Agoraphobia: Definition, Symptoms, And Treatment

Agoraphobia is an anxiety disorder characterized by a fear of being in certain, specific places or situations. Although it’s often associated with the fear of open spaces, agoraphobia is actually a much broader phobia—one that can relate to almost any situation that an individual views as precarious, unsettling, or unsafe. Sometimes, this phobia can be so broad and/or debilitating that it may cause an individual to have a fear of leaving their home, resulting in a significant negative impact on quality of life. Below, we’re going to cover what agoraphobia is, its symptoms, and how it can be treated.

What is agoraphobia?

Specific settings a person might avoid due to agoraphobia could include enclosed spaces (e.g., subways or elevators), crowded public areas (e.g., parks or large cities), or open spaces (e.g., festivals or golf courses), for example. 

An individual with agoraphobia might experience a panic attack when thinking of or faced with certain situation. Anxiety disorders, especially panic disorder, are often a comorbid condition with this phobia. In fact, about a third of people with agoraphobia also have panic disorder. Even experiencing one panic attack and fearing another can cause symptoms of agoraphobia to develop.

Agoraphobia can be debilitating, to the point where an individual can no longer leave their home. This tendency along with the symptoms of anxiety may also negatively impact an individual’s physical health, relationships, work, and quality of life. In the most extreme cases, a person with agoraphobia may also avoid activities like going outside to get the mail or take out the trash. As a result, some with this phobia may become dependent on others for daily help.

Symptoms of agoraphobia

Again, one of the primary symptoms of agoraphobia is a disproportionate level of fear around a situation in which an individual believes they may be exposed, uncomfortable, or unable to leave easily. It’s not uncommon for someone with a phobia to avoid potentially triggering situations, which is why some people with agoraphobia rarely or never leave the house. Those who do leave home may experience moderate to extreme distress while doing typically mundane activities such as going to work, sitting in traffic, or going grocery shopping. Typically, symptoms must last at least six months and represent a disruption to one’s life to qualify as clinical agoraphobia. This phobia usually manifests in adolescence or early adulthood, before age 35.

Since panic disorder is often comorbid with this phobia, it may also be helpful to learn about the common signs of this condition. Symptoms of a panic attack can include:

• A wave of fear or a sense of losing control

• Feelings of impending doom

• Rapid heart rate

• Shaking or trembling

• Trouble breathing

• Upset stomach

• Numbness or tingling in the hands

• Sweating

• Fear regarding the potential for a future panic attack

Panic attacks usually last between a few minutes and a half hour. They can produce strong mental and physical symptoms, so much so that they are often confused with heart attacks. Because they can be scary and even debilitating, the fear of having another one can cause an individual to do everything possible to avoid them. For example, if someone experiences a panic attack at a grocery store, they may start to avoid that and similar environments—which illustrates how panic disorder and agoraphobia can be linked.

Causes of agoraphobia

Genetics are thought to play a significant role in the development of agoraphobia. Environmental factors may also cause or contribute, such as overprotective parents, abuse or other trauma during childhood, fears experienced at a young age, being in a relationship with a controlling partner, and excess stress. A previous history of certain mental illnesses, such as depression, anorexia nervosa, bulimia, or issues with substance use may also increase the likelihood of developing this condition. Women may also be more likely to present with symptoms of agoraphobia.

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Again, having panic disorder may also put a person at higher risk for developing agoraphobia. As mentioned above, this is because even the experience of a single panic attack may cause someone to avoid situations where they could experience another. 87% of individuals with agoraphobia will experience other concurrent mental health conditions—usually either panic disorder, other phobias, social anxiety, or substance use issues. (Mental health research is constantly evolving, so older sources may contain information or theories that have been reevaluated since their original publication date.)

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Treatment for agoraphobia

Treatment for agoraphobia typically involves psychotherapy. Cognitive behavioral therapy (CBT) in particular is a widely accepted modality for treating this and other phobias. With this methodology, a qualified provider can help the individual learn to shift thought patterns around their triggers and develop healthy, effective coping mechanisms for dealing with symptoms that do arise. They may also work with the individual to slowly work up to facing their trigger(s) directly through some form of exposure therapy.

Medication is sometimes suggested in tandem with therapy for agoraphobia—typically antidepressants and/or medication for anti-anxiety. Always consult a qualified medical professional before starting or stopping any medication.

How online therapy can help

Since some people with agoraphobia find it difficult to leave the house, seeking treatment in the form of in-person therapy sessions may not be comfortable or possible. In cases like these, online therapy may be a more viable treatment option. With an online therapy platform like BetterHelp, you can get matched with a licensed therapist who you can meet with via phone, video call, and/or online chat to address the challenges you may be facing. See below for client reviews of BetterHelp counselors.

Research suggests that online therapy can be an effective treatment method for those who experience agoraphobia and panic attacks. The results of a systematic review and meta-analysis of 27 different studies show that online cognitive behavioral therapy can reduce symptoms of combined agoraphobia and panic disorder. Researchers also found that online CBT can be as effective as in-person therapy, and participants reported experiencing sustained improvements as a result of online treatment.