What is Agoraphobia?
Agoraphobia is the fear of being in situations in which someone may feel cornered or powerless. It is not the anxiety that occurs while in helpless situations, but rather the fear that one could lose control within a location.
People who live with agoraphobia experience such intense fears of specific situations that they may avoid them altogether. Avoiding triggers interrupts everyday life, and confronting these situations may cause panic attacks.
Signs and Symptoms of Agoraphobia
Agoraphobia is not the fear of just one thing. Someone can have many specific phobias that, when analyzed together, lead to an agoraphobia diagnosis. Someone with agoraphobia will have an extreme fear of at least two of the following:
- Utilizing public transportation (including taxis, buses, trains, boats, airplanes, and more)
- Being in open spaces in which they feel exposed (including parking lots, marketplaces, bridges)
- Being enclosed in spaces (such as theaters or elevators)
- Being in long lines or large crowds
- Leaving the home without someone else
Someone with agoraphobia may experience all of these fears, one of them, or another more specific worry. Due to the fear, people with agoraphobia will have at least one of the following behavioral or emotional symptoms:
- Avoid the agoraphobic fears
- Endure the situations, but with extreme anxiety
- Only face agoraphobic situations with help of another person
Sometimes, the fear can be so intense that someone with agoraphobia has a panic attack with physical symptoms.
Panic Attacks with Agoraphobia
Panic disorder with agoraphobia is common. People who have agoraphobia may experience panic attacks when they find themselves in situations they perceive as helpless. As such, many of the physical symptoms of agoraphobia overlap with those for panic attacks, including:
- Trouble breathing
- Feeling of dread
- Rapid heartbeat
- Flushing in the face
- Feeling like death is near
- Digestive issues, including vomiting and diarrhea
What Causes Agoraphobia?
In many cases, agoraphobia develops when someone has another anxiety disorder and panic attacks that go untreated for too long. After having a panic attack in public, people may begin to fear the next panic attack, leading to agoraphobia.
Not everyone with an anxiety disorder will develop agoraphobia. Some people without previously diagnosed anxiety disorders develop agoraphobia first.
Other risk factors that increase someone’s chances of living with agoraphobia include:
- Traumatic life events, such as being the victim of abuse or a violent crime
- A nervous temperament
- A close biological relative who lives with agoraphobia
People can develop agoraphobia in childhood, and most people who will have the disorder show symptoms by age 35. However, some patients do not have symptoms until late adulthood.
As with all types of anxiety, professionals may recommend prescription medication, therapy, or a combination of both to treat agoraphobia. Exposure therapy is a popular therapy for patients with agoraphobia.
In exposure therapy, a person gradually faces fears. For example, a man who is afraid to leave home alone may start by just stepping outside the home or walking around his block. When nothing bad happens, he can repeat this action several times. Eventually, he comes to realize that walking around the neighborhood isn’t so dangerous.
The counselor may then have him go to the market. After several times, he sees that this is also safe. After several rounds of this, the patient may live without symptoms of his agoraphobia.
As patients go through exposure therapy, they may need prescription medications to cope with the anxiety. Some people need to stay on the pills for the long term, while others rely on them only for a short while.
Telehealth for Agoraphobia
Due to the nature of agoraphobia, many patients may prefer online therapy and psychiatric services to in-person appointments. Many of the treatment options for agoraphobia are available through these telehealth options, including medication for panic attacks and individual treatment.
LifeStance Health offers these telehealth services through secure video conferencing software. We make it as easy as possible to get the care you need–from online booking to convenient telehealth appointments and insurance billing; we’re here to help.
Popular culture often portrays people with agoraphobia as unable to leave their homes. While this is one way that this anxiety disorder can present itself, many people with agoraphobia can function outside their homes. However, they may avoid specific types of situations, like public transportation.
The stigma surrounding agoraphobia keeps some people from seeking treatment. For example, someone may believe that their anxiety isn’t “severe enough” to warrant therapy because they can leave their homes. This type of thinking couldn’t be farther from the truth. Patients must not compare their experiences with stereotypes or other people.