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.
The exact cause of anxiety disorders is not known. Factors that may contribute to the development of agoraphobia include:
- 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.
Changes or genetic problems in the brain and nerves may contribute to agoraphobia.
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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
- 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
- Hot flashes or chills
- Numbness or tingling
- Feeling of loss of control
- Fear of having a heart attack or dying
Agoraphobia is also commonly associated with the following conditions:
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 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:
Lifestyle changes may include:
- Have a strong support system of family and friends
- Consider family therapy to help with understanding and coping skills
- Join a support group
Cognitive-behavioral therapy (CBT) can help to change troublesome thought patterns. It will help you learn how you can alter your actions.
The combination therapy will help you:
- Identify and change anxious thoughts
- Use relaxation techniques to decrease feelings of anxiety
- Control breathing by taking slower, deeper breaths
- Cope with physical changes associated with anxiety
- Confront feared situations
Exposure therapy exposes you to the factor causing the fear while in a safe environment. The sessions often include repeated, detailed imagining of the traumatic experience. The therapy will help people face their fear and gain control of it while it is happening. Exposure therapy methods range anywhere from a gradual approach to the fear to complete confrontation all at once.
Exposure therapy may be done alone or in combination with other treatments.
Your doctor may prescribe medication as well as therapy. Medication options may include:
- Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs)
- Benzodiazepines—may cause dependence
- Other anti-anxiety medications
It is important to take all medications as instructed by the doctor.
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.
American Psychiatric Association
Mental Health America
Canadian Psychiatric Association
Canadian Psychological Association
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Panic disorder. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115030/Panic-disorder. Updated April 17, 2017. Accessed January 31, 2018.
Phobias. Mental Health America website. Available at: http://www.mentalhealthamerica.net/conditions/phobias. Accessed January 31, 2018.
What are anxiety disorders? American Psychiatric Association website. Available at: https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders. Updated January 2017. Accessed January 31, 2018.
What is posttraumatic stress disorder? American Psychiatric Association website. Available at: https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd. Updated January 2017. Accessed January 31, 2018.
Last reviewed November 2018 by EBSCO Medical Review Board Adrian Preda, MD Last Updated: 1/31/2018