What is Agoraphobia?

Many of us might become agitated when we have to take public transportation or navigate a busy grocery store, but some people experience extreme fear or worry when they encounter public spaces that may be hard to escape. They may panic when they have to stand in line or find their heart racing when they find their seat in a crowded movie theater. This fear is sometimes called agoraphobia. When a person experiences agoraphobia, their life may become limited as they begin to avoid places that bring on this panic. They must deal with increasing isolation from others and from experiences they once enjoyed.

There is no exact cause of agoraphobia, but people sometimes begin to fear situations where they have experienced a panic attack or extreme anxiety. When they encounter them after the attack, they may find that they are overcome with worry that it will happy again.

Signs

To qualify for a diagnosis of agoraphobia, you must experience fear or anxiety about two or more of the following situations:1

  • public transportation
  • open spaces
  • enclosed places
  • being in a crowd
  • being outside of  their home

An example of an open space might include a bridge, a park, or a parking lot, and an enclosed space might be a theater, a plane, or a supermarket. Additional symptoms might include fearing being alone, fear of losing control in public places, depending more on others to navigate spaces, anger or agitation, and staying at home for long periods of time. In the most severe cases of agoraphobia, people may stay in their home for many years without leaving.

When a person with agoraphobia fears open or crowded places, they will begin to avoid them to prevent panic attacks or embarrassing themselves in public.2 When they begin to avoid these spaces, this behavior reinforces their fears and causes them to increase. If they are forced encounter these situations, they will experience intense anxiety and symptoms such as sweating, increased heart rate, trouble breathing, nausea, dizziness, chest pain, and trembling. They also may require someone to go with them.  These fears will interfere with home and work life and with socializing. When left untreated, these feelings of isolation and frustration can lead to depression and/or substance abuse.3

Treatment Options

Agoraphobia is usually treated with therapy, medication, or a combination of the two. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) are sometimes prescribed to help reduce the severity of anxiety symptoms. Cognitive behavioral therapy is also commonly used to help a person challenge their anxious thoughts and objectively access their safety in open or crowded places. Clinicians frequently use exposure therapy techniques to help a person gradually learn to manage their anxiety in public spaces. Therapy can also help a person learn to regulate their stress level and utilize relaxation techniques to lower anxiety. People with agoraphobia can also benefit from peer support groups, which can help them feel less isolate and gain the courage to manage their anxiety and overcome fears.

Though it might feel insurmountable, it’s important to remember that agoraphobia is highly treatable. If possible, prevention should be the first course of action. Roughly six million Americans will experience panic disorder in a year, and a third of these will develop agoraphobia.4 If you have had a panic attack or experienced intense anxiety in an open or crowded space, don’t wait until it gets worse to recruit help. Meeting with a counselor can help you learn to manage your fears before they feel unmanageable and lead to symptoms of agoraphobia. But if you already qualify for a diagnosis of agoraphobia, it definitely can be treated.

Action Steps

Educate yourself – One of the challenges of overcoming agoraphobia is learning to correct your irrational thoughts of certain environments being unsafe with no easy way to escape. Learning how to respond to the anticipatory anxiety of entering open and closed spaces can help you manage fear and worry.

Find support – Millions of Americans suffer from a specific phobia, so take some time to check out what support is available to you in your community. In-person and online support groups can be an encouraging force in the lives of people who want to manage their anxiety about leaving their home and entering open or closed spaces. Also, do not feel embarrassed to tell friends and family about your phobia and how they can support you in your treatment.

Recruit a professional – If you find yourself avoiding open or crowded spaces because they make you anxious, do not hesitate to talk to your doctor or a mental health professional. Your fear might seem manageable now, but avoiding spaces over time will only reinforce your anxiety and worry. You don’t have to let fear interfere with the life you want to lead and keep you from the places you want to go. Take the first step today, and recruit someone who can get you started on finding the right treatment for you.

If you think you or someone you care about may be suffering from agoraphobia, anxiety, or any other mental health condition, PsyCom strongly recommends that you seek help from a mental health professional in order to receive a proper diagnosis and support. We have compiled a list of resources (some even offer free or low-cost support) where you may be able to find additional help at https://www.psycom.net/get-help-mental-health.

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Last Updated: Jan 16, 2018