Agoraphobia: Causes, Risk Factors, Symptoms, Treatment, Recovery

Medically Reviewed by Dr. K on 13 May 2022.

Agoraphobia

Agoraphobia is a form of anxiety disorder that is relatively uncommon. Your worries prevent you from venturing out into the world. You dislike such locations and conditions because you fear being stranded and unable to get assistance.

When you're in, for example, you may be worried or panicked.

  • Public transportation: buses, trains, ships, or planes
  • Large, open spaces: parking lots, bridges, parks
  • Closed-in spaces: shops, movie cinemas
  • Being amongst large crowds
  • Waiting in line with many people
  • Being outside of your home on your own

You may only go to a few places, or you might even be afraid to leave your home.

 

Causes and Risk Factors

The cause of agoraphobia is unknown. It is believed to be hereditary. If you have a lot of panic attacks, you might get it. Panic attacks occur when you get unexpected bursts of panic when there's no actual risk that lasts a few minutes.

Agoraphobia is two to three times more common in women than in men, and it is more prevalent in teens and young adults.

Some factors that increase your risks include:

  • Having an underlying panic disorder, especially if it’s not treated
  • Having other phobias
  • Having a family member with agoraphobia
  • A previous history of very stressful or traumatic events

Symptoms

If you have agoraphobia and find yourself in a scary situation, you can feel afraid or panicked. Physical signs and symptoms include:

  • Fast beating and pounding heart
  • Sweating, trembling, shaking
  • Breathing shallow and rapidly
  • Feeling hot or cold
  • Sweating
  • Nausea
  • Diarrhea
  • Chest pain
  • Difficulty swallowing, dry mouth
  • Dizziness or feeling faint

You may feel like:

  • You might not be able to recover from a panic attack.
  • You are not in control.
  • You'll make a negative impression on people or they'll glare at you.
  • When you go somewhere, you need to be with someone you can trust.

You may also have:

  • The anxiety of being trapped in your home
  • A general sense of despair

 

Diagnosis

Many of the signs of agoraphobia are similar to those of other medical disorders such as heart failure, digestive problems, and respiratory difficulties. As a result, you might need to see the doctor or the emergency hospital several times before you and your doctor finds out what's actually wrong.

Your doctor may inquire:

  • Is it frightening or unpleasant for you to leave your house?
  • Do you need to stay away from some locations or situations?
  • What if you find yourself in one of them?

A physical exam and maybe other tests may be performed to rule out all other medical issues. They'll usually send you to a psychiatrist or therapist if they can't find a physical explanation for your problems.

You'll be asked questions about your thoughts and actions during your session. According to the American Psychiatric Association's guidelines, you might have agoraphobia if you experience intense anxiety or distress in at least two of the following situations:

  • You are alone outside your house.
  • In an open area, such as a parking lot or a shopping mall
  • In a confined space, such as a theatre or a small office
  • In a queue or a crowd
  • Using public transportation, including buses, trains, or planes

Treatments

Your doctor will almost probably recommend therapy, medication, or a mixture of the two to treat agoraphobia.

Therapy

Cognitive therapy will show you new ways to learn about or approach panic-inducing scenarios, allowing you to become less fearful. You will also practice breathing and calming techniques. Your psychiatrist may prescribe exposure therapy, which means progressively introducing yourself to the things that make you nervous.

Medicine

Your doctor may prescribe a variety of medications to treat agoraphobia, but antidepressants are the most popular. Doctors also begin with a low dose of one of these drugs, which increases the level of serotonin, a “feel-good" chemical in the brain. Citalopram, escitalopram oxalate, fluoxetine, sertraline, and venlafaxine are some of the medications that help stabilize serotonin.

You'll most likely be on drugs for at least 6 to 12 months. Your doctor may start tapering off your prescription if you're doing better and aren't as worried when you're in places that used to scare you.

In addition to antidepressants, your doctor can prescribe anti-anxiety medications called benzodiazepines for short-term relief. There are sedatives that may be useful in alleviating your symptoms. You don't want to get dependent on them, so don't rely on them for too long. Often, notify the doctor if you've ever had any problems with drinking or drugs.

Alternative therapies

Applied relaxation is a series of exercises that teach you how to recognize when you're being stressed and how to calm your muscles to relieve the stress. It usually takes 12 to 15 weeks, with each session lasting an hour.

Breathing techniques and meditation are two other complementary treatments that can be beneficial.

Lifestyle changes

Regular exercise and a balanced diet will also benefit. Caffeine and smoking should be avoided. They can aggravate the symptoms.

 

Outlook

Agoraphobia can be treated and dealing with it made better with the right mix of treatment and therapy. Here are a few other things to consider:

  • When you need assistance, seek it out. Family and friends will assist you with your fears, while a community network helps you to interact with those who are going through similar experiences.
  • Control the fear and tension. Consult your doctor for suggestions about how to relax and identify strategies that resonate with you.
  • Follow the doctor's instructions. It's important to take your prescription exactly as prescribed and to keep to your therapy appointments. Stay in touch with the medical team so that they can provide you with the best care possible.

Sources

Referenced on 2.3.2021:

  1. Anxiety and Depression Association of America: “Panic Disorder & Agoraphobia."
  2. Medscape: “Phobic Disorders."
  3. National Institute of Mental Health: “Panic Disorder."
  4. NHS: “Agoraphobia."
  5. Cleveland Clinic: “Agoraphobia: Diagnosis and Tests.”
  6. Victoria State Government: “Agoraphobia.”
  7. Mayo Clinic: “Agoraphobia.”
  8. Mount Sinai Health System: “Agoraphobia.”
  9. https://www.webmd.com/anxiety-panic/agoraphobia

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