Agoraphobia Therapy: Treatment Options

Medically reviewed by Laura Angers Maddox
Updated February 19, 2024by BetterHelp Editorial Team

Many people have days when it feels stressful just to walk out the front door. Whether they’re dreading a long day at work or are nervous about a date later that night, sometimes it can be tempting to simply stay at home. However, some people experience anxiety just being in public or in certain spaces such as elevators or crowded city streets on a regular basis. These individuals may be living with a mental health condition known as agoraphobia. Agoraphobia can cause feelings of fear and panic in specific situations, typically in public areas. This article explores the different types of treatment options available that can address and manage agoraphobia and help individuals gain more control over their lives. 

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What is agoraphobia?

Agoraphobia is part of a subset of anxiety disorders known as phobias. A phobia is defined as a strong sense of fear or anxiety associated with a specific object/situation that is disproportionate to the amount of danger it poses. Agoraphobia is commonly thought of as a fear of open spaces or of being in public. In actuality, it is the fear of any situation in which a person might experience panic. This could occur in open, public settings, enclosed areas, and, in rarer cases, any space outside a person’s home.

Agoraphobia is often associated with panic attacks and panic disorder. Panic disorder occurs when a person avoids situations that they fear may cause a panic attack. Panic attacks, panic disorder, and agoraphobia are all related, and they often occur together, but they are separate conditions. Agoraphobia refers to the fear and anxiety associated with the possibility of panic. A panic attack is the actual experience of symptoms of panic. Panic disorder is a mental health condition in which a person may begin to make changes that negatively impact their life such as restricting when they leave home, to avoid situations that might cause panic. 

How does agoraphobia therapy help?

Several different kinds of therapy have been found effective in treating agoraphobia symptoms. Many of these therapies work more effectively when combined with prescription medication. Still, the efficacy of medication can vary by individual, so it can be helpful to work with a therapist and doctor simultaneously to determine what type of medication, if any, may suit your needs. 

Medication

If your doctor and therapist agree that medication may help you manage symptoms of agoraphobia, you will likely be prescribed one of the three medications found to be most impactful for this condition: selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or benzodiazepines. 

SSRIs and SNRIs are forms of medication known as antidepressants. They work by impacting the way a person’s brain absorbs the neurotransmitters serotonin and norepinephrine. Antidepressants can help to regulate a person’s mood, which may enable them to manage their fears about panic and anxiety more effectively.

Benzodiazepines may address acute anxiety symptoms. Taking one of these medications could be helpful when a person with agoraphobia experiences panic while in public or in another setting that heightens their fear and anxiety. Benzodiazepines can be habit-forming, though, so they should be taken only when required, not as a long-term treatment for anxiety. Your doctor may also advise against taking benzodiazepines if you have a history of addiction or substance use. Always speak with a medical provider before starting or stopping a medication.

Talk therapy

Talk therapy may involve meeting regularly with a mental health professional to discuss thoughts, feelings, experiences, and events in one’s life. One of the most widely used methods of talk therapy, cognitive behavioral therapy (CBT), can be particularly effective when used to treat agoraphobia. CBT is considered the gold standard in therapeutic treatment for a variety of mental health conditions and is based on the philosophy that thoughts and behaviors are inherently linked.

A therapist practicing CBT can help people with agoraphobia identify unhealthy or disordered thought patterns that may lead to anxiety or panic. CBT therapists may work with clients to help them develop healthy responses and coping mechanisms to manage anxiety symptoms, including ways to relieve stress and de-escalate panic. These strategies can help a person feel less afraid of panic by teaching them how to gain more control over their emotional state. 

Exposure therapy

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Exposure therapy is a common treatment for many kinds of phobias, including agoraphobia. This type of therapy involves gradually exposing a person to the object or situation that triggers fear, but in a safe and controlled environment. Exposure therapy uses a process called systematic desensitization. For a person with agoraphobia, systematic desensitization may look like: 

  1. Asking the person to imagine a low-level scenario associated with their fear, such as observing a crowded area from afar.
  2. Working with the person to recognize and process their symptoms of anxiety and panic in response to the visualization.
  3. Once the person feels safe and the low-level image no longer results in anxiety, asking them to imagine a more intense scenario, such as approaching the crowd.
  4. Continuing to process the anxiety and imagine progressively more frightening scenarios, such as entering the crowd.
  5. Moving out of the realm of imagination and encouraging the client to participate in some of these scenarios in real life.

The goal of exposure therapy is to help people become desensitized to specific triggers of fear and panic so that their fear begins to feel manageable and no longer drives their decisions.  

Applied relaxation therapy

Applied relaxation therapy consists of “reverse-engineering” the anxiety process. Someone living with agoraphobia will often have physical responses to perceived stressors. For example, if someone with agoraphobia walks into an elevator full of people, they may experience fear and anxiety, which can cause their heart rate to skyrocket. With applied relaxation therapy, the therapist and client work to address these physical symptoms with the goal of calming the original fear response. This technique is based on the theory that by physically relaxing one’s body, the stressor can become less scary.

Applied relaxation therapy may include exercises designed to help patients identify the signs that they are becoming anxious, which often manifests as tension in various parts of the body. Once the tension is identified, individuals can learn how to progressively relax their muscles to relieve tension and soothe anxiety. The therapist can then teach the individual how to use these techniques in everyday life to address anxiety and prevent panic. 

Finding support for agoraphobia

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Experiencing agoraphobia can make the thought of driving, taking public transportation, walking down the street, or even simply leaving your house feel overwhelming and scary. If agoraphobia symptoms are making it difficult for you to get therapy appointments in person, you may want to consider online therapy as an alternative. With online therapy platforms like BetterHelp, you can receive support from the comfort of your home. Through video chats, phone calls, or in-app messaging, you can connect with a therapist who specializes in phobias and anxiety disorders and get the care you need.

The efficacy of online therapy for agoraphobia

Research has demonstrated that online therapy may be just as effective as traditional in-person therapy treatments in addressing a range of different mental health conditions, including phobias such as agoraphobia. One study analyzed a series of studies on the efficacy of cognitive behavioral therapy delivered online and found these interventions to be just as effective as in-person CBT in treating symptoms of agoraphobia and panic disorder. If agoraphobia symptoms are preventing you from seeking in-person therapy or you simply would like to experience therapy from the comfort of your own home, online therapy could be helpful.  

Takeaway

Agoraphobia is a serious mental health disorder that may result in overwhelming anxiety, panic attacks, or panic disorder. In extreme cases, the condition can prevent a person from going out in public or even leaving their house. Several treatment options have been found to be effective for agoraphobia, including cognitive behavioral therapy, exposure therapy, and applied relaxation therapy. Online therapy may be a more convenient way for people with agoraphobia to find treatment in a safe environment. To get matched with an online counselor who specializes in agoraphobia, reach out to BetterHelp today. 

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