Agoraphobia: how running can help

Run for body and mind Running can be a solitary sport, and it’s great to get out for a run on your own, getting lost in your thoughts, and just enjoying time with ‘you’. Yet for many of us, running with others, which leads to building friendships, feeling part of a community, and being social, are some of the most enjoyable aspects of our sport. It got me thinking - could running actually help people who suffer with anxiety in crowds, or who have a fear of going out? Agoraphobia - what is it? The common belief that people with agoraphobia simply fear stepping outside their home, is generally not true. As far back as 1871 German neurologist Carl Westphal first described the term after studying four male patients who had attacks of anxiety in public places. The term ‘agoraphobia’ derives from the Greek word ‘agora’ meaning the ‘market place’. Westphal felt this term was appropriate as it described how people felt vulnerable in public places, particularly when there was no obvious exit. Panic attacks seem to be linked to the ‘avoidance’ tendency that is key to the disorder. Today, there’s consensus that agoraphobics typically experience a cluster of fears/phobias, and that there are usually a number of causes rather than a single cause. Causes People aged between 18 and 35 most commonly develop the onset of agoraphobic symptoms, and the condition affects between 1.5% and 3.5% of the general population. Onset can be sudden or gradual, over weeks, months or even years; or it can come and go for a considerable length of time or become a permanent problem. Agoraphobics often have a causal relationship with depression, in that people with depressive or anxiety symptoms can develop agoraphobic symptoms (cause/effect) and people with agoraphobic symptoms, often feel so isolated and frustrated, they can then develop depressive/anxiety symptoms. So, it’s complicated. Agoraphobia can also be associated with stressful life events and people who endure repeated stresses can often develop phobic symptoms. People who experience a frightening situation (being trapped in a car, life, or fire) can also develop agoraphobic behaviours. People with agoraphobia generally find it almost impossible to carry out specific activities, such as going into crowded or public places, lifts, onto public transport or simply travelling anywhere away from home where 'escape' or immediate access to help is not possible. Agoraphobics can often fear standing in queues, going on bridges or sitting in any place where they feel 'trapped'. There can also be additional fears, often linked to social situations such as a fear of blushing, trembling, talking, eating or writing in front of people. A companion for outings is often needed and usually becomes essential. Can running help? New runners often say their main motivation to start - and continue - to run is of how it makes them feel; that is, the feeling of being connected to others and having support. Importantly, these aspects can have knock on effects on self-belief, confidence and motivation. For those who have panic attacks, or who get anxious in crowded or public places, running with a friend or a local running group, while initially quite stressful, could over time arguably help to reduce such anxiety/panic attacks because of the subtle emotional and physical support that running provides. Internal shifts Penny Lees, from Downpatrick, Ireland, found that running helped her overcome anxiety and helped build her confidence. Lees, who for many years was reclusive and felt isolated, suffered with panic attacks and agoraphobic tendencies (as reported in Belfast Telegraph, 8 Jan, 2016). Lees took up running after hearing that exercise helped with depression and anxiety. She entered a local 10k event and while it was nerve-wracking lining up at the start, she says felt like a different person at the finish: “It felt amazing - I had achieved something and it gave me the confidence to enter another Born2run event at Gosford,” Lees told the Belfast Telegraph reporter. Your confidence can grow as you push through comfort zones and achieve things you never thought you could, and can also be spurred on by other runners and club mates who enjoy the same sport and who encourage you. On the flip side, while many people use running as a way of coping with daily stresses and as a way to ‘release’ anxiety, it’s commonly known that for regular runners who stop running for a long period of time through injury, illness or other, can begin to experience signs and symptoms of stress, anxiety or depression. Running builds consistency One of the complicated aspects of panic attacks, anxiety and agoraphobic behaviours, is that the symptoms may come and go and there may be periods of years in between episodes where there are virtually no symptoms then all of a sudden, daily stresses increase and symptoms can be triggered. I spoke with several runners who told me that in the past, they suffered with anxiety and panic attacks on and off for years. However, when they took up running, the time gaps between anxiety/panic episodes grew wider, and when panic/anxiety attacks were experienced, the intensity of the episodes gradually decreased.