Agoraphobia Symptoms, Causes & Treatment Options

If you experience anxiety about being in specific locations or environments from which it is difficult for you to escape or embarrassing for you to be there, you may struggle with agoraphobia. Agoraphobia can be managed with therapy, medications, and self-help. [1]

Agoraphobia Symptom Checker

Take a quiz to find out if your symptoms point to agoraphobia

Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is Agoraphobia?

Summary

Agoraphobia is defined as experiencing anxiety that is related to being in a place or situation from which it is challenging to escape or embarrassing to be that leads to avoidance of specific environments. The diagnosis of agoraphobia requires you to experience marked anxiety in at least two of the following situations: using public transportation, being in open spaces, being in enclosed spaces such as a movie theater, standing in line or being in a crowd, and being outside the home alone. Agoraphobia may or may not be associated with panic attack symptoms such as sweating, feeling like your heart is racing, and have difficulty breathing. If you struggle with agoraphobia, you will have a prolonged duration of this anxiety; a diagnosis is made when you experience these fears for six months or longer. Cognitive behavioral therapy, medications, and bibliotherapy are all recommended to help treat agoraphobia. [2]

Recommended care

Agoraphobia Symptoms

Main symptoms

If you experience agoraphobia, you will suffer from intense anxiety that occurs when you are exposed to a specific situation such as using public transportation, being in open spaces, being in enclosed spaces such as a movie theater, standing in line or being in a crowd, and being outside the home alone. Your ability to complete daily activities will be hindered, and if you struggle from severe agoraphobia, you may be too afraid to leave your home. Agoraphobia can either occur alone or with panic attacks. During a panic attack, you may feel like your heart is racing, very sweaty, nauseous, or the need to flee and escape. [1] [6]

  • Fear of leaving home alone
  • Fear of crowds or waiting in line
  • Fear of enclosed spaces such as elevators, stores, movie theaters
  • Fear of open spaces such as parking lots
  • Fear of using public transportation such as a bus, train, or plane
  • Excessive worrying
  • Feelings of nervousness and/or apprehension

If you experience concurrent panic attacks at the same time as your agoraphobia, you may also have the following symptoms:

  • Rapid heart rate
  • Excessive sweating
  • Difficulty breathing
  • Feeling shaky
  • Feeling numbness or tingling
  • Experiencing chest pain, tightness, or pressure
  • Feeling lightheaded
  • Having an upset stomach or diarrhea
  • Feeling fearful of dying
  • Feeling a loss of control

Agoraphobia Causes

Similar to other anxiety-related disorders, you may be at risk for experiencing agoraphobia because of a combination of a genetic predisposition and environmental factors. Environmental factors that may contribute to a later risk of developing agoraphobia are early childhood trauma, abuse, or the death of a parent. [4] Additionally, there is a relationship between where you may have first experienced your first panic attack and the agoraphobia that you experience later in life. For example, if you experience a panic attack while riding the subway or driving a car, you are at a higher likelihood of developing fear of these forms of transportation later in life. [5] Other risk factors for agoraphobia include having panic disorder or another phobia, responding to panic attacks with excessive fear and avoidance, having an anxious temperament, and having a relative with agoraphobia. [6]

Agoraphobia Symptom Checker

Take a quiz to find out if your symptoms point to agoraphobia

Treatment Options, Relief, and Prevention for Agoraphobia

Treatment

Agoraphobia is treated with a combination of medications (e.g., antidepressants or anti-anxiolytics) and therapy (e.g., cognitive behavioral therapy). Although you can take either medication or participate in therapy, research has shown that a combination of the two treatments provides better, longer-lasting results because medications can help treat your symptoms in the moment, but therapy will help change the pathways in your brain that lead to your agoraphobic episodes. Additionally, sleeping well, eating a healthy balanced diet, and exercising regularly can help you feel better.

The medications that are used to treat agoraphobia are selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors. Both of these medications are anti-depressants which will not start working immediately, but rather take time to have an effect on your symptoms. If SSRIs or SNRIs do not help control your symptoms, your doctor may consider prescribing you an anti-anxiety medication.

The therapy that is recommended for individuals who struggle with agoraphobia is cognitive behavioral therapy (CBT). CBT involves working with a therapist who will teach you to recognize your thoughts that provoke fear and anxiety and teach you how to reprocess these thoughts in a more productive manner. Your therapist will also teach you stress management and relaxation methods that can help you manage your symptoms. As you progress through therapy, your therapist will ask you to re-imagine stressful locations that predispose your fear related to your agoraphobia to help you resolve them in the moment such that you can utilize this approach in your everyday life in real situations. If you take medication while participating in CBT, you will typically require 12 to 20 weeks of CBT to help your symptoms. However, if you do not take medication concurrently, one year of CBT is recommended to help manage your symptoms. [3] The combined medication-CBT approach has been demonstrated to reduce agoraphobic symptoms to the point where individuals can enjoy their everyday life again.

Prevention

It is difficult to prevent anxiety-related disorders such as agoraphobia; however, if you have mild agoraphobia, try going to the specific locations that precipitate your feelings of fear and anxiety over and over again rather than avoiding the locations altogether. If you continuously avoid the locations, your fear and anxiety related to these places will build up and become overwhelming to address by yourself. If it is difficult for you to go by yourself to these locations, you can ask a family member or close friend to accompany you. [6]

Additionally, if you are taking medications or receiving cognitive behavioral therapy, you should be consistent with these interventions. It is important to take the medications and to practice the skills learned in therapy regularly to ensure efficacy. You can also practice simple relaxation techniques such as yoga, breathing, and meditation to help your agoraphobia. It is important to practice these techniques when you are not nervous or anxious so that you can put them into action when you are in more stressful situations. As mentioned above, self-care is also important in both the treatment and prevention of agoraphobia. You should make sure you sleep regularly every night, you eat a healthy, balanced diet, and that you exercise frequently. Limiting substances such as alcohol, drugs, and caffeine can also help prevent agoraphobia. Moreover, finding a community or a support group of other individuals who struggle with agoraphobia or more broadly, anxiety disorders may help you manage your own agoraphobia. [7]

When to Seek Further Consultation for Agoraphobia

If you have symptoms that are interfering with your ability to complete tasks in your daily life, are unable to function at work, or are unable to participate in social situations, you should seek help from a medical professional because getting help earlier on in your disease will prevent your symptoms from worsening. [3] Additionally, if you fear leaving your house all together, are having thoughts of hurting yourself, or are having thoughts of hurting others, you should seek medical care immediately.

If you find that you are having frequent symptoms that you are not able to manage on your own, it is important to seek medical advice so your doctor can point you towards the right interventions such as prescription medicine, cognitive behavioral therapy, relaxation techniques, or support groups. [8]

Furthermore, if you have agoraphobia associated with panic attacks, you should see a doctor to discuss your symptoms to ensure that there is no other underlying disease that is contributing to your physical symptoms. Examples of symptoms related to panic attacks include sweating, feeling like your heart is racing, experiencing chest pain, or feeling like you cannot catch your breath. Additionally, early detection of anxiety-related panic attacks can help curb their severity in the future. [9]