Last Updated on April 13, 2023 by Mike Robinson

Agoraphobia is an anxiety disorder that arises when a person is in a place not considered safe. The agoraphobia symptoms make the person suffering from this disorder feel anxiety when it is difficult to escape to a safe place and where immediate help is unavailable in case of a panic attack.
This translates into fear of open spaces, of being in the middle of a crowd of people, of being in busy streets, in shopping centers, in supermarkets, of going to the movies, of having to queue, of traveling by bus, metro, train, or plane, et cetera.
And in being afraid to suffer a panic attack outside the home, to lose consciousness, to have a bad time, to get stuck and not be able to escape, to be ridiculed, to suffer a heart attack, to lose control, to go crazy, and even to die.
Agoraphobia, as its name suggests, is a phobia, that is, a set of intense and irrational fears that he is aware of but cannot avoid. The person knows that his fear of open spaces and crowds is irrational, but he cannot help but feel fear.
As we will see throughout the article, agoraphobia is one of the most disabling phobias that affect the quality of life of the affected person, preventing them from leading a normal life.
This disorder is more common in women than men, and its onset occurs at the beginning of adulthood.

Differences Between Agoraphobia and Panic Attacks

Agoraphobia and panic attacks are different pathologies that often occur together in the same person. Have you ever suffered a panic attack? If so, you know they are very annoying and unpleasant to experience.

Panic attacks begin abruptly, reaching their maximum expression after ten or twenty minutes, although some symptoms can remain for hours. The most frequent agoraphobia symptoms are an increased heart rate, suffocation, unreality, chest tightness, numbness, sweating, tremors, instability, nausea, dizziness, fainting, flushing, and chills.

During a panic attack, it is common for the person to confuse it with a heart attack.

The Most Common Symptoms of Agoraphobia

In addition to the symptoms of panic attacks, other symptoms typical of agoraphobia include:

• Cramps
• Fatigue
• Muscle weakness in the arms and legs
• development of new phobias
• Despair
• Disorientation
• Difficulty breathing
• Difficulty swallowing
• Shortness of breath
• Fatigue
• Hyperventilation
• Tingling in hands and feet
• Fear of what may happen
• Negative thoughts
• Catastrophic thoughts
• Stomach problems
• Bursts of heat and cold
• The feeling of lack of protection
• The sensation of not having control
• feeling of urinating
• Depressive symptoms
• Tension
• Vertigos
• Blurry vision
• Etc.

The person with agoraphobia symptoms does not know where the intense fear that he is feeling comes from; he is not able to locate its origin.

This ignorance makes the affected person believe that all these symptoms arise due to a physical problem or a serious illness, so he goes regularly to the doctor and hospitals to perform tests to confirm their suspicions.

Impact of Agoraphobia Symptoms

The consequences of this disorder are serious since the consequences of agoraphobia as an anxiety disorder are combined with the consequences of agoraphobia as a phobia and the consequences of panic attacks.

The primary and most serious consequence is that the person, regardless of whether he has suffered panic attacks, begins to avoid those situations and places that generate anxiety and fear and in which he does not feel safe.

That is, the person begins to avoid places like:

• shopping centers
• supermarkets
• restaurants
• busy streets
• using public transport
• going to the movies
•  traveling
• playing sports

All these activities generate problems in the quality of life of the agoraphobic. Therefore, he spends most of his time at home. Home is the only place he feels safe. When he has to leave, he has feelings of discomfort. These feelings include high levels of anxiety, and the fear of having a panic attack. Therefore, his trips tend to be scarce and quick.

In these cases, try to have someone you know to come with you: a family member, a friend, etc. Being accompanied is a search for safety and control for the affected person. Going accompanied does not make the symptoms disappear. They are still present, although at a lower intensity.

Another behavior carried out by agoraphobic people when they leave home is the use of “amulets”, which are nothing more than objects that, for one reason or another, give them a certain tranquility (a bottle of water, an anxiolytic, having a mobile phone by hand, etc.).

The consequences of the disorder seriously affect your daily life. The person stops going to work, stops meeting friends, and needs the company of someone close to perform any paperwork outside the home. In parallel, the person begins to distance himself from others, to feel alone, depressed, sad, and with thoughts and ideas of suicide, which pushes him to consume drugs, alcohol, and other drugs in an attempt to improve.

As with any other disorder or pathology, the problem does not improve with the consumption of these substances, but it alleviates it and could result in an addiction.

Causes of Agoraphobia?

Agoraphobia does not have a specific cause; it is not due to a genetic alteration or chemical imbalance in the brain as with other disorders.

But some factors can predispose the person to develop the problem, such as the tendency to:

• Respond alarmingly to any event.
• Avoid uncomfortable or embarrassing situations.
• Depend on others in excess.
• Worrying excessively about the physical symptoms of anxiety
• Etc.

This disorder can arise because the person feels mild anxiety in public or transited place and, from that moment on, progressively begins to be afraid of experiencing these symptoms again. Hence, he begins to avoid these places.

In the same way, the person may suffer a panic attack or an anxiety crisis in public abruptly, which is the turning point for the development of agoraphobia. It also happens that the person mistakenly attributes the symptoms he experiences because of a specific problem (for example, stress) to having an attack of anxiety or panic.

That person associates anxiety and panic attacks with the places where he has experienced these sensations and begins to avoid them at all costs.

Also read: Anxiety Disorders: Types, Symptoms, Causes, and Treatments

The problem is that this association is growing, and people are avoiding not only the place where the panic attack happened or where the symptoms of anxiety were experienced but also many other places with similar characteristics.

As a result, the person begins to reduce the places they can go to the point of staying at home because it is the only place where they are not afraid of suffering a panic attack or an anxiety crisis.

The person feels safe at home, and the mere idea of having to leave triggers very unpleasant emotions and feelings.

You could say that agoraphobia arises through mechanisms of association and learning specific to the person and that this emergence can be gradual or abrupt.

How to Overcome Agoraphobia

The person having agoraphobia symptoms needs a psychology professional to overcome his disorder since it tends to become chronic if he does not intervene. The more time passes, the harder it will be to try and overcome.

It is commonplace that the person does not seek help for months or even years because the intensity of agoraphobia usually fluctuates. There are periods in the life of the affected during which the disorder is more severe and disabling and others during which its intensity is lower.

The person believes he is recovering, and the problem will disappear soon, so do not seek help. Within psychology, there are many different orientations and treatments.

Cognitive Behavior Therapy

Cognitive-behavioral therapy (CBT) treatment is the most successful in treating agoraphobia and consists of gradually exposing the affected person to situations that cause fear and anxiety (open spaces and crowds).

For this exposure to be successful, the patient is previously taught the necessary skills to face their fears, such as relaxation techniques, cognitive techniques, or identifying bodily symptoms.

Many psychology cabinets, associations, and centers have virtual reality systems for treating various pathologies, mainly phobias. This new system exposes the patient virtually and progressively to their fears. You could combine virtual and real exhibitions to obtain better and more lasting results.

If panic attacks occur along with agoraphobia, the patient will learn the technique of interoceptive exposure.

This technique involves exposing the affected person to the symptoms that he fears, that is, the symptoms of the anxiety attack. In this way, the patient becomes accustomed to these sensations, learns to identify them, and can control them.

Many patients resist the techniques used to treat agoraphobia because their logic tells them to avoid what causes anxiety and fear, and the therapist proposes the opposite. To break down this resistance, the therapist must clearly explain the treatment, why it occurs this way, and that the exposure will be carried out gradually and according to their preferences.

Many research studies and experiments show that to overcome a phobia. The patient must face it and face what he fears, preferably progressively.

There are group therapies for agoraphobes for people who do not want individual treatment or those who wish to supplement this. The choice of one therapy over another will depend on the tastes and preferences of the patient.

Group Therapy

Group therapies benefit patients because they find support in other people going through the same thing, feel understood, and can help and be helped by people who consider them equal. In many cases, the treatment consists of the techniques I have briefly explained here and the consumption of certain drugs, mainly anxiolytics and antidepressants.

The drugs can be prescribed to treat agoraphobia, or some problem derived from this disorder, such as depression, but they should not be the first-choice treatment.

Related article. Agoraphobia: Symptoms, Causes and Treatments