Definition

Agoraphobia is an anxiety disorder. It is an irrational fear of being trapped in places or situations where escape is difficult. People with agoraphobia may not leave the house.

Causes

The exact cause of anxiety disorders is not known. Agoraphobia often occurs with panic disorders. People with a panic disorder may having a panic attack and not having anyone around to help them. This can lead them to avoid certain places or situations. Other factors that may contribute to the development of agoraphobia include:

• Genetics
• Changes in brain chemistry or activity
• Having a nervous system that reacts excessively, even to normal stimuli
• Increased awareness of physical changes, such as increased heart rate
• Distorted thinking, which may start a cycle of fear

Nervous System Changes or genetic problems in the nervous system (brain and nerves) may contribute to agoraphobia. Copyright © Nucleus Medical Media, Inc.

Risk Factors    TOP

Factors that may increase your chance of agoraphobia include:

• History of panic attacks or panic disorder
• A tendency to be nervous or anxious
• Stressful situations
• Family members with panic disorder or phobias
• Other psychiatric disorders

Symptoms    TOP

Symptoms include:

• Fear of being in a crowd, shopping, standing in line, or similar activities
• Fear of riding in a car, bus, or train
• Creation of a safe zone
• Feelings of anxiety when outside the safe zone
• Fear of being alone
• Avoidance of situations that might cause a panic attack
• Restriction of activities outside the home
• Feeling of being safer with a trusted friend

Feared situations may trigger a panic attack. Attacks start quickly and peak in about 10 minutes. A panic attack usually includes four or more of the following:

• Intense fear
• Shaking
• Rapid heartbeat
• Pounding or racing feeling in the chest
• Sweating
• Blushing
• Shortness of breath
• Chest pain
• Dizziness or lightheadedness
• Hot flashes or chills
• Numbness or tingling
• Nausea
• Feeling of loss of control or "going crazy"
• Fear of having a heart attack or dying

Agoraphobia is also commonly associated with the following conditions:

• Panic disorder
• Depression
• Anxiety
• Posttraumatic stress disorder (PTSD)

Diagnosis    TOP

The doctor will ask about your symptoms and medical history. A physical exam will be done. You may be asked questions about your:

• Use of alcohol and drugs
• Mental health history
• Family's mental health history

There are no tests for agoraphobia or panic disorder. Your doctor may order heart or blood tests done to look for an underlying cause.

Treatment    TOP

Treatment aims to help you overcome irrational fears and live more independently. Goals include:

• Reducing the number and severity of panic attacks
• Learning to manage panic attacks that do occur

Treatments may include:

Prevention    TOP

Agoraphobia often develops as a response to panic attacks. If you have had a panic attack, instead of avoiding the place or situation, seek medical care. Early treatment for panic attacks can help prevent agoraphobia.