Agoraphobia is a type of anxiety disorder in which you fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed. You fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd. The anxiety is caused by fear that there's no easy way to escape or get help if the anxiety intensifies. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to worry about having another attack and avoid the places where it may happen again. People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. You may feel that you need a companion, such as a relative or friend, to go with you to public places. The fear can be so overwhelming that you may feel unable to leave your home.
Symptoms
Typical agoraphobia symptoms include fear of:
- Leaving home alone
- Crowds or waiting in line
- Enclosed spaces, such as movie theaters, elevators or small stores
- Open spaces, such as parking lots, bridges or malls
- Using public transportation, such as a bus, plane or train
These situations cause anxiety because you fear you won't be able to escape or find help if you start to feel panicked or have other disabling or embarrassing symptoms.
In addition:
- Fear or anxiety almost always results from exposure to the situation
- Your fear or anxiety is out of proportion to the actual danger of the situation
- You avoid the situation, you need a companion to go with you, or you endure the situation but are extremely distressed
- You experience significant distress or problems with social situations, work or other areas in your life because of the fear, anxiety or avoidance
- Your phobia and avoidance usually lasts six months or longer
Causes
Biology — including health conditions and genetics — temperament, environmental stress and learning experiences may all play a role in the development of agoraphobia.
When to see a doctor
Agoraphobia can severely limit your ability to socialize, work, attend important events and even manage the details of daily life, such as running errands. Don't let agoraphobia make your world smaller. Call your doctor if you have signs or symptoms listed above.
Diagnosis
Agoraphobia is diagnosed based on:
- Signs and symptoms
- In-depth interview with your doctor or a mental health professional
- Physical exam to rule out other conditions that could be causing your symptoms
- Criteria for agoraphobia listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association
Treatment
Agoraphobia treatment usually includes both psychotherapy and medication. It may take some time, but treatment can help you get better. Psychotherapy involves working with a therapist to set goals and learn practical skills to reduce your anxiety symptoms. Cognitive behavioral therapy is one of the most effective forms of psychotherapy for anxiety disorders, including agoraphobia. Certain types of antidepressants are often used to treat agoraphobia, and sometimes anti-anxiety drugs are used on a limited basis. Antidepressants are more effective than anti-anxiety medications in the treatment of agoraphobia.
If you have agoraphobia, you may be too afraid or embarrassed to go to your doctor's office. Consider starting with a phone call to your doctor or a mental health professional, or ask a trusted family member or friend to go with you to your appointment.
