What Are the Signs, Symptoms, and Triggers of Agoraphobia?

Agoraphobia may prevent you from going to work, keeping in touch with your friends and family, or running errands.

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

When people with agoraphobia are in public, they may feel anxiety and panic. They may avoid certain places or have a hard time leaving the house at all.

People with agoraphobia may experience physical, behavioral, and cognitive symptoms.

Physical symptoms

Physical symptoms include:

• Chest pain
• Fast heartbeat
• Trembling
• Feeling hot and sweaty
• Dizziness
• Diarrhea
• Feeling sick
• Tinnitus (ringing in the ears)
• Hyperventilating (rapid breathing)
• Feeling faint
• Dysphagia (difficulty swallowing)

Behavioral symptoms

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

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

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 inherit genes that make them more likely to experience agoraphobia. In some cases, a stressful or traumatic event can bring on agoraphobia, such as

• Abuse
• Being attacked
• Death of a parent, close friend, or sibling

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.

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.

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.

Medication

Doctors may prescribe anti-anxiety medication to help people with agoraphobia.

Counseling/therapy

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.

Cognitive behavioral therapy (CBT) is also a treatment for agoraphobia. In this type of treatment, a therapist teaches you how to avoid negative thoughts that may lead to agoraphobia.

Lifestyle changes

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

Alternative treatments

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.