What is agoraphobia?
Agoraphobia is a type of anxiety disorder. People living with agoraphobia fear being in places that would be hard to escape from, such as public and crowded spaces. Examples of places that cause anxiety in people with this condition include:
- Public transportation
- Shopping malls
- Parking lots
- Movie theaters
Symptoms of agoraphobia
People with agoraphobia may experience physical, behavioral, and cognitive symptoms.
Physical symptoms include:
- Chest pain
- Fast heartbeat
- Feeling hot and sweaty
- Feeling sick
- Tinnitus (ringing in the ears)
- Hyperventilating (rapid breathing)
- Feeling faint
- Dysphagia (difficulty swallowing)
Behavioral symptoms include:
- Avoiding crowded places and other situations that could cause anxiety
- Staying home or close to home
- Only leaving home when you are with someone you trust
Cognitive symptoms are fears associated with the physical symptoms of agoraphobia. They include:
- Fear that you will experience a life-threatening panic attack
- Fear that you are losing your mind or sanity
- Fear that you may be unable to control yourself in public
- Fear that people will stare at you
- Fear that you will look stupid or be embarrassed in front of other people because of a panic attack
- Fear that you will experience physical symptoms, such as blushing or trembling
- Fear that you will be unable to escape if you have a panic attack
Causes of agoraphobia
Some people with agoraphobia experience panic attacks or anxiety before they develop agoraphobia. Then, they have a panic attack somewhere public and associate panic with that location.
Some people with agoraphobia develop it without experiencing trauma or having a panic disorder or a genetic history. People who abuse alcohol or drugs, are in an unhappy or controlling relationship, or who have a previous history of mental illness are also at risk for developing agoraphobia.
When to see the doctor for agoraphobia
Agoraphobia may prevent you from going to work, keeping in touch with your friends and family, or running errands. If you find it hard to do these things and experience some of the symptoms listed above, see your doctor.
Diagnosis and tests for agoraphobia
To diagnose agoraphobia, a doctor will start by asking you about your symptoms and your behaviors. They may also perform a physical exam and order lab tests to rule out other conditions, such as an overactive thyroid (hyperthyroidism), which can cause similar symptoms as a panic attack.
To make a diagnosis of agoraphobia, a medical professional may refer to the criteria posted in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This includes fearing at least two of the following five factors:
- Being on public transportation
- Being in open spaces
- Being in closed spaces
- Standing in line or in a crowd
- Leaving home by yourself
Additionally, to receive a diagnosis, you must experience these symptoms for six months or more, and they must cause distress and disrupt your normal functioning.
Treatments for agoraphobia
People living with agoraphobia may benefit from exposure therapy, a type of therapy in which you gradually face your fears until you no longer experience them.
Sometimes lifestyle changes can help reduce the symptoms of agoraphobia. These include:
- Exercising regularly
- Eating healthy, balanced meals
- Drinking less alcohol
- Avoiding drugs
- Avoiding caffeine
The herbal supplement kava (also called kava kava) is another possible treatment for agoraphobia, as it has been shown to reduce anxiety. However, this supplement can cause serious liver damage. Make sure to consult your doctor before using it.
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National Health Service: "Symptoms: Agoraphobia."
National Health Service: "Treatment: Agoraphobia."
Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration, 2016.