Agoraphobia: Symptoms, Causes and Treatment Options

Many mental health conditions are simply extreme degrees of minor challenges that most people face regularly. It’s perfectly natural to feel some nervousness when you’re going somewhere you’ve never been before or going to a crowded place where there are a lot of people you don’t know; But, agoraphobia is different.

If that slight tinge of nervousness becomes intense anxiety that prevents you from doing things you normally would, it might be a condition called agoraphobia.

What Is Agoraphobia?

Agoraphobia is an intense fear of situations where there may not be an easy way to escape or where you may feel trapped or helpless.

At its core, it’s a phobia of being in a situation where you’re panicking and there’s not an easy way out. This typically translates into a fear of familiar places, crowds, public transportation and very open areas like large parking lots and open water.

In any given year, about 2% of people experience agoraphobia. That is about 6.8 million people in the US. It’s more commonly diagnosed in women than in men.

Agoraphobia can have a profound impact on your daily life. It can range in severity from avoiding certain activities you might otherwise enjoy, like parties, concerts or other large social events, to being unable to leave your home.

Some people become homebound for years or are unable to maintain a career and care for themselves because of it.

The Relationship Between Agoraphobia and Anxiety and Panic Disorders

Agoraphobia, like any other phobia, is a type of anxiety disorder. But it also has a unique relationship to panic disorders.

Agoraphobia often develops after a panic attack in a public place where escape feels impossible. Even if you were able to get out of the situation the first time, you have a fear that next time you won’t be able to.

Symptoms of Agoraphobia

The symptoms of agoraphobia include an extreme fear of:

Unfamiliar places
Public spaces, especially crowded places
Waiting in line
Leaving home by yourself
Using public transportation
Enclosed spaces outside your home, like elevators or movie theaters
Large open spaces like parking lots or open water

Agoraphobia is specific to these types of circumstances, where you might not have a clear path to safety. Extreme anxiety in situations other than these might indicate other anxiety disorders.

Where’s the Line Between Worry and Agoraphobia?

One of the tricky aspects of phobias is understanding the difference between a “normal” amount of anxiety about a particular situation and a phobia. While only a mental health professional can diagnose agoraphobia, you could have this condition if:

Your level of anxiety in the situation is out of proportion with the actual danger
Your fear prevents you from doing things you would otherwise enjoy, like certain social outings
You stop doing certain things or going places unless you have a trusted companion with you
You’re experiencing these symptoms for six months or longer

When you’re in a situation that triggers your agoraphobia, the symptoms can manifest in physical, emotional or psychological and behavioral ways.

In these situations, physical symptoms can include:

Tightness in your chest
Rapid heartbeat
Shortness of breath or hyperventilating (breathing too fast)
Dizziness or disorientation
Shaking or trembling
Sweating even though you’re not warm
Upset stomach

Meanwhile, the emotional or psychological symptoms can include:

Dread
Fixating on what could go wrong
Feeling a loss of control
Fear that you’re dying

During agoraphobia triggering situations, you may also have these behavioral symptoms:

Avoiding certain situations, like crowded places
Only going to certain places if you have someone with you
Only going to certain places or events after planning out escape routes or what to do if you need to get out

Causes and Risk Factors of Agoraphobia

How do you know if you’re at risk for developing agoraphobia? It usually develops in the teenage or early adult years and does seem to have a genetic link. People who have a close relative with agoraphobia are more likely to develop it. Some studies indicate that the heritability is as high as 48-61%.

Genetics isn’t the only factor, though. There are often traumas and life experiences that contribute to agoraphobia, especially trauma that occurs in childhood. This can include abuse, being attacked or the loss of someone with whom you felt safe, such as a parent.

It’s also important to note that many people with agoraphobia have other mental health conditions too, like panic disorder, depression or PTSD. In particular, a large number of people with agoraphobia already had a panic disorder. Their agoraphobia may have been triggered after having a panic attack in a place where they felt unsafe or helpless.

While a panic attack in a public place might trigger agoraphobia, often these people already had some level of anxiety in these situations. So it may be a combination of panic disorder and existing agoraphobic tendencies.

How Agoraphobia Affects Daily Life

One of the hallmarks of a phobia or other anxiety disorders is its impact on your daily life and the limitations that it creates for you. It can affect your work, romantic relationships, family relationships and social life in numerous ways.

You may decline social events and invitations due to anxiety about the situation, or struggle to complete work assignments if they involve situations that make you anxious. You could be limited in the types of jobs you can accept.

Maybe you can only able to perform jobs where you can work from home or jobs that don’t involve situations in public or crowded places. Finally, your relationships may suffer because you aren’t able to join loved ones for the things they enjoy doing.

Agoraphobia can even prevent you from taking care of yourself and living independently, especially when it is severe. It could prevent you from doing essential tasks like going to the grocery store or running other errands, such as going to the doctor.

Finally, agoraphobia can have a substantial impact on your mental health, especially if you have co occurring conditions already. It can worsen conditions like depression, because you feel trapped at home or aren’t able to do activities that could boost your serotonin. In some cases, it can make substance use disorder worse, too.

How Is Agoraphobia Diagnosed?

Agoraphobia must be diagnosed by a medical or mental health professional, like a psychiatrist or psychologist.

They’ll consult with you about your symptoms and your emotional responses to certain occurrences or circumstances. Whether or not you meet the criteria for clinical agoraphobia is based on which situations give you severe anxiety, the frequency and severity of your symptoms and their duration.

Agoraphobia can often be diagnosed through telehealth sessions if you struggle with going to a therapist’s office in person.

While these two diagnoses have similar symptoms, agoraphobia is characterized more by avoiding certain situations or experiencing severe anxiety and fear around them.

Panic disorder is characterized by recurrent panic attacks, and potentially panic attacks in seemingly safe situations when you wouldn’t expect them.

Treatment Options for Agoraphobia

If you receive an agoraphobia diagnosis, the good news is that it’s a very treatable condition. It can be treated with a combination of therapy and lifestyle changes, and in some cases, medication.

Therapy for Agoraphobia

The way your therapist treats your agoraphobia will depend on you, your needs and what approaches you seem to respond to best. Typically, cognitive behavioral therapy or CBT is a key part of the treatment.

CBT involves helping you understand the connection between your thought patterns and behaviors, how to identify the thought patterns that influence your agoraphobia and avoidance and learning to intentionally change those thought patterns.

As you continue your treatment, your therapist is likely to incorporate exposure therapy. After you have developed some anxiety management techniques, exposure therapy involves going into situations that make you anxious and using the techniques you’ve learned to ease your anxiety.

You’ll start with lower anxiety situations and gradually work your way up to situations that once would have caused you to panic.

Medications for Agoraphobia

There aren’t medications that directly treat or cure agoraphobia. However, some medications may help improve your symptoms, especially by easing your symptoms enough to allow you to get treatment.

Anxiety medications are often helpful for people with agoraphobia, as long as they’re taken sparingly and as prescribed. In some cases, selective serotonin reuptake inhibitors or SSRIs can also benefit people with agoraphobia.

These SSRIs are commonly used to treat depression by increasing serotonin, making them especially helpful for people with co occurring depression and agoraphobia.

Self Help and Lifestyle Changes for Agoraphobia

Part of your therapy will likely be teaching you techniques you can use to manage your anxiety, both in the long term and in the moment when your anxiety is peaking.

These might include mindfulness, relaxation techniques and support groups where you can talk things through with other people who struggle with agoraphobia or similar conditions.

The goal is to give you tools to reduce your anxiety while empowering you to once again go into public places and live your life. For instance, like planning your route in advance or visualizing things going smoothly.

When to Seek Professional Help

How do you know when you need help for agoraphobia? The key red flag is when you find yourself being unable or unwilling to do things you would otherwise enjoy because of anxiety.

For example, if you find yourself turning down invitations to an event because of how crowded the event will be, this could be a sign that it’s time to seek therapy. Another example of a red flag might be when you aren’t able to do things that are necessary for your life.

In particular, being unable to do your work, complete errands or care for yourself independently.

Keep in mind, though, that your symptoms don’t have to reach that point before you get treatment. Maybe you find yourself having milder symptoms and agoraphobic tendencies, like getting anxiety about leaving your home, but not enough to prevent you from leaving home.

It is worthwhile to seek help from a therapist who can help you address these tendencies early, before you develop clinical agoraphobia.

Do You Need to Go to a Therapist’s Office to Get Agoraphobia Treatment?

Sometimes, agoraphobia worsens because a person knows they need help, but their anxiety is so high that it prevents them from physically going to a therapist’s office.

This may lead them to believe that they won’t be able to get help. Fortunately, therapy is often available online through telehealth platforms, so you don’t have to force yourself to leave home to get treatment.

Therapy.com Can Help

If you’re struggling with potential agoraphobia, good news: you’re already in the right place. Therapy.com helps you to find and connect with a therapist who meets your specific needs.

This could include therapists who offer telehealth, therapists who specialize in panic or anxiety disorders or therapists who specialize in treating people who have experienced trauma.

Our advanced directory of mental health professionals allows you to find the therapist you need from the comfort of your home, searching by the specific criteria you’re looking for. Explore your options and find a licensed therapist today.

Taking Back Your Life from Agoraphobia

You aren’t alone in this struggle. Agoraphobia is more common than most people think, affecting millions of Americans every day. Thankfully, this condition is treatable. Reach out to a therapist today and begin your journey toward a brighter future.