Definition

Agoraphobia is fear of being in places where help might not be available, typically fear of crowds, bridges, or of being outside alone.

Causes, incidence, and risk factors

Agoraphobia is a disorder that most often accompanies other anxiety disorders, such as panic disorder or specific phobias.

If it occurs with panic disorder, the onset is usually during a person's 20s, and women are affected more often than men. People with this disorder may become house bound for years, which is likely to hurt social and interpersonal relationships.

Symptoms

• Fear of being alone
• Fear of losing control in a public place
• Fear of being in places where escape might be difficult
• Becoming house bound for prolonged periods
• Feelings of detachment or estrangement from others
• Feelings of helplessness
• Dependence upon others
• Feeling that the body is unreal
• Feeling that the environment is unreal
• Anxiety or panic attack (acute severe anxiety)
• Unusual temper or agitation with trembling or twitching

Additional symptoms that may occur:

• Lightheadedness, near Fainting
• Dizziness
• Excessive sweating
• Skin flushing
• Breathing difficulty
• Chest pain
• Heartbeat sensations
• Nausea and vomiting
• Numbness and tingling
• Abdominal distress that occurs when upset
• Confused or disordered thoughts
  • Intense fear of going crazy
  • Intense fear of dying

Signs and tests

The individual may have a history of phobias, or the health care provider may hear a description of agoraphobic behavior from family, friends, or the affected person.

The individual may be sweating, have a rapid pulse (heart rate), or have high blood pressure.

Treatment

The goal of treatment is to help the phobic person function effectively. The success of treatment usually depends upon the severity of the phobia.

Systematic desensitization is a technique used to treat phobias. The person is asked to relax, then imagine the things that cause the anxiety, working from the least fearful to the most fearful. Graded real-life exposure has also been used with success to help people overcome their fears.

Antianxiety and antidepressive medications are often used to help relieve the symptoms associated with phobias.

Expectations (prognosis)

Phobias tend to be chronic but respond well to treatment.

Complications

Some phobias may have consequences that affect job performance or social functioning.

Calling your health care provider

Call for an appointment with your health care provider if symptoms suggestive of agoraphobia develop.

Prevention

As with other panic disorders, prevention may not be possible. Early intervention may reduce the severity of the condition.

Reviewed: 01/2006