The Symptoms of Agoraphobia

Defining and Understanding the Symptoms of Agoraphobia

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What are the signs and symptoms of agoraphobia? Agoraphobia is often misunderstood as being primarily a problem in which people are afraid to leave their house. Let's take a look at exactly what agoraphobia is, and using this more accurate definition, the specific behaviors that suggest a person may have agoraphobia.

Agoraphobia is a Phobia

It may sound redundant to state that agoraphobia is a phobia, yet understanding agoraphobia as a specific type of phobia, makes it much easier to understand the symptoms.

Agoraphobia is often misunderstood to be simply a fear of leaving home, however, this is not quite accurate. Agoraphobia is a phobia of being in a situation where escape would be difficult or impossible, or help would be unavailable if a panic attack should occur.

What is a Phobia?

A phobia is an overwhelming and unreasonable fear of an object or situation that poses little real danger but provokes anxiety and avoidance. Unlike the brief anxiety most people feel when they give a speech or take a test, a phobia is long-lasting, causes intense physical and psychological reactions, and can affect your ability to function normally at work or in social settings.

Not all phobias need treatment. But if a phobia affects your daily life, several therapies are available that can help you overcome your fears—often permanently.

Phobias are divided into three main categories:

  • Specific phobias. A specific phobia involves an irrational, persistent fear of a specific object or situation that's out of proportion to the actual risk. This includes a fear of situations (such as airplanes or enclosed spaces); nature (such as thunderstorms or heights); animals or insects (such as dogs or spiders); blood, injection or injury (such as knives or medical procedures); or other phobias (such as loud noises or clowns). There are many other types of specific phobias. It's not unusual to experience phobias about more than one object or situation.
  • Social phobia. More than just shyness, social phobia involves a combination of excessive self-consciousness and a fear of public scrutiny or humiliation in common social situations. In social situations, the person fears being rejected or negatively evaluated or fears offending others.
  • Fear of open spaces (agoraphobia). Agoraphobia is a fear of an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line or being in a crowd, or being outside the home alone. The anxiety is caused by fearing no easy means of escape or help if intense anxiety develops. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to fear another attack and avoid the place where it occurred. For some people, agoraphobia may be so severe that they're unable to leave home.

    Agoraphobia is Essentially a Fear of Panic Attacks

    Agoraphobia is often a progressive phobia, and may eventually lead to a fear of leaving the house. However, it is the panic attack, rather than the act of being in public, that is the cause of the fear.

    Specific Signs and Symptoms of Agoraphobia

    Signs and symptoms of agoraphobia may include:

    • Panicked feelings: Agoraphobia can become a self-replicating cycle. The sufferer is anxious about having a panic attack which can, in turn, lead to a panic attack. With time, the specific situations which could lead to a panic generalize, leading to a further sense of anxiety, and on and on.
    • Avoidant behavior:  Limiting life activities in an effort to avoid situations where help for a panic attack may not be available are referred to as avoidant behaviors. What initially may be a fear of a panic attack in one specific situation can slowly generalize, sequentially isolating a person.
    • Clustering: A pattern of avoided situations is generally present. Common clusters include public transportation; shopping; driving; and leaving home. While early on in the condition, symptoms may cluster around only one of these common "open spaces fears," with time, anxiety in others often develops as well. For example, at first a person may only feel a fear associated with pubic transportation. The limitations posed by this fear can then limit a persons ability to go shopping, get to work, and more. In time, this can lead to a fear of leaving home completely.

      Physical signs and symptoms occur when a person is challenged with being in an enclosed space, a place with no easy means of escape, leaving home alone, or using public transportation and include:

      • Excess sweating
      • Difficulty breathing
      • A rapid heart rate
      • Shaking or being tremulous
      • Numbness or tingling of your hands and feet
      • Indigestion
      • A feeling of loss of control

      Development of Agoraphobia

      Agoraphobia often develops out of an untreated panic disorder, and it's estimated that between a third and half of people with panic disorder go on to develop agoraphobia.

      However, agoraphobia sometimes develops with no prior history of panic disorder.

      In this case, the fear of being stuck in a particular situation does not result in a full-blown panic attack. Instead, symptoms may be more physical in nature, such as headaches or diarrhea.

      A mental health professional can determine whether your symptoms are those of agoraphobia or another disorder.

      Treatment Options for Agoraphobia

      Professional help is almost always recommended to control the symptoms of agoraphobia. Psychotherapy, specifically therapies such as systemic desensitization can be very effective in reducing symptoms. There are also things people can do themselves to help manage the symptoms of their agoraphobia, from using relaxation techniques, to finding social support.

      Bottom Line on the Symptoms of Agoraphobia

      It can be easier to understand the symptoms of agoraphobia if you recognize that the primary fear is of having a panic attack, rather than a specific situation. Hence, anything which could precipitate a panic attack, such as finding yourself in a place in which escape could be difficult, could lead to symptoms.

      This fear of having a panic attack then limits a person by making it difficult to go to work, go to the store, travel, or even leave the home.

      Without treatment, agoraphobia can lead to a tremendous sense of isolation and loneliness, but effective treatments are available.

      Sources:

      American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th Ed.). Washington, DC. 2013. Print.

      Imai, H., Tajika, A., Chen, P., Pompoli, A., and T. Furukawa. Psychological Therapies Versus Pharmacological Interventions for Panic Disorder With or Without Agoraphobia in Adults. Cochrane Database of Systematic Reviews. 2016. 10:CD011170.

      Inoue, K., Kaiya, H., Hara, N., and Y. Okazaki. A Discussion of Various Aspects of Panic Disorder Depending on Presence or Absence of Agoraphobia. Comprehensive Psychiatry. 2016. 69:132-5.

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