feel less overwhelmed, like a study room, bathroom, or sitting area. Knowing they have a place they can go in the event they do have a moment of intense anxiety can make all the difference.
Identifying a coping plan: When in a state of panic or intense fear, an individual may find themselves forgetting the things that help them cope. A reminder can make it much easier to cope. Those with agoraphobia may write down three things they can do to relax safely at school like deep breathing, listening to music, talking to a supportive person, or going for a walk.
Starting the day right: Having a morning routine can help start the day right, and help prepare a person for school. Individuals with agoraphobia can try identifying what makes mornings easier start a new morning schedule out to see what works for them. Having the time to wake up, get ready, and take care of their needs may help individuals reduce stress and make them less vulnerable to panic attacks or intense fear at school.
Giving oneself grace: If an individual does have agoraphobia symptoms frequently at school and in front of others, they may try to remember that this is not their fault. They are not crazy or “going crazy.” With time and treatment, their symptoms will improve and their current struggles will become temporary.

The Americans with Disabilities Act also applies to public higher education programs and many private higher education programs, in addition to public primary and secondary schools. For the purposes of this law, agoraphobia is considered a disability when it causes limitations in one's ability to participate in education at the same level of other students that do not have agoraphobia.

Students with disabilities are entitled to reasonable accommodations designed to help mitigate symptoms and increase their likelihood of academic success. Accommodations may include “time and a half” testing, a separate room for taking exams, or a designated spot in the front of the classroom, among others. Each school’s process of requesting accommodations may look different, so it can be helpful to speak with the school's administrator to understand their process and what documentation is required from the individual with agoraphobia.

Additional resources on agoraphobia

Many other people have suffered from agoraphobia, and the internet is full of communities and resources which can provide information and support.

Organizations & resources

Anxiety and Depression Association of America