Netflix's new thriller, The Woman in the Window, tells the haunting story of a psychologist named Anna who is confined to her home with agoraphobia, a mental health condition that comes with an intense fear of leaving home. "This is a safe place," she says at one point, after locking her doors.
"I'm agoraphobic. I can't go outside," Anna says in another scene. Anna ends up witnessing a crime she's later told didn't happen, and struggles to figure out what's real.
The movie, which is based on a bestselling novel of the same name, dropped at an interesting time, just as restrictions due to COVID-19 are lifting around the country. People are slowly resuming some level of normalcy after more than a year of living under pandemic conditions, and some have said on social media that it's hard for them to get out again, even citing agoraphobia as a reason.
"Throughout the pandemic, I've developed really bad agoraphobia," one person wrote on Twitter. "But today, I went out and went into a shop for the first time since lockdown first started. Really proud of myself for pushing past my fears."
"I've been on a walk every day for 4 days now—3 of them alone— despite my agoraphobia regressing over the last year & I'm very proud of myself," another said.
With agoraphobia popping up everywhere right now, from your Twitter feed to your Netflix queue, it's understandable you might have some questions. Here's a breakdown of the condition, as well as how it's treated.
What is agoraphobia?
Agoraphobia is an intense fear and anxiety of being in places where it's hard to escape, or where help might not be available, according to MedlinePlus.
"Oftentimes, it manifests in being in a crowd, standing in line, or traveling on a bus or train," Bunmi O. Olatunji, PhD, associate professor of psychiatry at Vanderbilt University, tells Health.
Agoraphobia is a type of anxiety disorder, and it's often linked to panic attacks, Luana Marques, PhD, associate professor in the department of psychiatry at Harvard Medical School and associate director and director of research at the Center for Anxiety and Traumatic Stress Disorders Program at Massachusetts General Hospital, tells Health.
What causes agoraphobia?
A more typical case of agoraphobia is when someone had a panic attack and then starts to be afraid of situations that might lead to another panic attack, Marques says. "If you were on a subway and had a panic attack, then you start to avoid the subway," she explains. "Then you start to avoid a lot of things, and that's when we get to agoraphobia."
There are people who just have agoraphobia without a panic attack link, Marques says, but the condition is more commonly tied to panic disorder.
Marques says it's "hard" to know why some people develop agoraphobia while others don't. "People have some vulnerability, and increased anxiety can make them more fearful," she says. "That can certainly make someone develop agoraphobia."
Continuing to avoid leaving the house can make agoraphobia worse, Alicia H. Clark, PsyD, author of Hack Your Anxiety, tells Health. "When you avoid something scary, it tends to get scarier," she says.
Olatunji agrees: "People experience a panic attack in a specific situation, and start to avoid that setting more and more. Before you know it, they're not leaving the house," he says.
What are symptoms of agoraphobia?
There are a lot. MedlinePlus specifically lists these out:
- Being afraid of spending time alone
- Being afraid of places where escape might be hard
- Being afraid of losing control in a public place
- Depending on others
- Feeling detached or separated from others
- Feeling helpless
- Feeling that your body is not real
- Feeling that your environment is not real
- Having an unusual temper or agitation
- Staying in your house for long periods
Can the pandemic create more cases of agoraphobia?
Experts don't necessarily think that clinical cases of agoraphobia will increase, but they say that they expect more people will have some degree of anxiety about being away from home more.
"We have to be mindful of the fact that there is a great deal of resiliency in people's responses to stressful events," Olatunji says. "I wouldn't necessarily predict that we're going to see a significant increase in the cases of agoraphobia, but people who had agoraphobic symptoms pre-pandemic are really going to be the ones that will have a harder time coming back as things start to go back to normal."
Still, Clark says it's to be expected that plenty of people will feel anxious about getting out more. "The pandemic has normalized agoraphobia," Clark says. "Getting back to normal will require a bit of exposure therapy." Meaning, you may feel nervous to get out again more regularly, even if it's safe. "The trick is to stick with it and notice the anxiety diminishing with progressive exposure," she says.
How is agoraphobia treated—and what should you do if you’re experiencing symptoms?
If you're feeling fearful of leaving your home, it's a good idea to try your best to push past it. Olatunji says it's important to not avoid certain everyday situations out of fear that something could happen. "It's important for people to learn that they can tolerate those symptoms," he says.
But, if you find that you're trying to get out more and you're still struggling, he says it's time to consult a mental health expert for help. "There are very good treatments out there for agoraphobia," Olatunji says.
Treatment for agoraphobia focuses on helping you feel better and being able to live your life normally. It usually uses a combination of talk therapy, including cognitive behavioral therapy (CBT), and medication, like selective serotonin reuptake inhibitors (SSRIs), MedlinePlus says. In more extreme cases, sedatives or hypnotic drugs may be prescribed.
CBT for agoraphobia tries to encourage the patient to expose themselves slowly to situations that scare them, Marques says. "We recommend finding a way to approach a situation in a way that their body can handle," she says. Even a walk around the block can feel like a lot for some people with agoraphobia, so doctors may recommend doing a short walk with a friend, building up to something like lunch outside. "It's about creating situations that are lessening anxiety, and doing it often enough," Marques says.
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