Definition

Agoraphobia is an anxiety disorder. It is an irrational fear of being trapped in places or situations where escape is difficult. People with agoraphobia may not be able to leave the house.

Causes

The exact cause of anxiety disorders is not known. Factors that may contribute to the development of agoraphobia include:

• Genetics
• Changes in brain chemistry or activity
• Having a nervous system that reacts excessively, even to normal stimuli
• Increased awareness of physical changes, such as increased heart rate
• Distorted thinking, which may start a cycle of fear

Agoraphobia often develops in people with panic disorders. These disorders are associated with frequent and severe panic attacks. Agoraphobia may develop when people begin to avoid certain places or situations to prevent these panic attacks.

Nervous System Changes or genetic problems in the brain and nerves may contribute to agoraphobia. Copyright © Nucleus Medical Media, Inc.

Risk Factors

Agoraphobia is nearly twice as common in women than in men. Other factors that may increase your chances of agoraphobia:

• History of panic attacks or panic disorder
• A tendency to be nervous or anxious
• Stressful situations
• Family members with panic disorder or phobias
• History of exposure to traumatic events
• Other psychiatric disorders

Symptoms

Symptoms include:

• Fear of open spaces, crowds, bridges, or standing in line
• Fear of enclosed spaces, such as cars, buses, trains, or airplanes, or being in a small theater or shop
• Fear that escape may be difficult when feelings of anxiety occur
• Creation of a safe zone
• Feelings of anxiety when outside the safe zone
• Fear of being alone outside of the home
• Avoidance of situations that might cause a panic attack
• Restriction of activities outside the home
• Feeling of being safer with a trusted friend or family member

Feared situations may trigger a panic attack. Attacks start quickly and peak in about 10 minutes. A panic attack usually includes four or more of the following:

• Intense fear
• Rapid heartbeat
• Pounding or racing feeling in the chest
• Chest pain
• Shortness of breath
• Shaking
• Sweating
• Blushing
• Lightheadedness
• Hot flashes or chills
• Numbness or tingling
• Nausea
• Feeling of loss of control
• Fear of having a heart attack or dying

Agoraphobia is also commonly associated with the following conditions:

• Panic disorder
• Depression
• Anxiety
• Post-traumatic stress disorder (PTSD)

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Agoraphobia will be diagnosed by the type and duration of symptoms.

You may be asked questions about your:

• Use of alcohol, coffee, and drugs
• Mental health history
• Family's mental health history

There are no tests for agoraphobia or panic disorder. Your doctor may order heart or blood tests done to look for an underlying cause.

Treatment

Treatment aims to help you overcome irrational fears and live more independently. Goals include:

• Reducing the number and severity of panic attacks
• Learning to manage panic attacks that do occur

Treatment of agoraphobia is similar to the treatment of panic disorder. Treatments may include:

Prevention

Agoraphobia often develops as a response to panic attacks. If you have had a panic attack, instead of avoiding the place or situation, seek medical care. Early treatment for panic attacks can help prevent agoraphobia.