Fear of being crowded
Agoraphobia - Symptoms and causes
Overview
Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed. You fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd.
The anxiety is caused by fear that there's no easy way to escape or get help if the anxiety intensifies. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to worry about having another attack and avoid the places where it may happen again.
People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. You may feel that you need a companion, such as a relative or friend, to go with you to public places. The fear can be so overwhelming that you may feel unable to leave your home.
Agoraphobia treatment can be challenging because it usually means confronting your fears. But with psychotherapy and medications, you can escape the trap of agoraphobia and live a more enjoyable life.
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Symptoms
Typical agoraphobia symptoms include fear of:
- Leaving home alone
- Crowds or waiting in line
- Enclosed spaces, such as movie theaters, elevators or small stores
- Open spaces, such as parking lots, bridges or malls
- Using public transportation, such as a bus, plane or train
These situations cause anxiety because you fear you won't be able to escape or find help if you start to feel panicked or have other disabling or embarrassing symptoms.
In addition:
- Fear or anxiety almost always results from exposure to the situation
- Your fear or anxiety is out of proportion to the actual danger of the situation
- You avoid the situation, you need a companion to go with you, or you endure the situation but are extremely distressed
- You experience significant distress or problems with social situations, work or other areas in your life because of the fear, anxiety or avoidance
- Your phobia and avoidance usually lasts six months or longer
Panic disorder and agoraphobia
Some people have a panic disorder in addition to agoraphobia.
Panic disorder is a type of anxiety disorder in which you experience sudden attacks of extreme fear that reach a peak within a few minutes and trigger intense physical symptoms (panic attacks). You might think that you're totally losing control, having a heart attack or even dying.
Fear of another panic attack can lead to avoiding similar circumstances or the place where it occurred in an attempt to prevent future panic attacks.
Signs and symptoms of a panic attack can include:
- Rapid heart rate
- Trouble breathing or a feeling of choking
- Chest pain or pressure
- Lightheadedness or dizziness
- Feeling shaky, numb or tingling
- Excessive sweating
- Sudden flushing or chills
- Upset stomach or diarrhea
- Feeling a loss of control
- Fear of dying
When to see a doctor
Agoraphobia can severely limit your ability to socialize, work, attend important events and even manage the details of daily life, such as running errands.
Don't let agoraphobia make your world smaller. Call your doctor if you have signs or symptoms listed above.
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Causes
Biology — including health conditions and genetics — temperament, environmental stress and learning experiences may all play a role in the development of agoraphobia.
Risk factors
Agoraphobia can begin in childhood, but usually starts in the late teen or early adult years — usually before age 35 — but older adults can also develop it. Women are diagnosed with agoraphobia more often than men are.
Risk factors for agoraphobia include:
- Having panic disorder or other phobias
- Responding to panic attacks with excessive fear and avoidance
- Experiencing stressful life events, such as abuse, the death of a parent or being attacked
- Having an anxious or nervous temperament
- Having a blood relative with agoraphobia
Complications
Agoraphobia can greatly limit your life's activities.
If your agoraphobia is severe, you may not even be able to leave your home. Without treatment, some people become housebound for years. You may not be able to visit with family and friends, go to school or work, run errands, or take part in other normal daily activities. You may become dependent on others for help.
Agoraphobia can also lead to or be associated with:
- Depression
- Alcohol or drug abuse
- Other mental health disorders, including other anxiety disorders or personality disorders
Prevention
There's no sure way to prevent agoraphobia. However, anxiety tends to increase the more you avoid situations that you fear. If you start to have mild fears about going places that are safe, try to practice going to those places over and over again before your fear becomes overwhelming. If this is too hard to do on your own, ask a family member or friend to go with you, or seek professional help.
If you experience anxiety going places or have panic attacks, get treatment as soon as possible.
Get help early to keep symptoms from getting worse. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
By Mayo Clinic Staff
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Fear of Crowds and How to Manage It
Enochlophobia refers to a fear of crowds. It’s closely related to agoraphobia (a fear of places or situations) and ochlophobia (a fear of mob-like crowds).
But enochlophobia has more to do with the perceived dangers posed by large gatherings of people you might encounter in your daily life. It also includes the fear of getting stuck, lost, or harmed in a crowd.
This fear falls under the umbrella of phobias, which are defined as irrational fears that may cause severe anxiety. In fact, the National Institute of Mental Health estimates that about 12.5 percent of Americans will experience phobias at some point during their lifetime.
If you have a fear of crowds, you might find certain situations challenging, especially if you live or work in a highly populated area.
Although there’s no official medical diagnosis for enochlophobia, some methods of therapy can help you overcome your fears. Other treatments can assist with the related symptoms.
Phobias like enochlophobia can lead to intense fear over events unlikely to take place. Even though you might realize that such an intense fear of crowds isn’t rational, it doesn’t lessen the real anxiety that can occur as a result of your phobia.
If you have enochlophobia, you might experience intense anxiety whenever you encounter a crowd of people. Your fear might not be limited to typically crowded events, such as festivals, sports games, or theme parks.
You might also experience a fear of crowds you could encounter on a daily basis, including:
- on a bus, subway, or other form of public transportation
- at movie theaters
- at grocery stores or shopping malls
- at outdoor parks
- at beaches or public swimming pools
It’s not only direct contact with crowds that can trigger enochlophobia.
In some cases, just thinking about being in a crowd might result in stress and anxiety.
Phobias like enochlophobia might also affect other areas of your life, such as work and school.
The symptoms of enochlophobia are similar to those of anxiety. They include:
- increased heart rate
- sweating
- dizziness
- shortness of breath
- stomachache
- diarrhea
- crying
Over time, your fear of crowds may leave you feeling like you can’t participate in certain activities. This can cause further psychological symptoms, including depression, low self-esteem, and reduced self-confidence.
While the exact cause of enochlophobia isn’t known, it’s thought that phobias may be linked to anxiety disorders.
They may also be learned or hereditary. If one of your parents has a history of fearing crowds, then you might’ve picked up on their phobias as a child and eventually developed some of the same fears yourself.
Though a certain phobia may run in your family, you could also develop a different type of phobia from your parents and relatives.
For example, one person might have agoraphobia or social phobia, while you might have enochlophobia.
Negative past experiences can also lead to a fear of crowds.
For example, if you once got injured in a crowd or lost in a large group of people, you might subconsciously think the same incident will happen again. Your mind will then tell you that you must avoid crowds to keep from encountering any danger.
What sets apart enochlophobia from a general dislike of crowds is that the fear can take over your daily life. As a result of your fear, you might practice avoidance, which means you alter your schedule and habits to make sure you don’t come across any crowds.
Avoidance can help you feel at ease because it keeps your phobia symptoms at bay. But it can put you at a disadvantage in the long term. It may lead you to skip important experiences or fun activities, and it could cause problems with family or friends.
Because enochlophobia can lead to intense fears, it could be a challenge to live with.
You might especially struggle if you’re regularly exposed to crowds.
Avoidance could help, but relying on this practice all the time may make your phobia worse. Instead, you can turn to other methods that might help you better live with or even reduce your fear of crowds.
Mindfulness is one way you can try to ease your enochlophobia. Focus on being in the moment, so your mind doesn’t wander to what-if scenarios. Doing this can help you stay grounded and prevent irrational fears from cropping up.
If you do encounter a large crowd or plan on being in one, try to visualize yourself safe and confident in your surroundings. When possible, you might ask a friend or loved one to accompany you to a crowded event.
Reducing anxiety could also help you manage symptoms of enochlophobia. Everyday strategies include:
- regular exercise
- a healthy diet
- enough sleep
- adequate hydration
- less caffeine
- relaxation techniques, such as breathing exercises
- time spent on activities you enjoy
- social activities that involve small groups
Therapy is the primary form of treatment for enochlophobia.
It may include a combination of talk therapy and desensitization techniques, such as the following:
- Cognitive behavioral therapy (CBT). CBT is a type of talk therapy that helps you work through your fears and learn how to replace irrational thinking habits with rational ones.
- Exposure therapy. In this form of desensitization, you’re gradually exposed to crowds. Your therapist may even accompany you.
- Virtual reality technology. This emerging form of exposure therapy may help you desensitize yourself to crowds without physically being in them.
- Visual therapy. With visual therapy, you’re shown photos and images of crowds to help reshape your thinking before real-life exposure.
- Group therapy. Group therapy can connect you with others who also deal with phobias.
Sometimes, a healthcare provider might prescribe medications to help ease anxiety symptoms you might experience with enochlophobia.
Therapists can’t prescribe these. Possible medication options include antidepressants, beta-blockers, and sedatives.
Online therapy options
Read our review of the best online therapy options to find the right fit for you.
If you or a loved one has a fear of crowds, chances are you’re already fully aware of what type of phobia it is. Not all phobias require medical attention, but if your enochlophobia is severe enough to interfere with your daily life, it may be helpful to talk with a doctor.
Your primary care doctor is a good place to start. Depending on the intensity of your symptoms, your doctor might refer you to a psychiatrist or psychologist for further evaluation.
No medical test can diagnose enochlophobia. Instead, a mental health professional may have you fill out a questionnaire that lets you rate the frequency and severity of your symptoms. That person can also help you identify what triggers your fears so you can work through them.
Seeing a mental health professional takes courage — and the sooner you seek help, the better the outcome for your intense fear of crowds.
You likely won’t overcome your fears overnight. But with continued therapy over weeks or months, you can learn to shift your current way of thinking.
A general dislike of crowds isn’t usually a cause for concern. But if you have an intense fear of them, you might have enochlophobia.
If this fear interferes with your daily routine and quality of life, it’s time to talk with your doctor and ask for some advice.
Therapy — and sometimes medications — can help you work through your fears so that one day you might be able to encounter a crowd with ease.
how not to be afraid of crowds, terrorist attacks and diseases
Callousness, bad ecology, accelerated pace of life, endless stress. This is how big cities are usually criticized by those who do not live in them, and they turn out to be right. However, they forget about the main thing - phobias that can appear in any resident of the metropolis. MIR 24 experts told what the residents of big cities are afraid of and how to learn to cope with their own fears.
Any phobia is a distorted self-preservation instinct. All human fears are connected in one way or another with the fear of death. In other words, fear is a consequence of evolution, it increases our chances of survival. But sometimes anxiety begins to subjugate our lives and can develop into a phobia, says the parapsychologist at the Raduzhny Istochnik health center Arina Kremleva .
The nature of the emergence of fear is not fully understood, but it is known for sure that those who have been taught from childhood that the world around them is hostile, as well as people with the habit of concentrating on the negative, are most predisposed to the emergence of phobias. So, for people who are afraid of the crowd, their parents could well say that a large crowd of people or the people themselves are a danger that they can offend or hit. When such a child grows up, a large crowd of people begins to terrify him. nine0005
“I'm afraid to ride the subway”
To understand where phobias come from, you need to understand what triggered them.
“In my practice, there was a man who was afraid to go down the subway. His blood pressure rose, he felt like he was dying. When we started looking for the reason, we found out that in the 90s bandits broke into his house. The oppressive state of hopelessness in a confined space provoked such fear in him, ”Kremleva said. nine0005
Fear of using public transport often occurs in people who were left at home alone by their relatives in childhood. When a person with this phobia gets into a crowded subway car, he may have a panic attack or unmotivated anxiety with physiological manifestations - shortness of breath, heart palpitations, ringing in the ears and impaired coordination. Panic attacks can occur at any time, even when leaving the house on the street. At the moment of attack, human perception is sharpened, and ordinary physiological processes such as breathing cease to seem normal. nine0005
As you might guess, the fear of public transport is always directly related to the fear of the crowd (demophobia).
A person with a phobia perceives a large crowd of people as a kind of substance that he is unable to control.
“The simplest advice is to avoid crowded places. In practice, this is difficult to do, so in a stressful situation, stick to the wall or less crowded places and breathe deeply at each count. Some people are more helped by prayers or music. The main thing is to understand that the panic will pass soon, and not to succumb to it,” said the founder of the medical rehabilitation center “Ortho-Doctor” Roman Alekhin .
Demophobia can be a consequence of agoraphobia - the fear of open spaces, which experts always consider separately, because they consider it very specific. People with this phobia are afraid to leave their comfort zone. Fear is caused by thoughts of an unfamiliar place where it is impossible to control the situation. Usually, such people find it difficult to travel alone, they are afraid of public places from which it is not always possible to get out immediately (crowded cinemas, intercity buses, hairdressers during a haircut).
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“I'm afraid to become a victim”
People who have learned about rape, robbery or murder are subject to no less stress than those who were victims of the incident. The same goes for terrorist attacks. This feature is confirmed by psychiatrists. Experts call the stress experienced against the background of disturbing news secondary trauma or secondary traumatic stress, and the fear of becoming a victim of criminals is called celerophobia. As in the case of demophobia, it can manifest itself with sudden panic attacks. nine0005
According to Oleg Ivanov , a psychologist and head of the Center for the Settlement of Social Conflicts , scelerophobia may well lead to the fact that a person may begin to see a criminal in everyone they meet. People with such a phobia are advised not to abuse social networks, as well as to dose their news consumption. If the development of this fear is not stopped, it can turn into social phobia - the fear of people and social relationships.
As the authors of the book “Go crazy! Guide to Mental Disorders for a Big City Resident, Fester Addams from The Addams Family can be considered a classic example of social phobia - the hero feels empathy, but any need to talk to someone terrifies him. nine0005
“I'm afraid of any infection”
Increased anxiety about one's health is commonly called the hypochondriacal syndrome. Many factors can provoke its development, including active life in an urban environment, for which a person might not be ready. For example, after moving from a small town. Then there is washing hands unnecessarily, obsessive thoughts about incurable diseases, wearing a medical mask “just in case”. According to Ivanov, it is important to catch this fear in time, before it seriously interferes with a fulfilling life. Again, we can find examples of increased anxiety for our health in the cinema. So, in the movie "It doesn't get better" the hero of Jack Nicholson goes to the same restaurant, taking with him a set of disposable dishes, and the hero of DiCaprio in "The Aviator" washes his hands every now and then.
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“Control how many times a day you wash your hands. If you notice that you have started walking around with wet antibacterial wipes, then this is a reason to see a doctor. But not in order to find another incurable disease, but to stop looking for diseases in the future, ”the expert explained.
According to Inna Maltseva, a child and family psychologist at the Clinical Diagnostic Center MEDSI on Krasnaya Presnya , cognitive-behavioral therapy can help cope with anxious thoughts in hypochondriacal syndrome. It is based on the ability to track automatic thoughts, that is, everything that comes to our mind suddenly and has no analytical basis. Automatic thoughts accompany many phobias of residents of large cities. You can learn to control them, for example, with the help of a self-observation diary. It helps to structure both behavior and thoughts, which means it can become an effective psychotherapeutic technique. nine0005
Maltseva added that there are a lot of psychological methods of dealing with phobias.
One of the popular ones is based on a paradoxical intention: a person should consciously face his fears, return himself to a sense of the situation that he is afraid of. This technique was developed by the Austrian psychiatrist Viktor Frankl. According to his theory, the best way to overcome aerophobia is to fly in airplanes. It is assumed that over time, fear will cease to seem significant and simply disappear. However, experts do not advise using this method without specialized psychotherapy, as well as for those people who do not have internal resources to overcome fear. nine0005
March 26 at 19.20 on the MIR TV channel, watch the TV series "The Cure Against Fear". This is a story about a military doctor Andrey Kovalev. He learns about the latest medical development that has not been tested but is being secretly used on soldiers. Together with the FSB colonel, he conducts an investigation and finds out that the drug turns all the fighters into killers. Will they be able to find and punish the dealers?
Types of phobias | Clinic prof.
Preobrazhensky Home / Neuroses, depressions, fears / Types of phobias
The concept of a phobia
Everyone knows the concept of “phobia”, but not everyone can coherently explain what exactly it is. Translated from Greek, "phobia" means "fear, fear." In reality, fears and phobias are very close, but there are significant differences between them. Fear is a natural protective function of the body in the face of a real danger, physiologically manifested in the release of hormones into the blood, heart palpitations, vegetative dysfunctions, etc. An interesting fact can help to understand the nature of fear - a person is born absolutely fearless. Small children are not afraid to fall from a height, drown in a bathtub or touch a fire with their fingers. Only later with experience does the feeling of fear come, and, in general, these fears are useful. Basically, the feeling of such fear helps to get away from dangerous situations or prevent them.
This feeling of fear is quite conscious and controlled by common sense and logic. nine0017 Phobias are fears that are characterized by a very significant stability, are not based on common sense (irrational) and are constantly present in the human psyche. Moreover, these fears are most often not in front of a real threat, but fears “within us”. Phobias, unlike fears, are very difficult to control thinking and common sense.
How to distinguish a phobia from a "simple" fear
Consider the difference between fear and phobia using a real example. There are enough people who are afraid to ride the subway. If the cause of fear is fear, it must be caused by certain negative experiences in the past. For example, a person once became ill in the subway. If the reason is fear, then the person will prefer to move around the city by land transport, but if necessary, he will still go down to the subway. Naturally, this will be accompanied by certain experiences, but will be controlled by common sense and logical thinking.
In the case of a phobia, the problems will be much more significant, depending on the severity of the phobia. In the mildest cases, a person will still go down to the subway, but any, even the most insignificant, car stops between stations will cause a pre-panic and panic state. In the most difficult cases, a person will not be able to force himself to go down to the subway even in case of emergency, contrary to logic and common sense, and any attempts to force it by other people can cause severe psychological trauma. nine0005
Is it relevant? According to world statistics, every eighth inhabitant of the planet Earth has phobias. Thus, phobias as a type of neurotic disorders (neurosis, depression, fears) are a widespread phenomenon.
Types of phobias. Classification of phobias
More than 500 types of phobias have been described so far. The most common of these are social phobia and agoraphobia.
- Social phobia is a type of phobia, which is characterized by a pronounced fear of being in the very center of attention of strangers, behaving in such a way that it will cause humiliation or embarrassment.
This type of phobia manifests itself in social everyday situations - during a meeting with friends, lunch in a cafe, the need to speak at a meeting, and others. nine0091 - Agoraphobia - a type of phobia associated with "helplessness, if you suddenly feel bad." This type of phobia manifests itself in the fear of traveling unaccompanied, being among strangers.
All other types of phobias are classified into the group of so-called isolated phobias. Below are examples of just a few of them.
Phobias of animals or insects:
- - cynophobia - fear of dogs;
- - gatophobia - fear of cats;
- - arachnophobia - fear of spiders;
- - ophidophobia - fear of snakes.
Phobias associated with situations:
- - claustrophobia - fear of closed spaces;
- - ochlophobia - fear of crowded places;
- - monophobia - fear of being alone with oneself;
- - xenophobia - fear of foreigners, strangers.
Phobias associated with natural forces:
- - acrophobia - fear of heights;
- - nyctophobia - fear of darkness, night;
- - aquaphobia - fear of water;
- - pyrophobia - fear of fire;
- - thalassophobia - fear of the sea.
Health-related phobias:
- - odontophobia - fear of dental treatment;
- - bacillophobia - fear of microorganisms;
- - cardiophobia - fear of cardiovascular diseases;
- - hematophobia - fear of the sight of blood.
Phobias related to states and actions:
- - stasibasiphobia - fear of vertical position and walking;
- - stasiphobia - fear of standing;
- - lalophobia - fear of speaking;
- - tremophobia - fear of trembling;
- - basilophobia - fear of walking;
- - amaxophobia - fear of driving.
Phobias associated with objects:
- - hyalophobia - fear of glass;
- - macrophobia - fear of large objects;
- - microphobia - fear of small objects; nine0091
- - computer phobia - fear of computers;
- - Belonephobia - fear of piercing objects.
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Symptoms of phobias
The symptoms of phobias are quite diverse. To establish a diagnosis of phobias, at least two of the following anxiety symptoms must be present, and one of them must be included in the top four: or chest discomfort
6. Choking
7. Difficulty breathing
8. Depersonalization or derealization
9. Vertigo
10 numbness or tingling
11 fear of death
12 fear of losing control
13 chills or hot flashes
14 nausea
Phobias are common in the modern world.
