Agoraphobia 

Introduction 

Phobias

Fear or phobia? Find out the difference between the two and the treatment options that can help you overcome them.

Media last reviewed: 11/01/2013

Next review due: 11/01/2015

How common is agoraphobia?

In the UK, up to two people in 100 have panic disorder. It's thought that around a third of those will go on to develop agoraphobia.

Agoraphobia is twice as common in women as men. It usually starts between the ages of 18 and 35.

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Agoraphobia is a fear of being in situations where escape might be difficult, or help wouldn't be available if things go wrong.

Many people assume that agoraphobia is simply a fear of open spaces but it's more complex than this. A person with agoraphobia may be scared of:

  • travelling on public transport
  • visiting a shopping centre
  • leaving home

If someone with agoraphobia finds themselves in a stressful situation they'll usually experience symptoms of a panic attack such as:

  • rapid heartbeat
  • rapid breathing (hyperventilating)
  • feeling hot and sweaty
  • feeling sick

They will avoid situations that cause anxiety and may only leave the house with a friend or partner. They will order groceries online rather than go to the supermarket. This change in behaviour is known as "avoidance".

Read more about the symptoms of agoraphobia.

What causes agoraphobia?

Agoraphobia usually develops as a complication of panic disorder (an anxiety disorder involving panic attacks and moments of intense fear). It may arise as a result of associating panic attacks with the places or situations where they occurred and then avoiding them.

A minority of people with agoraphobia have no history of panic attacks. In these cases, their fear may be related to issues such as a fear of crime, terrorism, illness or being in an accident.

Traumatic events, such as bereavement, may contribute towards agoraphobia, as well as certain genes that are inherited from your parents.

Read more about the possible causes of agoraphobia.

Diagnosing agoraphobia

Speak to your GP if you think you may be affected by agoraphobia. It should be possible to arrange a telephone consultation if you don't feel ready to visit your GP in person.

Your GP will ask you to describe your symptoms, how often they occur and in what situations. It's very important you tell them how you've been feeling and how your symptoms are affecting you.

Your GP may ask you the following questions:

  • Do you find leaving the house stressful?
  • Are there certain places or situations you have to avoid?
  • Do you have any avoidance strategies to help you cope with your symptoms, such as relying on others to shop for you?

It can sometimes be difficult to talk about your feelings, emotions and personal life. However, try not to feel anxious or embarrassed. Your GP needs to know as much as possible about your symptoms to make the correct diagnosis and recommend the most appropriate treatment.

Read more about diagnosing agoraphobia.

Treating agoraphobia

A stepwise approach is usually recommended for treating agoraphobia and any underlying panic disorder. These are usually:

  • Step one: educate yourself about your condition, possible lifestyle changes you can make, and self-help techniques to help relieve symptoms.
  • Step two: enrol yourself on a guided self-help programme (see below).
  • Step three: more intensive treatments, such as cognitive behavioural therapy (CBT) or medication.

Lifestyle changes may include taking regular exercise, eating more healthily, and avoiding alcohol, drugs and drinks containing caffeine, such as tea, coffee and cola.

Self-help techniques that can help during a panic attack include staying where you are, focusing on something that's non-threatening and visible and slow, deep breathing.

If your agoraphobia fails to respond to the above treatment methods, your GP may suggest that you try a guided self-help programme. This involves working through self-help manuals that cover the types of issues you might be facing, along with practical advice about how to deal with them.

Medication may be recommended if self-help techniques and lifestyle changes aren't effective in controlling your symptoms of agoraphobia. You'll usually be prescribed a course of selective serotonin reuptake inhibitors (SSRIs) which are used to treat both anxiety and depression.

In severe cases of agoraphobia, medication can be used in combination other types of treatment, such as CBT and relaxation therapy.

Read more about treating agoraphobia.

Outlook

Around a third of people with agoraphobia eventually achieve a complete cure and remain free from symptoms.

Around half experience an improvement in symptoms but they may have periods when their symptoms become more troublesome – for example, if they feel stressed.

Despite treatment, about one in five people with agoraphobia continue to experience troublesome symptoms. 




Page last reviewed: 08/05/2014

Next review due: 08/05/2016

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The 5 comments posted are personal views. Any information they give has not been checked and may not be accurate.

bon84 said on 09 October 2014

hi, i have suffered with this for about 10years now, i find it really hard and depressing being stuck in a constant loop.
i have never had any help and do not know what to do. i tried to explain to my GP almost a year ago, told me to fill out a questionnaire and we started to talk about it, but as soon as i started talking about the time my father passed away he just said i was still grieving, ripped up the questionnaire and said phone this number, didnt know who the number was for, where or with who. i didnt call the number because it made me too anxious everytime i looked at it.
i just feel i keep getting put down everytime i try to get help, the jobcentre dont care, when i try to explain, they send me to group sessions, which i cant phisically go to which means money gets stopped all the time. (had 4 payments in 8 months).
i feel like i cant get help from nowhere, i also find it really hard to talk to people, i try hard to hide how uncomfortable and anxious i am when i have to be around people, i think thats why no one takes me seriously.
is there any advice you could give me? i would be very appreciated

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sueollie said on 14 July 2014

I am so happy to have found this site, I hae been having panic attacks and anxiety for over 8 years now and have been referred for cbt. After just my first session the therapist recognised the agoraphobia and after reading other peoples fears and feelings on here, I can relate to everyone's way of life style. I hate mine and hope to be a tad better soon. Will keep you all posted. Good luck

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sootydog said on 03 June 2014

I've just read this and now realise I've been suffering from agoraphobia for about two years since we moved to Cornwall, and it's getting worse. I couldn't work out why I was so stressed all day long - I now realise it's because I hate going out anywhere!.

We live in a small village about 2.5 miles from a larger town where the main shops are etc. I have to work full time from home now so for about two years had no reason to go out apart from walk the dog, which I enjoyed. My partner used to take our eBay sales parcels to the Post Office and do the shopping at the same time. We had a sports car and I was worried about scratching the paint work on the hedges in the narrow lanes! Then that got sold and my partner inherited an automatic car which I hated driving as it was long and I wasn't used to automatics - so basically I stopped driving, which has made my condition worse.

Now we have nice manual small car specially for me to get used to driving again. I had to learn to drive all over again, I go out once every few days to the PO and physio sessions or swimming and I get SO stressed about it. I still have not been to the supermarket myself! I used to love driving and ran my own shop until two years ago. Now I'm a wreck :-( I know I need to force myself to go out, but I hate the stressed out feelings I get from the moment i wake up/ I try and give myself treats when I go out to make the trip more pleasant. I get stressed about them too ( going into a shop and buying it!) grr!

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User874088 said on 21 May 2014

I've been suffering with this also for abut 5 years, but 3 years ago went for medical help, which has really helped me, I still have bad days but i have learned to Overcome them, i'm back work now but i can only manage 3 days a week, its strange how people look at you when you say that you have Agorphobia, i don't think i'll ever be back to how i was but i just take each day as it comes

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UKman81 said on 25 August 2013

i think ive been suffering with this for 3 years, its been 3 years since ive last been outside into the public(most ive been is on my doorstep,i was supposed to go on a family break tommorow and first felt like i could overcome this but today im a bag of nerves and feel sick, ive yet to seek help

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