What is agoraphobia?
Agoraphobia is a type of anxiety disorder in which you fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed. You fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd.
People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. You may feel that you need a companion, such as a relative or friend, to go with you to public places. The fear can be so overwhelming that you may feel unable to leave your home.
How common is agoraphobia?
Agoraphobia is common. It is twice as common in women as men. It usually starts between the ages of 18 and 35. Please discuss with your doctor for further information.
What are the symptoms of agoraphobia?
Typical agoraphobia symptoms include fear of:
- Leaving home alone
- Crowds or waiting in line
- Enclosed spaces, such as movie theaters, elevators or small stores
- Open spaces, such as parking lots, bridges or malls
- Using public transportation, such as a bus, plane or train
These situations cause anxiety because you fear you won’t be able to escape or find help if you start to feel panicked or have other disabling or embarrassing symptoms.
- Fear or anxiety almost always results from exposure to the situation
- Your fear or anxiety is out of proportion to the actual danger of the situation
- You avoid the situation, you need a companion to go with you, or you endure the situation but are extremely distressed
- You experience significant distress or problems with social situations, work or other areas in your life because of the fear, anxiety or avoidance
- Your phobia and avoidance usually lasts six months or longer
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
Agoraphobia can severely limit your ability to socialize, work, attend important events and even manage the details of daily life, such as running errands. If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes agoraphobia?
Why agoraphobia happens remains unclear, but it is thought that areas of the brain that control the fear response may play a role.
Environmental factors, such as a previous break-in or physical attack, also contribute.
As there is evidence that anxiety disorders run in families, genetic factors may also play a role in agoraphobia and other panic disorders.
In some people, it occurs after they have had one or more panic attacks, and they begin to fear situations that could potentially lead to future panic attacks.
Other panic disorders or phobias can play a developmental role.
What increases my risk for agoraphobia?
There are many risk factors for agoraphobia, such as:
- Having panic disorder or other phobias
- Responding to panic attacks with excessive fear and avoidance
- Experiencing stressful life events, such as abuse, the death of a parent or being attacked
- Having an anxious or nervous temperament
- Having a blood relative with agoraphobia
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is agoraphobia diagnosed?
Agoraphobia is diagnosed based on:
- Signs and symptoms
- In-depth interview with your doctor or a mental health professional
- Physical exam to rule out other conditions that could be causing your symptoms
- Criteria for agoraphobia listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association
How is agoraphobia treated?
Psychotherapy involves working with a therapist to set goals and learn practical skills to reduce your anxiety symptoms. Cognitive behavioral therapy is one of the most effective forms of psychotherapy for anxiety disorders, including agoraphobia.
Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to better tolerate anxiety, directly challenge your worries and gradually return to the activities you’ve avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success.
You can learn:
- What factors may trigger a panic attack or panic-like symptoms and what makes them worse
- How to cope with and tolerate symptoms of anxiety
- Ways to directly challenge your worries, such as the likelihood of bad things happening in social situations
- That your anxiety gradually decreases if you remain in situations and that you can manage these symptoms until they do
- How to change unwanted or unhealthy behaviors through desensitization, also called exposure therapy, to safely face the places and situations that cause fear and anxiety
If you have trouble leaving your home, you may wonder how you could possibly go to a therapist’s office. Therapists who treat agoraphobia are well aware of this problem.
If you feel homebound due to agoraphobia, look for a therapist who can help you find alternatives to office appointments, at least in the early part of treatment. He or she may offer to see you first in your home or meet you in what you consider a safe place (safe zone). Some therapists may also offer some sessions over the phone, through email, or using computer programs or other media.
If the agoraphobia is so severe that you cannot access care, you might benefit from a more intensive hospital program that specializes in the treatment of anxiety.
You may want to take a trusted relative or friend to your appointment who can offer comfort, help and coaching, if needed.
Certain types of antidepressants are often used to treat agoraphobia, and sometimes anti-anxiety drugs are used on a limited basis. Antidepressants are more effective than anti-anxiety medications in the treatment of agoraphobia.
Antidepressants. Certain antidepressants called selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft), are used for the treatment of panic disorder with agoraphobia. Other types of antidepressants may also effectively treat agoraphobia.
Anti-anxiety medication. Anti-anxiety drugs called benzodiazepines are sedatives that, in limited circumstances, your doctor may prescribe to temporarily relieve anxiety symptoms. Benzodiazepines are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these drugs aren’t a good choice if you’ve had long-term problems with anxiety or problems with alcohol or drug abuse.
It may take weeks for medication to relieve symptoms. And you may have to try several different medications before you find one that works best for you.
Both starting and ending a course of antidepressants can cause side effects that create uncomfortable physical sensations or even panic attack symptoms. For this reason, your doctor likely will gradually increase your dose during treatment, and slowly decrease your dose when he or she feels you’re ready to stop taking medication.
Certain dietary and herbal supplements claim to have calming and anti-anxiety benefits. Before you take any of these for agoraphobia, talk with your doctor. Although these supplements are available without a prescription, they still pose possible health risks.
For example, the herbal supplement kava, also called kava kava, appeared to be a promising treatment for anxiety, but there have been reports of serious liver damage, even with short-term use. The Food and Drug Administration has issued warnings but not banned sales in the United States. Avoid using any product that contains kava until more-rigorous safety studies are done, especially if you have liver problems or take medications that affect your liver.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage agoraphobia?
The following lifestyles and home remedies might help you cope with agoraphobia:
- Sticking to a recommended treatment plan
- Learning how to relax and achieve and maintain a sense of calm
- Trying to face feared situations, as this can make them less frightening
- Avoiding alcohol and recreational drugs
- Staying healthful with physical activity, a balanced diet, and enough sleep
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: June 28, 2017 | Last Modified: December 8, 2019
Agoraphobia: Causes, symptoms, and treatment. http://www.medicalnewstoday.com/articles/162169.php. Accessed June 28, 2017.
Agoraphobia. http://www.nhs.uk/Conditions/Agoraphobia/Pages/Introduction.aspx. Accessed June 28, 2017.
Agoraphobia. http://www.mayoclinic.org/diseases-conditions/agoraphobia/home/ovc-20311918. Accessed June 28, 2017.