January 19th, 2009
12:22 PM ET


[cnn-photo-caption image=http://i2.cdn.turner.com/cnn/2009/TRAVEL/01/18/inauguration.travel/art.mall.crowd.gi.jpg

caption="Crowds gather on the Mall in Washington, D.C., on Sunday for a pre-inaugural concert."]
By Sabriya Rice
CNN Medical Tapes Producer

Half of my family lives in the D.C. area, so naturally everyone I know is curious about whether I plan to attend this year's historic inauguration. As much as I'd love to take a front-row seat in history, every time I read about the more than 1.5 million people expected to pack the streets of the District, I get nauseated. As I reflected on other idiosyncrasies of my life, like how I refuse to climb crowded staircases, or how I let several trains pass to avoid squeezing into a cramped car, I began to wonder if an undiagnosed phobia was the culprit of my peculiar inauguration evasion. And if so, what could I do about it?

Experts I spoke with said anxiety about being trapped in enclosed spaces is pretty common. According to Dr. Reid Wilson, a psychiatrist at the University of North Carolina, claustrophobia ranks among the top five phobias, along with fears of public speaking, heights, bugs and swimming. Maybe that explains why so many D.C. residents I know are actually planning to head out of town. Even my otherwise fearless father is considering a trip to Florida. Like many others, they are avoiding the crowds and opting to watch the ceremony on television. Certainly, they could attend if they wanted to, but made rational decisions to watch from elsewhere. Take a self-test if you think you may have an anxiety disorder.

For the 6 million Americans suffering from panic disorders, including phobias, the decision whether or not to attend may be a little more complex than for the mildly affected. For example, for agoraphobics - people with a fear of being in places where they feel immediate escape might be difficult - the thought of being among millions of spectators may generate more than the normal sense of discomfort. "Think about the worst feeling you've ever had, and then multiply it by one hundred," says Jerilyn Ross, president of the Anxiety Disorders Association of America. She describes it as a sensation of "sheer panic," which can be accompanied by rapid heartbeat, shortness of breath, trembling, and an overwhelming desire to get away.

Usually the fears are irrational. A person with a chronic phobia may work themselves into a tizzy wondering, for example: What if I suddenly have a heart attack? Or worse, what if a stampede of wild hyenas escapes confinement and rushes downtown, sending the entire mob into dizzying turmoil? These things aren't likely to happen, but fear of them could cause "significant distress."

When I think about it, it's fitting that it was during another inauguration speech some 77 years ago, when Franklin Delano Roosevelt voiced the now famous phrase "the only thing we have to fear is fear itself." And, anxiety coach Dr. David Carbonell says a substantial moment in American history like the Obama inauguration may be just big enough to motivate some mild phobia sufferers to overcome their anxieties. Find a therapist near you here.

Fortunately, my slight fear of crowded places isn't a clinical condition. But, whether or not you have a crowd phobia, the same advice still holds. The specialists I consulted said being prepared is the best course of action when dealing with such throngs of people. If you're going to be in the District of Columbia on Tuesday, having an emergency plan isn't a bad idea. Know, for example, the location of escape routes, or how to contact your friends and family if you get separated from your group. Just being prepared can help ease your troubled mind. And if you're still concerned about the masses, Dr. Carbonelle says, don't worry. "Stay long enough, and the fear will leave before you do."

Are you attending the inauguration? How do you plan to handle the crowd?

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.