What Are the Symptoms of Agoraphobia?

Mature man sitting at window looking worried

Westend61 / Getty Images

Table of Contents
View All
Table of Contents

What Are the Symptoms of Agoraphobia?

Agoraphobia is the persistent and extreme fear of spaces that are usually outside of the home. Common symptoms include:

  • Being afraid to leave your house
  • Avoiding crowded places
  • Feeling anxious
  • Feeling hot
  • Rapid heart rate
  • Shortness of breath
  • Feeling sick or faint
  • Chest pain
  • Dizziness
  • Trembling
  • Trouble swallowing

The symptoms of agoraphobia may include panic attacks in unfamiliar places and/or avoidance of public places. Those who have agoraphobia may experience a fear of having a panic attack in public as well.

Agoraphobia is often misunderstood as being primarily a problem in which people are afraid to leave their houses. However, there are more specific behaviors that suggest a person may have agoraphobia.

Panic Attack Symptoms

The physical symptoms of agoraphobia are similar to those that may occur during a panic attack, such as anxiety, increased heart rate, shortness of breath, and feeling sick or dizzy.

In addition, the fear of having a panic attack in public, losing your sanity during a panic attack, and worrying that a panic attack is life-threatening can be symptoms of panic attacks, panic disorder, and agoraphobia.

Diagnosis

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people who experience agoraphobia have a "marked fear" about two or more of the following scenarios:

  • Public transportation
  • Open spaces
  • Enclosed spaces (such as stores)
  • Standing in line or being in a crowd
  • Being outside the home by themselves

The criteria established to diagnose agoraphobia include the person's fear being "out of proportion" to any danger that could occur. Sometimes, this is referred to as an irrational fear. In addition, for a diagnosis of agoraphobia, the symptoms must be persistent, lasting at least six months.

Avoidant behavior is another part of the diagnostic criteria for agoraphobia. A person with avoidant behavior steers clear of the object or situation they fear as well as anything they associate with their fear. Living with restrictions on what they do, where they go, and who they interact with are common for someone experiencing agoraphobia.

Though symptoms of agoraphobia and panic disorder can be similar, agoraphobia is its own diagnosis outside of panic disorder.

In other words, you don't have to be diagnosed with panic disorder to be diagnosed with agoraphobia. Though, even if you don't have panic disorder, you may still have panic attacks associated with agoraphobia.

Though there are many conditions that are commonly associated with agoraphobia, you don't have to be diagnosed with any of them, either, to be diagnosed with agoraphobia.

Causes

The exact cause of agoraphobia is unknown, but experts think it arises due to a variety of factors. One study found that agoraphobia was likely to occur alongside social anxiety disorder or panic disorder.

Another study found that people with panic disorder and agoraphobia were also frequently diagnosed with obsessive compulsive disorder (OCD).

With social anxiety disorder, a person becomes overwhelmed and their fear response is triggered by social interactions or being around people. Agoraphobia could arise from this fear, leaving those who are affected to avoid places with other people entirely.

For those with panic disorder, there are a number of reasons experts think a person might develop symptoms of agoraphobia, including a sensitive fight or flight response, a neurotransmitter imbalance (which could trigger panic), or weakened spatial awareness (causing someone to feel disoriented in a crowd).

There are other psychological risk factors as well. These include:

  • A traumatic experience such as a death or sexual assault
  • A stressful life event
  • Other mental health concerns (anxiety, depression, eating disorders)
  • Drug or alcohol abuse
  • Relationship issues or abuse

Experts also link agoraphobia to a number of other specific phobias. These include the fear of being the victim of a crime, the fear of contracting an illness, and the fear of social humiliation.

Not all phobias need treatment. But if a phobia affects your daily life, several kinds of therapies are available that can help you overcome your fears—often permanently.

Impact

Agoraphobia can be difficult to cope with for both the person experiencing it directly and their loved ones or caregivers. If you have agoraphobia, it's possible you experience low self-esteem.

It is common for those with agoraphobia to feel self-critical, or disappointed in themselves, especially if they want to participate in activities or go to places but are inhibited by their phobia.

In addition, if you or someone you know has agoraphobia, it's best to be on the lookout for signs of anxiety and depression. Coping with a phobia can be a challenge in everyday life and in the long term. It's important that mental health effects produced by agoraphobia are also addressed.

Treatment

Though treating a condition like agoraphobia might feel intimidating at first, know that you have plenty of options and it's all about finding what works best for you.

Treatments for agoraphobia are generally similar to the types of treatment you would receive with other anxiety disorders. Studies have found that the combination of both therapy and medication is most effective.

Psychotherapy

Psychotherapy has been found to be helpful in treating agoraphobia. Specifically, cognitive behavioral therapy (CBT) has proven very effective. Cognitive behavioral therapy involves addressing the fears, thinking patterns, and behaviors that contribute to the disruption of your daily life.

CBT offers individualized attention, focusing on you and what you need, which has also been found to be particularly helpful to those experiencing agoraphobia.

Your therapist would work with you to address the reasons why you're afraid, form a deeper understanding of your feelings, and reframe how you view your environment. For some, therapy might be the primary method of treatment. Studies show that CBT may be better tolerated than medication in some patients.

Exposure therapy is another method that has been studied for agoraphobia and other anxiety disorders. You might work with a therapist to gradually face your fears, learning coping mechanisms to handle the anxiety that arises along the way.

For instance, if you have a phobia of riding the bus, your therapist might suggest you first look at photos of a bus. Then, you could work your way up to walking to the bus stop and returning home. You might take a short bus ride, eventually riding for longer amounts of time until you are able to ride the bus without fear.

Medication

Doctors commonly prescribe antidepressants to treat agoraphobia, as well as to treat related conditions like panic disorder and generalized anxiety disorder.

Your doctor might prescribe you selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs), both of which are classes of drugs commonly used to treat depression.

Antidepressants may help address the physical symptoms of anxiety, such as muscle tension, and the cognitive symptoms, such as anxious thoughts. Since depression and anxiety sometimes co-exist, antidepressants may help with both.

Benzodiazepines (such as Xanax) are sometimes prescribed for a short-term period, usually to help you feel calm in a specific event. However, this class of drugs should be used with caution and under careful supervision as they have the potential to become addictive.

Coping

It can certainly be intimidating to address deep fears, anxieties, and our physical responses to these feelings, but there are many coping mechanisms you can try right away that may ease your discomfort.

For instance, many techniques related to mindfulness have been shown to improve the symptoms that are associated with agoraphobia. For instance, focusing on one thing, taking deep breaths, and visualizing a peaceful place are all positive methods that can promote relaxation.

In addition, lifestyle changes can work wonders for your anxiety levels. These include:

  • Exercise
  • Sufficient sleep
  • Avoiding drugs or alcohol
  • Limiting caffeine

If symptoms of agoraphobia are keeping you from your everyday activities—such as sleeping, eating, and working—try seeking the help of a mental health professional, or your primary care doctor who can get you started on ways to cope.

A Word From Verywell

Aside from the symptoms and manifestations of agoraphobia listed here, there are many ways you might find yourself feeling and reacting to stimuli around you. Remember that you deserve to feel comfortable performing your everyday activities without disruption. If you experience agoraphobia or any related symptoms, be sure to express your concerns to a health care professional. There are many paths to recovery and you will be able to find the one that works best for you.

Was this page helpful?
Article 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.
  1. National Health Service. Symptoms - Agoraphobia.

  2. Substance Abuse and Mental Health Services Administration. Table 3.10, Panic disorder and agoraphobia criteria changes from DSM-IV to DSM-5. In: Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016.

  3. Shin J, Park D-H, Ryu S-H, Ha JH, Kim SM, Jeon HJ. Clinical implications of agoraphobia in patients with panic disorder. Medicine. 2020;99(30):e21414. doi:10.1097/md.0000000000021414

  4. Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st centuryDialogues Clin Neurosci. 2015;17(3):327-335. doi: 10.31887/DCNS.2015.17.3/bbandelow

  5. Torres AR, Ferrão YA, Shavitt RG, et al. Panic disorder and agoraphobia in ocd patients: clinical profile and possible treatment implications. Comprehensive Psychiatry. 2014;55(3):588-597. doi:10.1016/j.comppsych.2013.11.017

  6. National Health Service. Causes - Agoraphobia.

  7. van Tuijl LA, Glashouwer KA, Bockting CLH, Tendeiro JN, Penninx BWJH, de Jong PJ. Implicit and explicit self-esteem in current, remitted, recovered, and comorbid depression and anxiety disorders: The NESDA study. Seedat S, ed. PLOS ONE. 2016;11(11). doi:10.1371/journal.pone.0166116

  8. Ströhle A, Gensichen J, Domschke K. The diagnosis and treatment of anxiety disorders. Deutsches Aerzteblatt Online. 2018;115:611-20. doi:10.3238/arztebl.2018.0611

  9. Aslam N. Management of panic anxiety with agoraphobia by using cognitive behavior therapy. Indian Journal of Psychological Medicine. 2012;34(1):79-81. doi:10.4103/0253-7176.96166

  10. Meuret AE, Wolitzky-Taylor KB, Twohig MP, Craske MG. Coping skills and exposure therapy in panic disorder and agoraphobia: Latest advances and future directions. Behavior Therapy. 2012;43(2):271-284. doi:10.1016/j.beth.2011.08.002

  11. National Health Service. Treatment - Agoraphobia.

Additional Reading