Agoraphobia: Definition, Symptoms, And Treatment
Agoraphobia is an anxiety disorder characterized by an individual’s fear of being in a place where a panic attack could occur, escape may be difficult, or they would otherwise feel unsafe or uncomfortable. Often associated with the fear of open spaces, agoraphobia is actually a much broader phobia—one that can be brought on in almost any situation an individual views as precarious. Because agoraphobia can be applied to so many different scenarios, it can lead to an individual avoiding leaving home, which can significantly impact their quality of life. Below, we’re going to cover agoraphobia, its symptoms, and how it can be treated.
What Is Agoraphobia?
Agoraphobia is a strong fear of being in a situation that could make an individual feel helpless, without escape, or as though they’re going to experience panic. This can include enclosed spaces (e.g., subways or elevators), crowded public areas (e.g., parks or large cities), open spaces (e.g., festivals or golf courses), and a variety of other settings.
Agoraphobia and panic attacks are closely related, and panic disorder is often a comorbid condition. Frequently, symptoms of agoraphobia develop after an individual experiences a panic attack and begins to fear living through another one.
Agoraphobia can be debilitating, to the point where an individual may no longer leave home. Without treatment, some people remain homebound, while others may experience negative effects associated with relationships, work, and their physical health. In the most extreme cases, an individual with agoraphobia may abstain from participating in activities like going outside to get the mail or taking out the garbage. As a result, some people become dependent on others for daily help.
Symptoms Of Agoraphobia
One of the primary symptoms of agoraphobia is a disproportionate amount of fear of a situation in which an individual believes they may be exposed, uncomfortable, or unable to leave easily. While some phobias are dormant, agoraphobia is almost always activated by a triggering situation. So, to avoid the fear, individuals with agoraphobia often avoid these situations.
Those who can leave home despite their fears may feel extreme distress doing otherwise mundane activities, like going to work, sitting in traffic, or going grocery shopping. Typically, for this condition to be diagnosed, symptoms must last for at least six months.
Because panic disorder is closely linked with agoraphobia, the symptoms of a panic attack can be included in the symptoms of agoraphobia:
- Feelings of impending doom
- Fear regarding the potential for a future panic attack
- Rapid heartbeat
- Trouble breathing
- Upset stomach
What Causes Agoraphobia?
Genetics is thought to play a large part in the development of agoraphobia. Additionally, environmental factors like overprotective parents, fears experienced at a young age, and excess stress can lead to agoraphobia.
Because agoraphobia often develops after panic attacks, those who live with panic disorder have a greater risk of having the phobia. One panic attack may be all it takes to make someone fear that they could experience another one.
Panic Disorder And Agoraphobia
Panic attacks and agoraphobia are so closely linked that many perceive agoraphobia as a natural complication of panic disorder. Panic disorder is a condition in which an individual may frequently experience panic attacks, which are abrupt episodes of extreme fear, often without a discernable cause.
Panic attacks usually last between a few minutes and a half hour. They can produce strong mental and physical symptoms, so much so that panic attacks are often confused with heart attacks.
Because panic attacks can be 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 similar environments.
While the connection between agoraphobia and panic disorder is strong, panic disorder does not have to be present for an individual to develop agoraphobia.
Risks Of Developing Agoraphobia
Who is at risk for developing the disorder? Almost anyone, including children can have agoraphobia, but it typically presents during a person’s late teen or early adult years, usually before they reach the age of 35. Agoraphobia can also be brought on by outside influences, such as environmental stressors and learning experiences. Those who have a nervous temperament may be more likely to develop agoraphobia. A traumatic life event—such as witnessing a natural disaster or experiencing the death of a close friend or relative—can also be a cause.
Gender has been connected to the development of agoraphobia, with women experiencing it at a high rate. Alcohol use and tobacco have also been linked to the development of agoraphobia, though the connection between smoking and anxiety and panic disorder remains unclear.
Agoraphobia can develop alongside a number of other disorders; in fact, approximately 87% of people with agoraphobia will experience another mental health condition at some point, with the most common being panic disorder. Other common comorbid disorders include social anxiety disorder, specific phobia, and substance use disorder.
Treatments for agoraphobia frequently includes cognitive behavioral therapy (CBT) and medication.
Medication for agoraphobia is usually either antidepressants (e.g., sertraline, SSRIs) or anti-anxiety medications (e.g., benzodiazepines). Antidepressants are often used for comorbid agoraphobia and panic disorder, while anti-anxiety medications are typically prescribed for the short-term treatment of symptoms of anxiety.
Always consult with a medical or mental health professional before starting or stopping any medication.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a widely accepted modality for treating agoraphobia. This form of psychotherapy can teach the individual specific skills needed to cope with anxiety, help them face their fears, and give them the tools to return to the life they previously enjoyed.
CBT can help a person with agoraphobia identify and replace negative or disordered thought patterns that could lead to panic. For example, a therapist may help an individual see that the possibility of being trapped in an enclosed space is highly unlikely, which may help alleviate their fears. Therapy can also provide coping mechanisms for managing symptoms when they occur.
Treating agoraphobia may be more complicated if an individual has to leave their home to meet with a therapist. In this case, online therapy might be a beneficial treatment option to explore.
How Online Therapy Can Help
Research points to online therapy as 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 (CBT) can reduce symptoms of combined agoraphobia and panic disorder. Researchers found that online CBT can be as effective as in-person therapy, and participants reported experiencing sustained improvements from treatment after a period of 3-6 months.
Online therapy can help you address symptoms of agoraphobia that may make it difficult to leave the house or do the things you want to do. With online therapy through BetterHelp, you can connect with a qualified mental health professional from the comfort of home, through video call, voice call, or in-app messaging. Your therapist can also connect you with useful resources, like at-home exercises, that you can complete to help you work through your fears. Read below for some reviews of BetterHelp therapists from people experiencing similar concerns.
“It’s amazing how beneficial therapy is. The EMDR sessions with Keith have enabled me to reclaim my power and control over my own life. As a result of my work with Keith I went from too scared and anxious to leave the house with crippling panic, to being able to enjoy walks with my husband in the park, garden and we have even traveled by plane, and train. I’ve been able to leave some toxic relationships that weren’t serving me, and now feel equipped to not only face life but to enjoy the richness and fullness of it. I highly recommend Keith as a counselor and the EMDR sessions.”
“I want to say a Big Thank You to betterhelp.com for assigning Noami Kim to me…I don’t know if I’d have gotten a better session like hers. My 2 weeks alone with her has recorded some noticeable progress on coping with my frequent panic attacks/disorder. My experience so far with her has been very relaxing and conversational even when at times it was difficult for me to express myself. I feel very positive that’ll come out better and more focused in fighting this PAD. Thank You Noami Kim.”
Agoraphobia can make it difficult to do the things you want to in life. If you’re living with the complicated symptoms of agoraphobia, panic disorder, or similar mental health-related concerns, know that help is available. With the support and advice of a licensed therapist, you can work through your symptoms, face your fears, and live the life you deserve.
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