It’s hard to believe that Prince Harry, such a public figure, struggles with agoraphobia. However, he admits in his new memoir, Spare, that he suffered with the anxiety disorder that may result in people being afraid of leaving their homes. The 38-year-old recalls “one speech, which couldn’t be avoided or canceled, and during which I’d nearly fainted.”
According to TODAY, Prince Harry’s new book chronicles several episodes of public panic attacks due to his condition. Experts say agoraphobia is an anxiety disorder that involves intense fear and anxiety in situations where it would be difficult to escape. Jacqueline Bullis, a Boston-based clinical psychologist who specializes in treating adults with anxiety disorders is an instructor in the department of psychiatry at Harvard Medical School, says these situations could include traveling on a plane or other forms of public transportation, being in a crowd, going to a movie theater or grocery store, or even sitting down for a haircut.
“Agoraphobia used to be thought of more of this fear of open spaces, but now we really understand it as more of a fear of fear,” Bullis tells TODAY. “It’s more about the fear that they’re going to experience distressing or panic-like symptoms in that situation, and then it would be really hard or really embarrassing to escape from it.” As people avoid more places, they become more homebound, says Bullis.
“Someone’s world becomes smaller and smaller,” she says. Those suffering from the condition may start to avoid activities that illicit strong emotions such as sex, exercise, going to scary movies, or consuming caffeinated drinks that can trigger a racing heart or distressing physical sensations. It’s common that agoraphobia is accompanied by panic attacks, as Harry reported, but they are two distinct conditions.
Although the Prince appears comfortable giving speeches at public events, Bullis says that looks can be deceiving. The expert, who has not treated Harry, says “we oftentimes cannot visibly see the amount of distress that someone is under, which may be the case with Harry in some of these situations.”
The National Institute of Mental Health says that agoraphobia is a fairly rare disorder affecting 1.3% of U.S. adults at one point in their lives. Cognitive behavior therapy, or CBT, is the first line of treatment, says Bullis. Medication such as beta blockers usually prescribed to treat high blood pressure and disturbances in heart rhythms may be used but Bullis says that using drugs can backfire in the long run because it’s not teaching people to cope on their own.
Therapy helps sufferers feel okay with the physical sensation triggered by their fear. Bullis say the goal is to help people recognize that their reaction is not dangerous and that they can “still give this talk or I can still go into this situation and that I’m safe.”