Prince Harry's memoir contained many revelations, but there's one in particular that would have resonated with many people.
And that's his struggle with agoraphobia.
“I was an agoraphobe," he writes in Spare. "Which was nearly impossible given my public role.”
He also recalls how he 'nearly fainted' during one speech that 'couldn’t be avoided or canceled'.
Agoraphobia is an anxiety disorder that causes intense fear in certain situations, such as among crowds. The unpleasant feelings can be so overwhelming that many sufferers can become housebound.
Medical website Healthline has outlined what the condition actually is - and how best to beat it:
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What actually is agoraphobia?
Agoraphobia is defined as an 'excessive, irrational fear of being in open or unfamiliar places, resulting in the avoidance of public situations from which escape may be difficult,' according to the American Psychological Association.
This can mean a fear of practically anywhere outside a person's home, crowds, public transportation or enclosed spaces.
Gregory Jantz, a US-based clinical psychologist, says agoraphobia can be exacerbated the further a sufferer gets from home, with the increasing miles making them feel less and less safe.
It is not uncommon for people with agoraphobia to also show signs of panic disorder.
If left unchecked, constant worry and rumination can lead to a panic attack - which is a sudden feeling of intense fear, often accompanied by symptoms such as trouble breathing, lightheadedness or dizziness, a rapid heart rate, sudden flushing or chills, or excessive sweating.
'It's not all in the mind - physiological things are happening'
In a vicious circle, an agoraphobe who has had a panic attack may then avoid certain places or situations in an attempt to prevent another occurence.
“As their anxiousness builds, they feel a dread of a potential panic attack,” said Jantz. “So they’re basically afraid of this fear.”
In some cases, agoraphobia can be so severe it can stop a sufferer leaving their house, which can cause great strain on their family and working life.
Jantz said a common misconception about this condition is that a person’s fear is often dismissed as 'all in the mind'.
However, “even if the fear has nothing to do with reality, that doesn’t mean the anxiety is not real,” he said. “Your body is reacting and there are physiological things happening.”
How many people are affected?
The NHS says up to two UK people in every 100 have a panic disorder, with around a third going on to develop agoraphobia.
The condition is twice as common in women as men and usually starts between the ages of 18 and 35.
Researchers are still trying to understand why certain people develop agoraphobia, but it is believed to all come down to a combination of genetics and experiences.
Certain factors increase the risk of agoraphobia, including:
Having a nervous or anxious personality
- Experiencing stressful life events such as abuse, a natural disaster or the death of a parent
Having a panic disorder or phobias (excessive fear reactions)
- Having a close relative with agoraphobia
How can it be treated?
Before any treatments can begin, Jantz says it’s important to find out if the anxiety is caused by anything else such as medication, increased alcohol use or a medical condition.
If these are a factor, then they need to be addressed alongside the anxiety and agoraphobia.
Talk therapies such as cognitive behavioral therapy (CBT) or dialectical behavioral therapy (DBT) have often proved extremely helpful in combatting the condition.
Healthline says: "These therapies help people learn what may trigger a panic attack or panic-like symptoms, and provide ways for them to cope with the increased anxiety that occurs in certain situations".
The NHS says that lifestyle changes can also be enormously helpful, 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 necessary, a physician may also prescribe an antidepressant or anti-anxiety medication.
