What is Agoraphobia?
Agoraphobia is a type of anxiety disorder that causes people to avoid places and situations that might cause them to feel:
People with agoraphobia often have symptoms of a panic attack, such as a rapid heartbeat and nausea, when they find themselves in a stressful situation. They may also experience these symptoms before they even enter the situation they dread. In some cases, the condition can be so severe that people avoid doing daily activities, such as going to the bank or grocery store, and stay inside their homes most of the day.
The National Institute of Mental Health (NIMH) estimates that 0.8 percent of American adults have agoraphobia. About 40 percent of cases are considered severe. When the condition is more advanced, agoraphobia can be very disabling. People with agoraphobia often realize their fear is irrational, but they’re unable to do anything about it. This can interfere with their personal relationships and performance at work or school.
If you suspect you have agoraphobia, it’s important to receive treatment as soon as possible. Treatment can help you manage your symptoms and improve your quality of life. Depending on the severity of your condition, treatment may consist of therapy, medications, and lifestyle remedies.
Symptoms of Agoraphobia
People with agoraphobia are typically:
- afraid of leaving their home for extended periods of time
- afraid of being alone in the social situation
- detached or estranged from others
- afraid of losing control in a public place
- afraid of being in places where it would be difficult to escape, such as a car or elevator
- anxious or agitated
Agoraphobia often coincides with panic attacks. Panic attacks are a series of symptoms that sometimes occur in people with anxiety and other mental health disorders. Panic attacks can include a wide range of severe physical symptoms, such as:
- hot flashes
- chest pain
- a racing heart
- shortness of breath
- tingling sensations
People with agoraphobia may experience panic attacks whenever they enter a stressful or uncomfortable situation, which further enhances their fear of being in an uncomfortable situation.
Diagnosis of Agoraphobia
Agoraphobia is diagnosed based on symptoms and signs. Your doctor will ask you about your symptoms, including when they started and how often you experience them. They’ll ask questions related to your medical history and family history as well. They may also perform blood tests to help rule out physical causes for your symptoms.
In order to be diagnosed with agoraphobia, your symptoms need to meet certain criteria listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is a manual often used by healthcare providers to diagnose mental health conditions.
You must feel intense fear or anxiety in two of more of the following situations to be diagnosed with agoraphobia:
- being in enclosed spaces, such as an elevator or car
- being in a crowd
- using public transportation, such as a train or bus
- being in open spaces, such as a store or parking lot
- being away from home alone
There are additional criteria for a diagnosis of panic disorder with agoraphobia. You must have recurrent panic attacks, and at least one panic attack must have been followed by:
- a fear of the consequences of panic attacks, such as having a heart attack or losing control
- a fear of having more panic attacks
- a change in your behavior as a result of the panic attacks
You won’t be diagnosed with agoraphobia if your symptoms are caused by another illness. They also can’t be caused by substance abuse or another disorder.
Treatments for Agoraphobia
There are a number of different treatments for agoraphobia. You’ll most likely need a combination of treatment methods.
Psychotherapy, also known as talk therapy, involves meeting with a therapist or other mental health professional on a regular basis. This gives you the opportunity to talk about your fears and any issues that may be contributing to your fears. Psychotherapy is often combined with medications for optimum effectiveness. It’s generally a short-term treatment that can be stopped once you’re able to cope with your fears and anxiety.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is the most common form of psychotherapy used to treat people with agoraphobia. CBT can help you understand the distorted feelings and views associated with agoraphobia. It can also teach you how to work through stressful situations by replacing the distorted thoughts with healthy thoughts, allowing you to regain a sense of control in your life.
Exposure therapy can also help you overcome your fears. In this type of therapy, you’re gently and slowly exposed to the situations or places you fear. This may make your fear diminish over time.
Certain medications can help relieve your agoraphobia or panic attack symptoms. These include:
- selective serotonin reuptake inhibitors, such as paroxetine (Paxil) or fluoxetine (Prozac)
- selective serotonin and norepinephrine reuptake inhibitors, such as venlafaxine (Effexor) or duloxetine (Cymbalta)
- tricyclic antidepressants, such as amitriptyline (Elavil) or nortriptyline (Pamelor)
- anti-anxiety medications, such as alprazolam (Xanax) or clonazepam (Klonopin)
Lifestyle changes won’t necessarily treat agoraphobia, but they may help reduce everyday anxiety. You may want to try:
- exercising regularly to increase the production of brain chemicals that make you feel happier and more relaxed
- eating a healthy diet that consists of whole grains, vegetables, and lean protein so you feel better overall
- practicing daily meditation or deep breathing exercises to reduce anxiety and fight the onset of panic attacks
During treatment, it’s best to avoid taking dietary supplements and herbs. These natural remedies aren’t proven to treat anxiety, and they may interfere with the effectiveness of prescribed medications.
Causes of Agoraphobia
The exact cause of agoraphobia isn’t known. However, there are several factors that are known to increase your risk of developing agoraphobia. These include having:
- a history of physical or sexual abuse
- a substance abuse problem
- other phobias, such as claustrophobia and social phobia
- another type of anxiety disorder, such as generalized anxiety disorder or obsessive compulsive disorder
- a family history of agoraphobia
Agoraphobia is also more common in women than in men. It usually begins in young adulthood, with 20 years being the average age of onset. However, symptoms of the condition can emerge at any age.
Outlook for People with Agoraphobia
It isn’t always possible to prevent agoraphobia. However, early treatment for anxiety or panic disorders may help. With treatment, you have a good chance of getting better. Treatment tends to be easier and faster when it’s started earlier, so if you suspect you have agoraphobia, don’t hesitate to seek help. This disorder can be quite debilitating since it prevents you from participating in everyday activities. There’s no cure, but treatment can greatly relieve your symptoms and improve your quality of life.