Social Anxiety Disorder Related Conditions The Relationship Between Agoraphobia and Social Anxiety By Arlin Cuncic Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." Learn about our editorial process Updated on September 28, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Rachel Goldman, PhD, FTOS Medically reviewed by Rachel Goldman, PhD, FTOS Facebook LinkedIn Twitter Rachel Goldman, PhD FTOS, is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in eating behaviors, stress management, and health behavior change. Learn about our Medical Review Board Print Don Bayley/E+/Getty Images You may have heard that agoraphobia and social anxiety disorder are closely connected and that's true. What have we learned about the similarities and differences between these disorders as well as how often they occur together? The Relationship Agoraphobia and social anxiety disorder are interrelated in many ways. In order to understand this, it's helpful to talk about the definition of these disorders, how the two may differ, and how to tell them apart. That said, many people have both agoraphobia and social anxiety disorder, a phenomenon referred to in medicine as "comorbidity." Let's take a look at what we've learned about the interaction of these two conditions. Association With Panic Attacks and Panic Disorder Agoraphobia is typically thought of as the fear of leaving your home. While it is true that many people with agoraphobia are housebound, agoraphobia actually refers to the fear of being in situations or places from which escape would be difficult or embarrassing in the event of a panic attack. In a sense, it can be thought of as having a fear of having a panic attack. Agoraphobia usually leads to the avoidance of specific places such as crowds, automobiles, buses, trains, elevators, and bridges. In addition, people with agoraphobia may fear leaving the house alone. Most people with agoraphobia are better able to cope if in the company of a trusted companion. Although agoraphobia can be diagnosed without panic disorder, over 95 percent of people diagnosed with agoraphobia also have a diagnosis of panic disorder. Agoraphobia most often occurs in conjunction with panic disorder. When agoraphobia is diagnosed without panic disorder, severe anxiety is experienced but not to the degree that it constitutes a panic attack. Panic Attack Types and Symptoms How They Differ Although both agoraphobia and social anxiety disorder (SAD) can involve the fear of public places, people with SAD feel anxiety only in situations where scrutiny by others may occur. For example, being on an elevator alone or in a car alone would not be uncomfortable. While people with agoraphobia usually feel better in the company of a trusted companion, people with social anxiety disorder may feel worse because of potential scrutiny by the companion as well. Social Anxiety Disorder: Diagnosis and Treatment Agoraphobia Fear of leaving house Fear of having a panic attack in public places Fear of being in situations where escape might be difficult or that help wouldn't be available if things go wrong Feel better with trusted companion SAD Fear of public places Fear of situations where scrutiny by others may occur Fear of being in a position of being negatively judged Feel worse with trusted companion due to fear of scrutiny Comorbidity When it is difficult to distinguish between the anxiety of agoraphobia and SAD, it may be that both diagnoses apply. Results of an older National Comorbidity Survey conducted in the United States showed a correlation of .68 between diagnoses of agoraphobia and social anxiety disorder, meaning that the two disorders occurred together around 68 percent of the time. More recent studies have found that major depression is often a comorbidity as well. Some studies suggest that having both disorders together is more common in women than in men and that when both disorders are present, the course tends to be more severe. Studies comparing the particular neurophysiological pathways in the brain with different anxiety disorders have found a close correlation between pathways in agoraphobia and social anxiety disorder, though these differ somewhat from those involved in other anxiety disorders such as obsessive-compulsive disorder. Coping There are effective treatments that can help with symptoms of agoraphobia and social anxiety disorder and there is considerable overlap. Ways of managing agoraphobia and treatments for social anxiety disorder can often help with the other condition as well, although treatments such as systemic desensitization and others are used primarily with agoraphobia. This underlines the importance of an accurate diagnosis and the care of a psychotherapist with who you feel comfortable. What Is Psychotherapy? A Word From VeryWell Agoraphobia and social anxiety are closely related conditions but have some important differences in the causes of the symptoms. With agoraphobia, it is the fear of enclosed places, transportation, and leaving home that leads to isolation, but the primary fear is that escape may not be possible and/or embarrassment of a panic attack. In contrast, with social anxiety disorder, it is the exposure to people and chance of being judged that leads to emotional and sometimes physical distress. Whereas a person with agoraphobia often welcomes a companion, this is not the case with social anxiety disorder. That said, agoraphobia and social anxiety disorder frequently occur together, and this is thought to occur more than half the time. When this happens, the symptoms appear to be more severe than if one of these conditions were present. Fortunately, treatments are available for both disorders, which can help to get to the base of the problem and restore a person's life. 5 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Gerez M, Suárez E, Serrano C, Castanedo L, Tello A. The crossroads of anxiety: distinct neurophysiological maps for different symptomatic groups. Neuropsychiatr Dis Treat. 2016;12:159–175. doi:10.2147/NDT.S89651 Ströhle A, Gensichen J, Domschke K. The diagnosis and treatment of anxiety disorders. Dtsch Arztebl Int. 2018;155(37):611–620. doi:10.3238/arztebl.2018.0611 Koyuncu A, İnce E, Ertekin E, Tükel R. Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges. Drugs Context. 2019;8:212573. doi:10.7573/dic.212573 Magee WJ, Eaton WW, Wittchen HU, Mcgonagle KA, Kessler RC. Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Arch Gen Psychiatry. 1996;53(2):159-68. doi:10.1001/archpsyc.1996.01830020077009 Batinic B, Opacic G, Ignjatov T, Baldwin DS. Comorbidity and Suicidality in Patients Diagnosed with Panic Disorder/Agoraphobia and Major Depression. Psychiatr Danub. 2017;29(2):186-194. doi:10.24869/psyd.2017.186 By Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Social Anxiety Disorder Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.