We all have certain fears in life or scenarios that we’d prefer to avoid. For example, activities we don’t enjoy or situations like walking home alone in the dark.
However, agoraphobia goes beyond every day fears and preferences. People with agoraphobia often experience intense fear around not being able to escape certain situations, which can even result in panic attacks. In some cases, agoraphobia can be severe enough to prevent people from leaving their home at all.
With that said, we’ll explore exactly what agoraphobia is, as well as possible causes, treatments, and ways to cope.
What is agoraphobia?
The NHS defines agoraphobia as a fear of being in situations that might be difficult to escape from or where help may not be available if things go wrong.
Agoraphobia is generally understood as a fear of open spaces, but the condition is actually much more complex. For example, someone with agoraphobia might also be afraid of travelling on public transport, visiting a shopping centre, or even leaving their home.
What are the symptoms of agoraphobia?
The severity of agoraphobia can vary significantly from person to person. For example, severe agoraphobia may prevent someone from leaving the house at all, while someone with mild agoraphobia may be able to travel short distances without too much trouble.
Symptoms of agoraphobia can generally be classified into three separate categories. We’ll cover these below.
Physical symptoms
The physical symptoms of agoraphobia typically occur when people find themselves in a situation or environment that causes anxiety.
If someone with agoraphobia finds themselves in a stressful situation, they may experience symptoms similar to those of a panic attack. This can include…
- Rapid breathing (hyperventilating)
- Rapid heartbeat
- Chest pain
- Nausea
- Dizziness or feeling faint
- Feeling hot and sweaty
- Diarrhoea
However, physical symptoms can also be rare in many people with agoraphobia. This is often because they’ll do what they can to avoid situations that cause anxiety in the first place.
Cognitive symptoms
While some people with agoraphobia have certain fears and worries that cause physical symptoms, this isn’t always the case. Some people may experience mostly cognitive symptoms, while others may experience both.
Some cognitive symptoms of agoraphobia include fear that…
- You’ll look stupid or feel embarrassed experiencing panic in front of other people
- A panic attack might be life threatening. For example, you might fear that you’ll be unable to breathe or that your heart will stop beating
- You’d be unable to escape from a situation if you were to have a panic attack
- You’re losing your sanity
- People may stare at you
- You could lose control in public
Psychological symptoms unrelated to panic attacks, such as feeling you’d be unable to survive without the help of others, fearing being alone in your home, and experiencing general anxiety or dread, are also common.
Behavioural symptoms
People with agoraphobia may carry out avoidance behaviours in an effort to avoid situations that cause anxiety.
This can include…
- Only leaving the house with another person
- Avoiding situations that could cause panic attacks, such as public transport, crowded places, or queues
- Ordering groceries online instead of going to the supermarket
- Avoiding being far from home
- Not leaving your house for long periods of time
What can cause agoraphobia and are there any risk factors?
Agoraphobia typically starts in late teenage or early adult years – with 20 being the average age of development. However, symptoms of agoraphobia can appear at any age.
The exact cause of agoraphobia isn’t currently known, but there are a number of factors and conditions thought to increase a person’s risk of developing it.
This includes…
- Depression
- Other phobias, such as social phobia and nosophobia.
- Other types of anxiety disorders, such as obsessive compulsive disorder (OCD) or social phobia
- Family history of agoraphobia
- Struggling with substance abuse
- A history of physical or sexual abuse
Research also shows that agoraphobia is more common in women than men.
How is agoraphobia diagnosed?
If you suspect you’re struggling with agoraphobia, it’s important to speak to your GP. If your symptoms prevent you from visiting your GP in person, it should be possible to arrange a consultation over the phone.
During your appointment, your GP will ask you to describe your symptoms – including how often they occur, and what tends to trigger them.
Your GP may also ask you questions like whether you find leaving the house stressful and whether you have any avoidance strategies to cope with your symptoms, such as relying on other people to go to the supermarket for you.
Coming to terms with your symptoms and talking about your personal life with your GP can feel difficult, but it’s important to be as honest and open as you can. In order to make the correct diagnosis and prescribe the most appropriate treatment, your GP needs to know as much as possible about your symptoms.
In some cases, your GP may also carry out a physical examination, such as a blood test, to rule out any underlying physical conditions. For example, an overactive thyroid gland (hyperthyroidism) can cause similar symptoms to a panic attack.
If your GP has any doubt about your diagnosis, they may refer you to a psychiatrist for a more detailed assessment.
You can read more about how agoraphobia is diagnosed on the NHS website.
Lifestyle changes and self-help techniques that can help with agoraphobia
Agoraphobia can have a significant impact on someone’s quality of life. Self-help techniques are often the first treatment advice for agoraphobia. So, if you’re struggling, it’s important to consider what might help you to cope better.
One of the most useful steps to take is to learn more about agoraphobia – particularly its link with panic disorder and panic attacks.
Many people find that having a better understanding of their condition helps make them better able to manage their symptoms when they find themselves in uncomfortable situations or environments.
For example, during a panic attack, it can be helpful to…
- Stay where you are and resist the urge to flee to a place of safety.
- Practise slow and deep breathing to help calm any feelings of panic and anxiety.
- Focus on something visible and non-threatening – for example, an item in the supermarket.
- Challenge your fear and remind yourself that you’re safe and your feelings of panic will pass.
- Think of a place or situation that brings you peace and makes you feel at ease and do you best to focus your attention on it.
For further advice, you might like to have a read of these 5 tips for coping with panic attacks from Priory Group.
Some people also find that they’re able to significantly improve their symptoms through simple lifestyle changes.
We’ll cover some of these below.
1. Stay active
Exercise is a great stress-reliever and known mood-booster. And research has found that fitness levels can play a role in a person’s experience of agoraphobia and panic attacks.
If you’d like to get more active, head over to the fitness and exercise section of our website for inspiration.
Alternatively, if the thought of exercising – particularly outside – causes you anxiety, you might like to have a read of these tips on exercising with agoraphobia from Discussing Psychology.
2. Eating a healthy, antioxidant-rich diet
Eating a healthy, balanced diet is not only important for our health, but it can also help us to feel our best selves too.
When it comes to reducing the feelings of anxiety that often come along with agoraphobia, eating a diet rich in antioxidant-rich, mood-boosting foods has been found to be particularly beneficial.
For example, various studies have linked high intake of antioxidant-rich nutrients like zinc, magnesium, omega-3 fatty acids with reduced anxiety.
According to experts, one of the best dietary models to follow is the Mediterranean diet.
3. Avoid or limit your consumption of caffeine
Caffeine has been labelled as one of the most common dietary triggers for people with anxiety disorders.
Some studies have even been found that caffeine may potentially trigger panic attacks.
Other substances, including alcohol and high concentrations of sugar, have also been found to have a negative impact on mood and anxiety levels.
4. Practise relaxation techniques to help manage stress
Stress can be a major cause of anxiety and has been shown to contribute and worsen – and sometimes trigger – many physical and mental health conditions.
Mindfulness, yoga, Pilates, massage, and breathing exercises are all examples of simple relaxation techniques that may help to manage stress levels. For more ideas, have a read of our article; 9 simple stress relieving activities.
5. Consider joining a support group
Some people with agoraphobia find it useful to join a support group, because it allows them to connect with others who are struggling.
While it’s helpful to speak to close friends and family members about how you’re feeling, connecting with people who can directly relate to your situation can offer a unique form of support.
If this is something you’d like to consider, you can search for a support group near you on the Hub of Hope website.
I’m still struggling – can agoraphobia be treated professionally?
If agoraphobia is impacting your life and you’re struggling to create any lasting changes on your own, there are a number of treatment options you can consider.
That being said, it’s important to note that even with professional help, it’s still recommended that you continue making lifestyle changes too.
The most common form of treatment for agoraphobia are talking therapies, for example, cognitive behavioural therapy (CBT). CBT is based on the idea that unhelpful and unrealistic thoughts lead to negative behaviour. For agoraphobia treatment, it’s often combined with exposure therapy. Your therapist will work with you to find ways of challenging negative thoughts and setting goals to overcome your fears.
For more information on how CBT works, you might like to have a read of our article; An introduction to cognitive behavioural therapy (CBT).
You can either ask your GP to refer you to a talking therapy service. Or, if you prefer, you can refer yourself directly to NHS talking therapies without seeing your GP.
Medication may also be recommended for agoraphobia if self-help techniques aren’t effective. Or, if agoraphobia is severe, medication may also be prescribed in combination with other types of treatment like CBT.
You can read more about how agoraphobia is treated on the NHS website.
Final thoughts...
Agoraphobia can have a significant impact on quality of life and feel overwhelming and draining to cope with.
However, if you’re struggling, it’s important to remember that you’re not alone and that with the right approach and treatment, it’s possible to manage symptoms and have a fulfilling life. Whether that means making lifestyle changes or seeking professional support, just remember to always be kind to yourself and take it one day at a time.
For further reading and mental health support, head over to the healthy mind section of our website. Here you’ll find information on topics like how to improve confidence and self-esteem to powerful ways to conquer self-limiting beliefs.