Agoraphobia is a form of anxiety disorder in which you fear and avoid places that could cause you to panic and be trapped.

Anxiety is caused by the fear that there is no easy way to escape or get help if the tension escalates. 

Most people with agoraphobia develop it after having one or more panic attacks, which causes them to worry about having another attack.

People with agoraphobia often have trouble feeling safe in any public place, especially where crowds gather. 

Treating agoraphobia can be difficult because it usually means facing your fears. But with psychotherapy and medication, you can escape the trap of agoraphobia and live a more enjoyable life.

Symptoms

Typical symptoms of agoraphobia include fear of:

• Stand in line
• Closed spaces, such as cinemas, elevators, or small shops
• Open areas, such as parking lots, bridges, or shopping malls
• Use public transport (bus, plane, or train).

These situations cause anxiety because you worry that you won’t be able to escape or that you won’t find help if you start to feel panicked.

In addition:

• Fear or anxiety almost always results from exposure to the situation
• Your fear or anxiety is out of proportion to the real danger of the situation
• You avoid the case, you need a companion to accompany you, or you put up with the problem, but you feel distressed
• Your phobia and avoidance usually last six months or more

Example of agoraphobia

A person is afraid to leave home and must be accompanied to go further than their condition allows. She can call a relative to let her know she is leaving alone. This avoidance has a deleterious impact on professional functioning.

The causes

Biology, stress, and learning experiences can all play a role in developing agoraphobia.

Risk factors

Agoraphobia can start in childhood but usually in late adolescence or early adulthood – usually before age 35. Older adults can also develop it, and women are diagnosed with agoraphobia more often than men.

Risk factors for agoraphobia include:

• Having panic disorder or other phobias
• Respond to panic attacks with excessive fear and avoidance
• Experiencing stressful life events, such as abuse, death of a parent, or assault.
• Having an anxious or nervous temperament
• Having a parent with agoraphobia

Complications

Agoraphobia can significantly limit the activities of your life. If your agoraphobia is severe, you may not even be able to leave your home. 

Without treatment, some people remain housebound for years. 

You may not be able to visit family and friends, go to school or work, run errands, or participate in other normal daily activities. 

Agoraphobia can also cause or be associated with:

• Depression
• Alcohol or drug abuse
• Other mental health disorders, including other anxiety disorders or personality disorders

Prevention

There is no sure way to prevent agoraphobia. However, anxiety tends to increase as you avoid situations you fear. 

If you start to have mild fears about going to safe places, try to practice going there again and again before your anxiety becomes overwhelming. 

If it’s too difficult to do it yourself, ask a family member or friend to go with you, or seek professional help.

If you feel anxious or have panic attacks, get treatment as soon as possible. Get help early to prevent symptoms from getting worse. Anxiety, like many other mental health issues, can be harder to deal with if you wait.

Diagnostic

Agoraphobia is diagnosed based on the following:

• Signs and symptoms
• In-depth interview with your doctor or a mental health professional
• Physical examination to rule out other conditions that could be causing your symptoms
• Criteria for agoraphobia are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Treatment

Treatment for agoraphobia usually includes both psychotherapy and medication. It may take some time, but treatment can help you get better.

Psychotherapy

Psychotherapy involves working with a therapist to set goals and learn practical skills to reduce anxiety symptoms. Cognitive-behavioral therapy is one of the most effective psychotherapies for anxiety disorders, including agoraphobia.

Medications

Certain types of antidepressants are often prescribed to treat agoraphobia, and sometimes benzodiazepines are used on a limited basis. 

Medications can take weeks to relieve symptoms. 

Alternative medicine

Some dietary and herbal supplements claim to have calming and anti-anxiety benefits. Before taking these drugs for agoraphobia, please speak with your doctor.

Although these supplements are available without a prescription, they are not without health risks.