Agoraphobia

Written by Rose Kivi and Elizabeth Boskey, PhD | Published on July 16, 2012
Medically Reviewed by George Krucik, MD

What Is Agoraphobia?

Agoraphobia is an anxiety disorder. People with agoraphobia avoid situations that might cause them to feel:

  • trapped
  • helpless
  • panic
  • embarrassment
  • fear

Approximately 0.8 percent of the adult population has agoraphobia.

The Types of Agoraphobia

There are two types of agoraphobia:

Panic Disorder with Agoraphobia

People who have panic disorder with agoraphobia experience recurrent panic attacks related to their agoraphobia. Panic attacks are episodes of intense fear. This is the most common type of agoraphobia.

Agoraphobia without a History of Panic Disorder

This is an uncommon form of agoraphobia. It occurs in people who have not experienced panic attacks.

What Causes Agoraphobia?

People with agoraphobia link anxiety to certain settings or situations. They then avoid those settings or situations. They are afraid they may feel anxious again or have another panic attack.

Who Is at Risk for Agoraphobia?

You may be at risk of developing agoraphobia if you:

  • have a panic disorder
  • are experiencing or have experienced stressful life events
  • have a history of childhood physical or sexual abuse
  • are a nervous or anxious person
  • have an alcohol or substance abuse problem

Agoraphobia is more common in women then men. It usually first appears in young adulthood. However it can occur at any age.

What Are the Symptoms of Agoraphobia?

You may experience one or more of the following symptoms with either type of agoraphobia:

  • fear of leaving your house for long periods of time
  • dependence on others
  • fear of being alone
  • fear of being at places where it would be difficult to escape
  • fear of losing control of yourself in a public place
  • detachment or estrangement from others
  • feeling helpless
  • feeling that your body is not real
  • feeling that the environment is not real
  • agitation or anger

The following are symptoms of a panic attack:

  • chest pain
  • rapid heartbeat
  • shortness of breath
  • dizziness
  • trembling
  • feeling faint
  • choking
  • fear you are losing control
  • fear you are dying
  • fear you are going crazy
  • sweating
  • hot flashes
  • chills
  • nausea
  • numbness or tingling sensations

How Is Agoraphobia Diagnosed?

Your healthcare provider will ask about agoraphobia symptoms. She may also examine you or perform blood tests. These are intended to rule out physical causes for your symptoms.

To be diagnosed with agoraphobia, your symptoms must meet certain criteria. You will not be diagnosed with agoraphobia if your symptoms are caused by illness. They also can not be caused by substance use or another disorder.

There are additional criteria for a diagnosis of panic disorder with agoraphobia. You must have recurrent panic attacks. Furthermore, at least one panic attack must have been followed by:

  • fear of having more panic attacks
  • worries about the consequences of the panic attacks - such as having a heart attack, losing control, or going crazy
  • changing your behavior because of the attacks

How Is Agoraphobia Treated?

There are a number of different treatments for agoraphobia.

Cognitive Behavioral Therapy (CBT) can help you understand the distorted feelings and views associated with agoraphobia. CBT can also teach you how to replace the distorted thoughts with healthy thoughts.

Exposure therapy can help you overcome your fears. Exposure therapy gently and slowly exposes you to the situations that cause you fear.

Service dogs or other animals may help reduce your fear when you go out in public.

Medications can help relieve your agoraphobia or panic attack symptoms. Some medications used for agoraphobia include selective serotonin reuptake inhibitors (SSRIs), antidepressants, and anti-anxiety medications.

Agoraphobia Prognosis

With treatment, you have a good chance of getting better. Treatment tends to be easier and faster when started earlier.

Preventing Agoraphobia

There is no guaranteed way to prevent agoraphobia. Early treatment for anxiety or panic disorders may help.

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