Agoraphobia

What is agoraphobia?

Agoraphobia is an anxiety disorder that causes an intense fear of becoming overwhelmed or unable to escape or get help. Because of fear and anxiety, people with agoraphobia often avoid new places and unfamiliar situations, like:

• Large, open areas or enclosed spaces.
• Crowds.
• Places outside of their home.
• Public transportation.

How common is agoraphobia?

Researchers don’t know the exact cause of agoraphobia. However, it’s often associated with an existing panic disorder. Panic disorder causes short, intense attacks of fear for no particular reason. About a third of people who have panic disorder develop agoraphobia. But agoraphobia also can occur alone.

What are the symptoms of agoraphobia?

Everyone experiences anxiety sometimes. But an anxiety disorder causes excessive worry that affects daily activities. Agoraphobia can make you feel extreme fear and stress, which may cause you to avoid situations. The signs of agoraphobia are similar to a panic attack. You may experience the following symptoms when you’re in situations or spaces that cause fear:

• Chest pain or rapid heart rate.
• Fear or a shaky feeling.
• Hyperventilation or trouble breathing.
• Lightheadedness or dizziness.
• Sudden chills or flushing (red, hot face).
• Excessive sweating (hyperhidrosis).
• Upset stomach.

What causes agoraphobia?

Researchers don’t know the exact cause of agoraphobia. However, it’s often associated with an existing panic disorder. Panic disorder causes short, intense attacks of fear for no particular reason. About a third of people who have panic disorder develop agoraphobia. But agoraphobia also can occur alone.

What are the risk factors for agoraphobia?

Risk factors for developing agoraphobia include:

• Having panic attacks.
• Responding to panic attacks with excess fear and apprehension.
• Having other phobias.
• Experiencing stressful life events, such as the death of a loved one, assault or abuse, especially during childhood.
• Being sensitive to anxiety or having other anxiety disorders.
• Having a relative with agoraphobia.

How is agoraphobia diagnosed?

If you think you have agoraphobia, and the anxiety is interfering with your daily life, you should talk to a primary care physician or a mental healthcare provider, like a psychiatrist or psychologist. If you’re afraid to visit a medical office in person, you may be able to schedule a telephone or video appointment.

The healthcare provider may ask you:

• Do you get stressed about leaving your house?
• Are there any places or situations you avoid because you’re afraid? Why does it cause fear?
• Do you rely on others to do your shopping and errands?

A healthcare provider can diagnose agoraphobia based on your symptoms, how often they happen and how severe they are. It’s important to be open and honest with your providers. Your provider may diagnose agoraphobia if you meet specific standards developed by the American Psychiatric Association. To have a diagnosis of agoraphobia, a person must feel extreme fear or panic in at least two of the following situations:

• Using public transportation.
• Being in an open space.
• Being in an enclosed space, such as a movie theater, meeting room or small store.
• Standing in a line or being in a crowd.
• Being out of their home alone.

How is agoraphobia treated?

Agoraphobia treatment usually involves a combination of treatment methods:

• Psychotherapy (talk therapy).
• Medication.
• Lifestyle changes.

Psychotherapy

A therapist can help you work through your fears. Using cognitive behavioral therapy (CBT), a mental healthcare provider can help you recognize thoughts that cause you anxiety. Then, you’ll learn ways to react more productively.

Using relaxation and desensitization techniques, your provider may have you imagine a scary situation and manage the feelings. Eventually, you’ll be able to take part in activities that produce anxiety, and you’ll know how to manage your emotions. Over time, therapy can train your brain to think and respond differently.

Medications

Your healthcare provider also may suggest medications called selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). These medications can treat depression and anxiety disorders.

Lifestyle changes

The following lifestyle changes may also help you manage agoraphobia:

• Avoid alcohol, caffeine and other substances.
• Eat a healthy, well-balanced diet.
• Exercise regularly.
• Practice breathing exercises.

How can I learn to cope with agoraphobia?

Take good care of yourself, take your medications as prescribed and practice techniques you learn from your therapist. And don’t allow yourself to avoid situations and places that spark anxiety. The combination can help you do things you enjoy with less fear.

A note from Cleveland Clinic

Agoraphobia can make you feel afraid and isolated. But with treatment, you can manage the symptoms and lead a full life. If agoraphobia or any anxiety disorder affects the way you live your life, talk to a healthcare provider. An open, honest conversation can lead to the help you need.