Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.
With agoraphobia, you fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line or being in a crowd. The anxiety is caused by fear that there's no easy way to escape or seek help if intense anxiety develops. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to fear another attack and avoid the place where it occurred.
People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. You may feel that you need a companion, such as a relative or friend, to go with you to public places. The fears can be so overwhelming that you may feel unable to leave your home.
Agoraphobia treatment can be challenging because it usually means confronting your fears. But with talk therapy (psychotherapy) and medications, you can escape the trap of agoraphobia and live a more enjoyable life.
Typical agoraphobia symptoms include:
In addition, you may have signs and symptoms of a panic attack, such as:
Some people have a panic disorder in addition to agoraphobia. Panic disorder is a type of anxiety disorder in which you experience sudden attacks of extreme fear that reach a peak within a few minutes and trigger intense physical symptoms (panic attacks). You might think that you're totally losing control, having a heart attack or even dying.
Fear of another panic attack can lead to avoiding similar circumstances or the place where it occurred in an attempt to prevent future panic attacks.
Agoraphobia can severely limit your ability to socialize, work, attend important events and even manage the details of daily life, such as running errands.
Don't let agoraphobia make your world smaller. Call your health care provider if you have symptoms.
Having panic disorder or other phobias, or experiencing stressful life events, may play a major role in the development of agoraphobia.
Agoraphobia is diagnosed based on signs and symptoms, as well as an in-depth interview with your health care provider. You may also have a physical exam to rule out other conditions that could be causing your symptoms.
To be diagnosed with agoraphobia, you must meet criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
Diagnostic criteria for agoraphobia include severe fear or anxiety about two or more of the following situations:
These situations cause anxiety because you fear you won't be able to escape or find help if you develop panic-like symptoms or other disabling or embarrassing symptoms.
In addition, diagnostic criteria for agoraphobia include:
Agoraphobia can greatly limit your life's activities. If your agoraphobia is severe, you may not even be able to leave your home. Without treatment, some people become housebound for years. You may not be able to visit with family and friends, go to school or work, run errands, or take part in other normal daily activities. You may become dependent on others for help.
Agoraphobia can also lead to or be associated with:
There's no sure way to prevent agoraphobia. However, anxiety tends to increase the more you avoid situations that you fear. If you start to have mild fears about going places that are safe, try to practice going to those places before your fear becomes overwhelming. If this is too hard to do on your own, ask a family member or friend to go with you, or seek professional help.
If you experience anxiety going places or have panic attacks, get treatment as soon as possible. Get help early to keep symptoms from getting worse. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
Certain dietary and herbal supplements claim to have calming and anti-anxiety benefits. Before you take any of these for agoraphobia, talk with your health care provider. Although these supplements are available without a prescription, they still pose possible health risks in some people.
For example, the herbal supplement called kava appeared to be a promising treatment for anxiety, but reports of serious liver damage — even with short-term use — caused several European countries and Canada to pull it off the market. The Food and Drug Administration has issued warnings but not banned sales in the United States. Avoid using kava until more rigorous safety studies are done, especially if you have liver problems or take medications that affect your liver.
Living with agoraphobia can make life difficult. Professional treatment can help you overcome this disorder or manage it effectively so you don't become a prisoner to your fears.
You can also take these steps to cope and care for yourself when you have agoraphobia:
Agoraphobia usually starts before age 35, but older adults also can develop it. Women are diagnosed with agoraphobia more often than men are.
In addition to having panic disorder or other phobias, agoraphobia risk factors include: