What are people usually afraid about in public?

 Why are People Afraid of Public Speaking?

How can I be less scared of going outside?

What Is Agoraphobia?

Agoraphobia is a rare type of anxiety disorder. If you have it, your fears keep you from getting out into the world. You avoid certain places and situations because you think you’ll feel trapped and not be able to get help.

For example, you might worry or panic when you are in:

Public transportation (buses, trains, ships, or planes)

Large, open spaces (parking lots, bridges)

Closed-in spaces (stores, movie theaters)

Crowds or standing in line

Being outside your home alone

You may be willing to go just a handful of places, or you may even dread leaving your house. 

Agoraphobia Causes and Risk Factors

Doctors aren't sure what causes agoraphobia. They think it runs in families. You may get it if you have a lot of panic attacks. That's when you have bursts of fear that come out of the blue and last for a few minutes. These happen when there's no real danger.

Less than 1% of people in the U.S. have agoraphobia. Women are two to three times more likely to have it than men, and it's more common in teenagers and young adults. 

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A few other things that can raise your chances of it include having:

Panic disorder, especially if it’s not treated

Other phobias

A family member who has agoraphobia

A history of very stressful or traumatic events

Agoraphobia Symptoms

If you have agoraphobia and end up in a place that scares you, you can become very anxious or panic. Physical symptoms of this can include:

Fast, pounding heart

Sweating, trembling, shaking

Breathing problems

Feeling hot or cold

Nausea or diarrhea

Chest pain

Problems swallowing

Dizziness or feeling faint

You may feel like: 

You might not survive a panic attack.

You’re not in control. 

You’ll look bad in front of others or that they’ll stare at you.

You need to be with someone you trust when you go anywhere.

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You also might have:

A fear of being alone in your house

A general feeling of dread

Agoraphobia Diagnosis

A lot of the symptoms caused by agoraphobia are the same as those of other medical conditions like heart disease, stomach issues, and breathing problems. So you may make several trips to the doctor or emergency room before you and your doctor figure out what's really going on.

Your doctor may ask:

Do you find it scary or stressful to leave your house?

Do you have to avoid some places or situations?

What happens if you end up in one of them?

They’ll do a physical exam and maybe some tests to rule out any other medical problems. If they don’t find a physical reason for your symptoms, they’ll probably recommend that you see a psychiatrist or therapist. 

At your session, you’ll answer questions about your feelings and your behavior. According to standards created by the American Psychiatric Association, you could be diagnosed with agoraphobia if you feel extreme fear or panic in at least two of these situations:

Outside your house by yourself

In an open space, like a parking lot or mall

In an enclosed space, like a theatre or small office

In a line or in a crowd

On public transportation, including planes

Agoraphobia Treatments

Your doctor will usually treat agoraphobia with therapy, medication, or a combination of the two. 

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Therapy. Cognitive therapy can teach you new ways to think about or face situations that cause panic and help you be less afraid. You may also learn relaxation and breathing exercises. Sometimes your therapist may suggest exposure therapy, in which you gradually start to do some of the things that make you anxious.

Medicine. There are many drugs that your doctor might suggest for agoraphobia, but the most common are antidepressants. Doctors often start with a low dose of one of these medicines that raises the level of a "feel-good" chemical in your brain called serotonin. Some medications that help balance serotonin are citalopram (Celexa), escitalopram oxalate (Lexapro), fluoxetine (Prozac), sertraline (Zoloft), and venlafaxine (Effexor).

You'll probably take medicine for at least 6 months to a year. If you feel better and no longer are stressed when you're in places that used to scare you, your doctor may begin tapering off your medicine.

For short-term relief, your doctor may recommend anti-anxiety medications, called benzodiazepines, in addition to antidepressants. These are sedatives that can help with your symptoms. You can start to depend on them, so you shouldn’t take them for long. And be sure to tell your doctor if you’ve had any issues with alcohol or drug abuse.

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Alternative therapies. Applied relaxation is a series of exercises that help you notice when you start to feel tense and learn how to relax your muscles and ease that tension. It typically takes an hour-long session each week for 12 to 15 weeks.

Other alternative therapies that may help include breathing exercises and meditation.

Lifestyle changes. It can help to exercise regularly and eat a healthy diet. Skip caffeine and alcohol. They can make your symptoms worse.

Agoraphobia Outlook

The right combination of medication and therapy can help manage agoraphobia and make living with it easier. A few other things to keep in mind:

Get help when you need it. Family and friends can help you work through your fears, and a support group lets you connect with people who are going through the same things you are.

Manage anxiety and stress. Talk with your therapist about ways to calm yourself and find relaxation techniques that work for you.

Follow your doctor’s guidance. It’s really important to take medication as directed and keep your therapy appointments. Stay in touch with your health team so they can do their best for you.   

Why am I scared of going outside?

About agoraphobia

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Agoraphobia is a type of anxiety disorder. A person with agoraphobia is afraid to leave environments they know or consider to be safe. In severe cases, a person with agoraphobia considers their home to be the only safe environment. They may avoid leaving their home for days, months or even years.

Translated, agoraphobia means ‘fear of the marketplace’. Generally, busy public places (such as supermarkets, shopping centres, trams, trains, planes and airports) are feared the most. However, any public place – even a quiet church or an empty park – may seem threatening to a person suffering from agoraphobia. 

Typically, agoraphobia often starts off as a mild anxiety about a particular event, place or situation that escalates over time into a generalised fear of being in public. Mental health experts believe that the root of agoraphobia is fear of the physical and mental sensations of anxiety and, often, of panic or of losing control or embarrassing oneself. A person with agoraphobia is unwilling to visit ‘unsafe’ places because they’re afraid that doing so will trigger anxiety or a panic attack. 

Symptoms of agoraphobia

The symptoms and signs of agoraphobia may include: 

• anxiety in response to being away from an environment that feels ‘safe’
• panic attack including symptoms such as breathlessness, sweating, dizziness, fast heart rate, choking sensations, nausea, and feelings of extreme fear or dread
• anticipation of anxiety if the person is required to leave their safe environment
• low self-esteem and loss of self-confidence
• reluctance to leave the house or venture beyond familiar surrounds
• depression, which can sometimes accompany the condition.

Agoraphobia develops over time

Agoraphobia usually begins with a stressful event – for example, a person loses a job or a relationship ends. They feel distressed and limit their contact with the outside world (this is called ‘avoidance behaviour’). As time passes, they may consider more and more public places as ‘out of bounds’ until they are eventually confined to their home. 

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In other cases, a stressful life event triggers a panic attack. Since panic attacks are so unpleasant, the person may avoid any situation or place that they think might trigger another attack until many situations and places are eventually feared and avoided. 

Complications of agoraphobia

Untreated, agoraphobia can severely reduce a person’s quality of life. For example: 

• Activities outside of the home such as work, school, socialising, hobbies and many forms of exercise are out of reach. 
• Financial hardship, isolation, loneliness and boredom may lead to greater feelings of distress and increase the risk of depression.
• The person may recognise that their fear is irrational, but feel powerless to do anything about it. 
• They may feel angry and frustrated with themselves. 
• These negative feelings damage self-esteem and contribute to depression, and other anxieties and fears.
• The person may try to cope using unhealthy methods (such as comfort eating, drugs or alcohol), which in turn can cause or contribute to further health problems.

Diagnosis of agoraphobia

Diagnosis is usually based on the person’s reported symptoms. However, the doctor may run a series of medical tests to make sure the symptoms are not caused by an underlying physical illness. The doctor may suggest referral to a psychologist or psychiatrist for further evaluation and treatment.

Treatment for agoraphobia

Agoraphobia responds well to treatment. The treatment options suggested by your doctor or therapist will depend on your circumstances and preferences, but may include: 

• a course of medications, such as antidepressants or anti-anxiety medications
• cognitive behaviour therapy and exposure therapy
• counselling and talk therapy
• relaxation training
• support groups
• instruction in self-help methods.

Self-help methods to manage agoraphobia

The key to conquering agoraphobia is learning to control anxiety symptoms and progressively going into the situations that you fear.

Be guided by your doctor or therapist, but general self-help suggestions include: 

• Breathe slowly – hyperventilation (breathing too fast and too shallow) will make the symptoms of a panic attack worse. Consciously slow your breathing. Concentrate on expanding your abdomen, not your chest, with every inhalation. 
• Use relaxation techniques – learning to relax may include methods such as meditation, deep muscle relaxation or regular exercise. You may need to experiment to find the relaxation method or methods that work best for you.
• Find out about your condition – overcoming agoraphobia involves understanding how anxiety affects the mind and body. 
• Change your lifestyle – it may help to limit or avoid caffeine, alcohol and certain medications. Regular exercise burns off stress chemicals and is known to reduce anxiety levels. See your doctor for further information and advice. 
• Gradually increase exposure – this involves facing the feared environment in a controlled way. This will help you to see that nothing bad is going to happen. Typically, you choose the least threatening environment first, take along a trusted friend or your therapist as support, and use slow breathing and the other coping methods you’ve learned to control your anxiety. With regular practise, the fear of the place or situation will ease. This technique is also known as systematic desensitisation. It’s important to have the guidance of a mental health professional.

Why are people afraid of public?

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Seinfeld’s old quip about the widespread fear of public speaking rings true for many Americans, who often claim they fear public speaking more than they fear death. While the numbers don’t quite support that theory, they are staggering: 15 million American adults suffer from social anxiety, and nearly 30 percent of Americans report that they’re “afraid or very afraid” of public speaking. In fact, this fear is so widely accepted that many scientists researching stress will actually induce anxiety by asking study participants to give a speech.

Why is Public Speaking So Terrifying?

Academic researchers hypothesize that this intense fear of public speaking comes from evolution. In the past, when humans were threatened by large predators, living as a group was a basic survival skill, and ostracism or separation of any kind would certainly mean death. This may have evolved into the fear of public speaking — and it makes sense. What situation embodies that kind of separation more than standing all alone in front of a room full of people? On a deep level, people are afraid their audience will reject them.

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Another theory states that when we enter a state of social anxiety, which is common in public speaking, our ability to pick up on angry faces is heightened. In a 2009 study, psychologist Matthias Wieser measured participants’ brain responses to angry, happy, and neutral images. In order to elicit anxiety, Wieser told some of the participants they would have to give a speech. The anxious participants were significantly more sensitive to the angry images than to happy or neutral ones, but the rest of the participants did not exhibit the same bias. It’s easy to see how this phenomenon becomes something of a vicious cycle in the context of public speaking. When we start out nervous, no matter how many people are smiling or nodding along, we’re apt to lock onto the one person who looks angry, which makes us even more nervous.

How Do Speakers Display their Fear?

It is common knowledge that nervous speakers experience sweaty palms and dry mouth, and often struggle to get their words out. But what do audiences actually perceive, and how can we make sure we appear cool and confident?

We used our communication analytics platform and database of communication samples from TED Speakers, Fortune 500 executives, politicians, and other leaders to identify the key indicators of confidence and fear. We compared the most confident presentations in our database to the least confident ones and found that, when it comes to showing fear, three metrics matter.

1.    Confident Speakers Exhibit More Passion

The most confident speakers demonstrate 22.6 percent more passion than nervous speakers, meaning their delivery exhibits the kind of energy and engagement that indicates they’re really invested in their topic.

Quantified Communications coach Briar Goldberg says many nervous speakers have a hard time being mentally present for their speeches. In some cases they essentially black out as they talk — the next thing they know, they’re walking off stage. In other cases, they become distracted by the voices in their head worrying that they’ve forgotten what to say next.

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Either way, a disengaged speaker is more likely to give a presentation that sounds rote and monotonous compared to the passion a confident presenter can demonstrate.

2.    Confident Speakers Offer More Insight

We also found that confident speakers incorporate, on average, 1.2 times the insight of fearful speakers, meaning they’re diving below the surface of the topics they’re presenting on.

This finding matches our intuition — more confident speakers are comfortable thinking about and discussing their topics in depth and, likely, are people who’ve truly mastered the concepts they’re discussing. On the other hand, a nervous speaker may lose track of the more insightful information, or may not be as well versed in the material as her confident counterparts.

3.    Confident Speakers are More Inclusive

We were really fascinated by our third finding, that confident speakers use 46.9 percent more inclusive language than nervous speakers, meaning they’re using collaborative words and personal pronouns to help the audience feel more involved in the message.

This finding could indicate that the most confident speakers are community oriented, and suggests that camaraderie-driven language can help nervous speakers build confidence by overcoming that evolutionary fear of ostracism.

So How Can I Become a More Confident Speaker?

If you’re nervous about an upcoming speech, most coaches will offer general tips like “be prepared,” or “breathe and stretch to calm your nerves,” or “remember the audience is on your side.” These are all great strategies, but the metrics above offer more specific advice. If you’re nervous, channel that nervous energy into demonstrating your passion for the topic at hand as you share your best insights with your audience — and be sure to include the kinds of collaborative language that will help you and your listeners feel like part of the group. By focusing on these strategies, you’ll convince your audience you’re a confident and fearless presenter.

And we’d be willing to bet, once you’ve mastered these techniques, you’ll find you really are a confident and fearless speaker.

Social Anxiety | Overcome the Fear of Being Judged

Does speaking in public fill you with fear and anxiety? Try these tips for overcoming your fear of public speaking

Article by:

Rosemary Black

Jump to:Symptoms of Glossophobia Causes of Glossophobia Treatment Options Action Steps

Glossophobia, or a fear of public speaking, is a very common phobia and one that is believed to affect up to 75% of the population. Some individuals may feel a slight nervousness at the very thought of public speaking, while others experience full-on panic and fear. They may try to avoid public speaking situations at all cost or if they must speak in public, they endure shaking hands and a weak, quavering voice. How to overcome a fear of public speaking? With persistence and preparation, it’s entirely possible to beat glossophobia.

“The fear of public speaking is more common in younger patients as compared to older ones and may be more prevalent in females as compared to males,” says Jeffrey R. Strawn, MD, FAACAP, associate professor of psychiatry and pediatrics and director of the Anxiety Disorders Research Program in the Department of Psychiatry & Behavioral Neuroscience at the University of Cincinnati. “We know that some individuals tend to have more anxiety related to certain circumstances in which there may be a fear of evaluation and embarrassment.”

A fear of public speaking often is present in individuals with social anxiety disorder, Dr. Strawn says, and these social anxiety disorders may affect 5 to 9% of Americans. “However, it is important to point out that not all individuals with a fear of public speaking have social anxiety disorder or another psychiatric disorder,” he explains. “For a diagnosis of a psychiatric disorder, clear functional impairment is generally required.”

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Symptoms of Glossophobia

Glossophobia causes a variety of symptoms such as:

Increased blood pressure

Increased perspiration

Dry mouth

A stiffening of the upper back muscles

Nausea and a feeling of panic when faced with having to speak in public

Intense anxiety at the thought of speaking in front of a group.

Causes of Glossophobia

Most phobias seem to appear out of the blue, often starting in childhood or early adulthood. A phobia may arise because of a combination of genetic tendencies and other environmental, biological, and psychological factors.  People who fear public speaking may have a real fear of being embarrassed or rejected.

Glossophobia may relate to one’s prior experiences, Dr. Strawn says. “An individual who has a bad experience during public speaking may fear a repeat of that prior experience when attempting to speak again,” he admits.

Or if a person is told to speak to a group on the spot with no chance for advance preparation, and it does not go well, she may begin to fear public speaking.

Treatment Options

Glossophobia is treatable, and in general, exposure-based treatments and exercises are the most helpful, Dr. Strawn says.

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In exposure therapy, an individual is taught coping skills and, over time, learns to handle the situation that is causing the fear. Cognitive Behavioral Therapy (CBT) is useful because it helps an individual to effectively manage her symptoms.

People with glossophobia also may benefit from anxiety management and relaxation techniques, and a combination of several treatments may be recommended.

“In individuals with a social anxiety disorder accompanied by a fear of public speaking, medications may be helpful, especially when they are combined with psychotherapy,” Dr. Strawn says.

Action Steps

Be prepared. If you want to overcome your fear of public speaking, get yourself organized ahead of time. Try to visit the venue where you will be giving your talk, and carefully review any and all equipment beforehand. And learn all you can about your topic well in advance. This makes it less likely that you will say something incorrect or go off track. If you do stray slightly, knowing your topic well will increase your odds of recovering quickly.

Practice makes perfect. Don’t just “give” your complete presentation to a volunteer audience once. Do it several times with friends, family members, or anyone else you feel comfortable with. Ask for feedback and review everyone’s comments carefully. You may even want to make a video of your speech so you can see it and make any revisions that you think will make it better.

Pay attention to the material at hand, rather than your audience. Generally, an audience is focusing on the new information they are listening to rather than how it is presented. Chances are that they won’t even notice your trepidation.

Don’t be afraid of the sounds of silence. When you momentarily lose track of what you are saying, you may feel nervous and feel that you have been silent forever. But it’s probably no longer than a few seconds, so simply take a few slow, deep breaths and proceed.  Remind yourself that even if the moment of silence was longer than a moment, that’s okay, too. Your audience probably figured that the pause was planned and they won’t mind a bit.

What is the fear of being in public?

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Agoraphobia is a fear of being in situations where escape might be difficult or that help wouldn't be available if things go wrong.

Many people assume agoraphobia is simply a fear of open spaces, but it's actually a more complex condition. Someone with agoraphobia may be scared of:

travelling on public transport

visiting a shopping centre

leaving home

If someone with agoraphobia finds themselves in a stressful situation, they'll usually experience the symptoms of a panic attack, such as:

rapid heartbeat

rapid breathing (hyperventilating)

feeling hot and sweaty

feeling sick

They'll avoid situations that cause anxiety and may only leave the house with a friend or partner. They'll order groceries online rather than going to the supermarket. This change in behaviour is known as avoidance.

Read more about the symptoms of agoraphobia.

What causes agoraphobia?

Agoraphobia usually develops as a complication of panic disorder, an anxiety disorder involving panic attacks and moments of intense fear. It can arise by associating panic attacks with the places or situations where they occurred and then avoiding them.

A minority of people with agoraphobia have no history of panic attacks. In these cases, their fear may be related to issues like a fear of crime, terrorism, illness, or being in an accident.

Traumatic events, such as bereavement, may contribute towards agoraphobia, as well as certain genes inherited from your parents.

Read more about the possible causes of agoraphobia.

Diagnosing agoraphobia

Speak to your GP if you think you may be affected by agoraphobia. It should be possible to arrange a telephone consultation if you don't feel ready to visit your GP in person.

Your GP will ask you to describe your symptoms, how often they occur, and in what situations. It's very important you tell them how you've been feeling and how your symptoms are affecting you.

Your GP may ask you the following questions:

Do you find leaving the house stressful?

Are there certain places or situations you have to avoid?

Do you have any avoidance strategies to help you cope with your symptoms, such as relying on others to shop for you?

It can sometimes be difficult to talk about your feelings, emotions, and personal life, but try not to feel anxious or embarrassed. Your GP needs to know as much as possible about your symptoms to make the correct diagnosis and recommend the most appropriate treatment.

Read more about diagnosing agoraphobia.

Treating agoraphobia

Lifestyle changes may help, including taking regular exercise, eating more healthily, and avoiding alcohol, drugs and drinks that contain caffeine, such as tea, coffee and cola.

Self-help techniques that can help during a panic attack include staying where you are, focusing on something that's non-threatening and visible, and slow, deep breathing.

If your agoraphobia fails to respond to these treatment methods see your GP.

You can also refer yourself directly for psychological therapies, including cognitive behavioural therapy (CBT), without seeing your GP.

Read more about psychological therapies on the NHS.

Medication may be recommended if self-help techniques and lifestyle changes aren't effective in controlling your symptoms. You'll usually be prescribed a course of selective serotonin reuptake inhibitors (SSRIs), which are also used to treat anxiety and depression.

In severe cases of agoraphobia, medication can be used in combination with other types of treatment, such as CBT and relaxation therapy.

Read more about treating agoraphobia.

Outlook

Around a third of people with agoraphobia eventually achieve a complete cure and remain free from symptoms.

Around half experience an improvement in symptoms, but they may have periods when their symptoms become more troublesome – for example, if they feel stressed.

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Despite treatment, about 1 in 5 people with agoraphobia continue to experience troublesome symptoms.

How common is agoraphobia?

In the UK, up to 2 people in 100 have panic disorder. It's thought around a third will go on to develop agoraphobia.

Agoraphobia is twice as common in women as men. It usually starts between the ages of 18 and 35.