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Agoraphobia is a fear of being in situations where escape might be difficult or that help wouldn't be available if things go wrong.
Many people assume agoraphobia is simply a fear of open spaces, but it's actually a more complex condition. Someone with agoraphobia may be scared of:
If someone with agoraphobia finds themselves in a stressful situation, they'll usually experience the symptoms of a panic attack, such as:
They'll avoid situations that cause anxiety and may only leave the house with a friend or partner. They'll order groceries online rather than going to the supermarket. This change in behaviour is known as avoidance.
Read more about the symptoms of agoraphobia.
Agoraphobia usually develops as a complication of panic disorder, an anxiety disorder involving panic attacks and moments of intense fear. It can arise by associating panic attacks with the places or situations where they occurred and then avoiding them.
A minority of people with agoraphobia have no history of panic attacks. In these cases, their fear may be related to issues like a fear of crime, terrorism, illness, or being in an accident.
Traumatic events, such as bereavement, may contribute towards agoraphobia, as well as certain genes inherited from your parents.
Read more about the possible causes of agoraphobia.
Speak to your GP if you think you may be affected by agoraphobia. It should be possible to arrange a telephone consultation if you don't feel ready to visit your GP in person.
Your GP will ask you to describe your symptoms, how often they occur, and in what situations. It's very important you tell them how you've been feeling and how your symptoms are affecting you.
Your GP may ask you the following questions:
It can sometimes be difficult to talk about your feelings, emotions, and personal life, but try not to feel anxious or embarrassed. Your GP needs to know as much as possible about your symptoms to make the correct diagnosis and recommend the most appropriate treatment.
Read more about diagnosing agoraphobia.
With psychological treatment (talking therapies), most people with agoraphobia will make significant improvements, particularly if the three steps described below are followed.
A stepwise approach is usually recommended for treating agoraphobia and any underlying panic disorder:
Self-help techniques that can help during a panic attack include staying where you are, focusing on something that's non-threatening and visible, and slow, deep breathing.
If your agoraphobia fails to respond to these treatment methods, your GP may suggest trying a guided self-help programme. This involves working through self-help manuals that cover the types of issues you might be facing, along with practical advice about how to deal with them.
Medication may be recommended if self-help techniques and lifestyle changes aren't effective in controlling your symptoms. You'll usually be prescribed a course of selective serotonin reuptake inhibitors (SSRIs), which are also used to treat anxiety and depression.
In severe cases of agoraphobia, medication can be used in combination with other types of treatment, such as CBT and relaxation therapy.
Read more about treating agoraphobia.
Around a third of people with agoraphobia eventually achieve a complete cure and remain free from symptoms.
Around half experience an improvement in symptoms, but they may have periods when their symptoms become more troublesome – for example, if they feel stressed.
Despite treatment, about one in five people with agoraphobia continue to experience troublesome symptoms.