All About Agoraphobia

Agoraphobia is an extremely common anxiety disorder, affecting about 1.8 million adults. Although common, agoraphobia is serious and can impact the sufferer’s quality of life. Agoraphobia is the intense fear of being unable to escape, often presenting as fear of crowded or closed-off spaces.

Symptoms

Agoraphobia is classified by the DSM-5 as an individual diagnosis. Although it may occur with other diagnoses, it can also stand alone. The symptoms and effects of agoraphobia can impact a person’s ability to live a normal life.

To be diagnosed, someone must experience fear or panic in at least two of the following situations:

  • Being in an enclosed space (theater, mall, restaurant)

  • Waiting in a line or being in a large crowd

  • Being out of the home alone

  • Being in a wide-open space (fields, bridges, etc.)

  • While on public transit (buses, trains, planes)

In someone with agoraphobia, many of the above day-to-day situations will cause extreme anxiety and panic. An individual usually fears that something bad is going to happen to them and they will be unable to escape. Someone with agoraphobia may also experience more intense bouts of fear, called panic attacks, which can produce both physical and mental symptoms and can be debilitating.

People with this phobia may change their routines to avoid crowds or other situations that trigger anxiety. At least one-third of people with agoraphobia are unable to leave their homes due to extreme anxiety.

To qualify for a diagnosis, an individual needs to exhibit these anxious and avoidant behaviors for six months or longer.

Causes of Agoraphobia

The causes of agoraphobia can vary from person to person and can be hard to pin down. Some common causes that can lead to agoraphobia are:

  • Experiencing a trauma, such as being mugged or attacked

  • High levels of neuroticism

  • Having family members with the condition (The DSM-5 notes a 61% heritability.)

  • Growing up with caretakers who were very protective

  • Having panic attacks

    • Sometimes, people who have panic attacks eventually develop agoraphobia as a result. It usually starts because they fear having a panic attack in a public space and being unable to get help or embarrassing themselves.

Co-Occurring Mental Health Conditions

Many people with agoraphobia have other mental health conditions as well. Clinical samples have shown that over 50% of people diagnosed with agoraphobia have a history of panic attacks. A large majority of people with agoraphobia have co-occurring anxiety disorders of some type. Sometimes, a person who suffers from agoraphobia and other anxiety disorders may abuse drugs or alcohol to self-soothe. This can cause other mental health conditions, like addiction and depression.

Getting Help

If you or someone you know is impacted by signs and symptoms of agoraphobia, seek professional help. Agoraphobia can be managed with therapy. A therapist can give the sufferer a toolkit of resources to use when feeling afraid. The therapist can also treat any co-occurring disorders that may be exacerbating agoraphobia. With professional help, someone with agoraphobia can begin to enjoy day-to-day life again.

Andrea Zorbas