Agoraphobia: The Fear of Open Places or Crowds

Agoraphobia The Fear of Open Places or Crowds

Agoraphobia is described as the fear of open places or crowds.

Agoraphobia is best explained as an anxiety disorder that makes people deliberately avoid situations and places that might make them have a feeling of:

  • Being trapped
  • Helplessness
  • Embarrassed
  • Panic
  • Scare

People who have agoraphobia often report suffering symptoms of a panic attack, such as nausea or a rapid heartbeat, when they find themselves in a complicated or stressful situation.

It is also possible that they experience these symptoms even before they find themselves in the dreaded condition.

In some cases, the fear can become so severe that people deliberately begin to skip daily activities, such as going grocery shopping, or going to the bank, and spend entire days, weeks, and even months stay inside their homes.

The National Institute of Mental Health (NIMH) has estimated that 0.8 percent of American adults have agoraphobia. An estimated 40 percent of all reported cases of this phobia is considered severe.

In the case of the condition being more severe, agoraphobia can be very uncomfortable and disabling for the sufferer. People living with agoraphobia often come to a realization that their fear is irrational, but they are helpless or have no control over it.

This feeling of helplessness can interfere with their personal relationships with family and friends and performance at school or work.

If you suspect you or a loved one has agoraphobia, it’s essential to seek treatment from a professional immediately. The available treatment options are not exactly created to be cures, but as a way to manage symptoms and improving the patient’s quality of life.

Depending on how severe the condition is, treatment may consist of medications, therapy, and lifestyle remedies.

What Are the Symptoms of Agoraphobia?

People who have agoraphobia are:

  • Scared of leaving their home for long periods
  • Scared of going out alone or being alone in the social situation
  • Scared of losing control or composure in a public place
  • Scared of being in places or situations where they would find it difficult to escape, such as in an elevator or a car.
  • Anxious or agitated
  • Detached or estranged from family and friends

Agoraphobia and panic attacks mostly work in tandem. Panic attacks are best described as a series of symptoms that sometimes manifest in people dealing with anxiety and other mental health disorders.

Panic attacks can also include a broad range of severe physical symptoms, like the following:

  • Choking
  • Sweating
  • Hot flashes
  • Chest pain
  • Diarrhea
  • Numbness
  • Tingling sensations
  • A racing heart
  • Shortness of breath
  • Dizziness
  • Trembling
  • Chills
  • Nausea

People who have agoraphobia may suffer panic attacks whenever they find themselves in an uncomfortable or stressful situation, which further promotes their phobia of being in situations they can’t control.

What Causes Agoraphobia?

Just like most other phobias, the specific cause of agoraphobia has not been identified. However, there are a wide range of factors that are known to increase a person’s risk of developing agoraphobia. These factors include the following:

  • Other phobias, such as claustrophobia and social phobia
  • Depression
  • Another type of anxiety disorder, such as OCD or generalized anxiety disorder
  • A history of physical or sexual abuse
  • A family history of agoraphobia
  • A substance abuse problem

Agoraphobia has been discovered to also be more common in women than in men. Unlike other phobias that begin in childhood, agoraphobia usually starts in young adulthood, with 20 years identified as the average age of onset.

But, symptoms of this phobia can emerge at any age.

How Is Agoraphobia Diagnosed?

Just like other phobias, there is no lab test to diagnose Agoraphobia. However, it is diagnosable based on the symptoms and signs of patient experiences.

Your doctor will inquire about the symptoms you experience, including when they began, and how often you deal with them.

They’ll also ask questions about your family and medical history. They may also need to perform blood tests to help dismiss the possibility of physical causes for your symptoms.

For a person to be diagnosed with agoraphobia, there are specific criteria that symptoms need to meet, according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).

The manual is often used by doctors and other healthcare providers to diagnose mental health conditions correctly.

To be diagnosed with agoraphobia, a person must feel intense anxiety or fear in two or more of the situations listed below:

  • Commuting with public transportation, such as a bus or train
  • Staying in open spaces, such as a parking lot or store
  • Being in enclosed spaces, such as a car or an elevator
  • Being in a crowd
  • Being away from home alone

There are a few additional criteria that must be met for a diagnosis of agoraphobia with panic disorder. You must have reported repeated panic attacks, and at least one of the episodes must have been followed by:

  • Fear of the consequences of panic attacks, like suffering a heart attack or losing control
  • A fear of having more panic attacks
  • A change in your behavior as a result of the panic attacks

You will not get an agoraphobia diagnosis if your symptoms are revealed to be caused by another illness. Your symptoms must also not be caused by any other phobia, mental illness, or substance abuse.

How Is Agoraphobia Treated?

While I’m there is no cure, there are different treatments currently available to help people manage agoraphobia. A patient may do well with a single treatment method or need a combination of treatment methods.


Psychotherapy is also called talk therapy and involves meeting with a mental health professional consistently.

This gives you the chance to express yourself and talk about your fears and any other challenges that may trigger or add to your worries. Psychotherapy is excellent on its own but often combined with medications to achieve optimum effectiveness.

It is a short-term treatment method that can be stopped immediately; you’re able to handle your anxiety and fears.

Cognitive Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is the most popular type of psychotherapy used for the treatment of many phobias, including agoraphobia.

CBT is helpful to patients when it comes to an understanding of the distorted views and feelings associated with having agoraphobia.

Patients can also learn how to work through challenging and stressful situations by replacing the scary thoughts with calm and healthy ones, allowing them to regain full control of their lives.

Exposure Therapy

Exposure therapy is another standard treatment method of phobias, as is effective at helping people overcome their fears. In this type of treatment, patients will gradually be exposed to things and situations or places that give them a scare.

The purpose is to become accustomed to such conditions and associate them with something that put your mind at ease, rather than fear or panic.


Certain medications can help patients heal fast from agoraphobia or panic attack symptoms. Some of them are:

  • Selective serotonin reuptake inhibitors, such as fluoxetine (Prozac) or paroxetine (Paxil)
  • Selective serotonin and norepinephrine reuptake inhibitors, such as duloxetine (Cymbalta) or venlafaxine (Effexor)
  • Tricyclic antidepressants, such as nortriptyline (Pamelor) or amitriptyline (Elavil)
  • Anti-anxiety medications, such as clonazepam (Klonopin) or alprazolam (Xanax)

Lifestyle Changes

Lifestyle changes do not necessarily treat any phobia, but they may help with reducing daily anxiety. You may want to consider any of the following:

  • Often exercising to increase the production of dopamine to make you feel more relaxed and happier.
  • Eating a healthy diet that consists of organic foods and less meat or carbs
  • Practicing daily deep breathing exercises to reduce anxiety or meditation and fight the start of panic attacks

When undergoing treatment, you must avoid taking any herbs or dietary supplements. These natural remedies do not have any scientific backing and are not proven to treat anxiety. They may also interfere with prescribed medications.

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