Agoraphobia

People with agoraphobia are typically:

• afraid of leaving their home for extended periods of time
• afraid of being alone in the social situation
• 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
• detached or estranged from others
• 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:

• chest pain
• a racing heart
• shortness of breath
• dizziness
• trembling
• choking
• sweating
• hot flashes
• chills
• nausea
• diarrhea
• numbness
• 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.

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:

• depression
• other phobias, such as claustrophobia and social phobia
• another type of anxiety disorder, such as generalized anxiety disorder or obsessive compulsive disorder
• a history of physical or sexual abuse
• a substance abuse problem
• 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.

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:

• using public transportation, such as a train or bus
• being in open spaces, such as a store or parking lot
• being in enclosed spaces, such as an elevator or car
• being in a crowd
• 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 having more panic attacks
• a fear of the consequences of panic attacks, such as having a heart attack or losing control
• 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.

There are a number of different treatments for agoraphobia. You’ll most likely need a combination of treatment methods.

Therapy

Psychotherapy

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

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.

Medications

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

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.

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.