Agoraphobia

Medically Reviewed by Shruthi N, MD on August 26, 2024
Written by Mary Jo DiLonardo, Keri Wiginton
14 min read

Agoraphobia is an anxiety disorder. It triggers intense fear of being in situations outside your home where you might not be able to leave easily or get help, particularly if you have a panic attack. 

Agoraphobia symptoms range from uncomfortable to disabling – you might be able to go to a handful of familiar places or not be able to leave your home. 

How common is agoraphobia?

Up to 2% of the population might get agoraphobia each year. But some researchers think the condition is underdiagnosed and undertreated in many people, so rates might be higher than that. 

You’re more likely to get diagnosed with agoraphobia if you’re a woman or assigned female at birth, compared to men or people assigned male at birth. 

Agoraphobia vs. social anxiety

Agoraphobia can trigger intense terror in social situations. But if you have social anxiety, you’re more likely to get nervous and worry about social embarrassment or judgment, rather than fearing for your safety. 

Situations that are more likely to trigger social anxiety include: 

  • Speaking in front of a crowd
  • Going to a party where you don’t know anyone
  • Eating somewhere out in the open, like a restaurant
  • Talking to cashiers when you buy things

Social anxiety disorder is more commonly diagnosed than agoraphobia, affecting about 13% of the population. Both conditions can cause you to have panic-like symptoms, such as a fast heart rate, shortness of breath, and sweating.

Doctors aren't sure what causes agoraphobia. But you’re more likely to get it if a sibling or other family member has it. This suggests your genes might play a role. 

Your odds of agoraphobia are also higher if you have a panic disorder or history of panic attacks. These are episodes of intense mental and physical anxiety. They may come on suddenly and last only a few minutes. When you have one, you feel really scared or like you might die, even though you’re usually not in any major danger.

If you have a lot of panic attacks, you may start to avoid the places you think will trigger one. You may develop agoraphobia as a result of this so-called anticipatory anxiety.

Other things that raise your chances of agoraphobia include having:

  • Another anxiety or panic disorder, especially one that’s untreated
  • Other phobias, also called excessive fear reactions
  • Depression, eating disorders, or other mental health conditions
  • A relationship with someone who controls or abuses you

A history of stressful life events, especially if you’re abused as a child or have a parent die when you’re young, are also risk factors for agoraphobia. Other traumatic experiences that raise your chances of getting serious anxiety include grief, losing your job, and getting a divorce.

If you have agoraphobia, you get intense anxiety in certain situations. This affects everyone differently. Here are some common signs and symptoms of agoraphobia to watch for.

You might feel unsafe or panic when you are in:

  • Public transportation (buses, trains, ships, or planes)
  • Big, open spaces (parking lots, bridges, shopping centers)
  • Closed-in spaces (small shops or stores, movie theaters, elevators)
  • Crowds or standing in line 
  • A car traveling
  • Any place outside your home, especially when you’re alone

While not everyone with agoraphobia has panic attacks, physical symptoms of the strong anxiety caused by agoraphobia can include:

Agoraphobia symptoms can also make you feel like: 

  • You might not survive a panic attack.
  • You’re having a heart attack.
  • You’re choking. 
  • You’re not in control. 
  • You’ll do something embarrassing in front of others or that they’ll stare at you.

You also might have a general feeling of dread or not be able to go anywhere unless you’re with someone you trust.

Agoraphobia symptoms in kids

Agoraphobia symptoms in children look similar to those in adults and may show up in the same or different situations. 

If your child has agoraphobia, they may feel helpless, trapped, or have a panic attack when: 

  • They’re standing in line or sitting in a long row of other kids. 
  • They do something they feel is embarrassing, like fall or throw up.
  • They’re in the center of a row in a movie theater.
  • They’re separated from a parent or caregiver.
  • They have to go over bridges or get in an elevator.
  • They have to be in an open space, like a playground or field.
  • They have to go to enclosed spaces like shopping malls. 

Agoraphobia is diagnosed more often in older children, especially adolescents with a history of panic attacks. But tell your doctor if you think your child has it. To find the right treatment, they’ll want to rule out other phobias and mental health conditions, including depression, general anxiety, and social anxiety. 

Agoraphobia isn’t common and causes symptoms similar to those of other health conditions. As a result, your doctor may not diagnose you with it right away. 

To rule out other medical conditions, your doctor may:

  • Give you a physical exam and ask about all your symptoms
  • Take some blood to check for other health problems that cause anxiety
  • Run tests to check the health of your heart
  • Check your lungs or airways for breathing problems
  • Ask for your full physical and mental health history

There isn’t a single agoraphobia test. If your regular doctor can’t find a physical cause for your symptoms, they may ask how your anxieties affect your daily life. 

Be prepared to answer questions such as: 

  • Are you afraid to leave your house because of overwhelming anxiety?
  • Do you avoid certain places or situations out of fear?
  • How do you feel when you end up somewhere that scares you? 
  • Does your anxiety interfere with your ability to work, travel, or have relationships?

Your doctor may refer you to a psychologist or psychiatrist. These are specialists trained to diagnose and treat mental health conditions. They’re usually more familiar with agoraphobia and other anxiety disorders, compared to regular doctors. 

You have to meet certain standards (or criteria) to get a diagnosis of agoraphobia. You’ll need to feel extreme fear or panic in two or more of the following situations:

  • When you leave your home by yourself
  • When you use public transportation
  • When you’re in an open space, like a parking lot or market
  • When you stand in line or are in a crowd
  • When you’re in a closed-in space, like a store or movie theater

If you do get scared, your thoughts need to include fear that you won’t be able to get out of the situation easily or that no one will help you if you panic. In other words, agoraphobia makes you feel trapped and alone.

You’ll also need to have all of the following for agoraphobia: 

  • You get scared every time or almost every time you’re in certain situations.
  • You actively avoid people or places that trigger your anxiety and/or:
  • If you can’t avoid the situation, you have to have someone with you. 
  • Your fear is too big for the actual threat of what you’re afraid of. 
  • You feel like you need to avoid places that really upset you or; 
  • Your need to avoid places or situations makes it hard to work or socialize. 
  • If you have a medical condition, your concerns about your health problems are overblown (or at least your doctor thinks they are).

According to the American Psychiatric Association, your doctor might have you rate your anxiety in certain situations. These questions are usually based on how you feel in crowds, public places, or while using public transportation like buses or planes. 

Here’s an example: 

During the past 7 days, I have (never, occasionally, half the time, most of the time, or all of the time): 

  • Suddenly felt terror or fear of a crowd or public space
  • Felt anxious, worried, or nervous about going into certain situations 
  • Thought I might have a panic attack
  • Felt my heart beat very fast, started sweating, or had trouble breathing
  • Stayed close to exits if I did leave my home
  • Had to use drugs, alcohol, or another substance to manage panic-like symptoms

If you’re diagnosed with agoraphobia, your doctor might want you to keep track of your symptoms over time. This can help gauge how serious your condition is and if you get better once you start treatment. 

Sometimes, anxiety or panic disorders get better on their own, but you should talk to your doctor about your symptoms. Treatment typically includes talk therapy, medication, or both. 

Agoraphobia therapies. The most effective treatment for agoraphobia is cognitive behavioral therapy (CBT) with exposure therapy. CBT is a short-term treatment (12-20 weeks) that helps you change the thoughts and behaviors that add to your anxiety. You may also learn relaxation and breathing exercises. 

During cognitive behavioral therapy, your therapist will teach you: 

  • What things trigger your anxiety or panic attacks
  • What a panic disorder is
  • How you can manage physical and emotional symptoms of anxiety 
  • How to challenge your thoughts that something bad will always happen 

When you’re able to handle exposure therapy, your doctor will help you start to slowly and safely do some of the things that make you anxious.

Tell your doctor if your symptoms are so serious that you can’t leave your house. Many therapists offer virtual visits by computer or phone.

Treatment inside a hospital may also be an option. You might be able to go during the day and return home at night. Sometimes, you can stay in the hospital the whole time you get agoraphobia treatment. 

Agoraphobia medicine. There are many drugs that your doctor might suggest for agoraphobia, but the most common are antidepressants. 

The most effective medications used to treat agoraphobia include selective serotonin reuptake inhibitors (SSRIs) such as:

You’ll take these drugs every day. While they start to work in your body right away, you may not notice their full effects for several weeks. You might need to try more than one dose or type of antidepressant before you find one that eases your symptoms.

Other medications sometimes used to treat agoraphobia include: 

  • Serotonin norepinephrine reuptake inhibitors (SNRIs) 
  • Tricyclic antidepressants
  • Antipsychotics
  • Mood stabilizers

Your doctor may also give you short-term anti-anxiety medications. These are drugs you take only when you get anxious (acute anxiety) or when you’re in a situation known to trigger panic.

Anti-anxiety medications used to treat agoraphobia or other panic disorders include: 

Beta-blockers. These drugs block the stress hormone adrenaline. They can help control physical symptoms of anxiety such as a fast heart rate, sweating, or shaking.

Benzodiazepines. Drugs such as alprazolam and clonazepam work well to calm acute anxiety or panic, but they’re habit-forming. Your body may come to depend on them. You shouldn’t take them often or if you have a history of alcohol or substance use.

Other sedatives. Antihistamines such as hydroxyzine are sometimes used to treat anxiety disorders. There’s not much evidence on how well they work for agoraphobia, but antihistamines are considered a safer alternative to benzodiazepines because they’re less addictive..

Other therapies. Your doctor might suggest you try applied relaxation. This is a technique where you learn how to notice physical tension in your body and how to relax your muscles linked to anxiety. 

Some of the goals of applied relaxation include to: 

  • Stop physical anxiety from worsening mental anxiety
  • Teach you how to relax within 20-30 seconds
  • Break the anxiety cycles that cause you to panic

As with cognitive behavioral therapy, you may see the best results from applied relaxation if you work with a therapist regularly for a few months. But even a few sessions can be helpful. 

Other therapies or techniques used to ease stress and anxiety include:

  • Deep breathing exercises 
  • Meditation 
  • Yoga
  • Massage
  • Positive visualization 

Talk to your doctor before you try vitamins or supplements or other complementary therapies to ease anxiety. They’ll let you know what alternative therapies for agoraphobia are science-based and safe. 

Lifestyle changes. You may have less anxiety if you:

  • Exercise regularly
  • Eat nutritious foods (fruits, vegetables)
  • Limit or avoid ultra-processed foods (sweets, packaged snacks, sugary drinks)
  • Limit or avoid caffeine and alcohol

Agoraphobia treatment in children

The goal of agoraphobia treatment in kids is the same as with adults: to teach your child how to relax and that they don’t need to avoid everything that triggers their anxiety. The main way to do that is with behavioral therapy, particularly CBT and exposure therapy. 

During CBT and exposure therapy, your child’s therapist may: 

  • Explain how doing scary things can actually lessen their anxiety
  • Ask your child to make a list of places or situations that make them feel uneasy
  • Slowly expose your child to fearful situations
  • Teach your child how to calm themselves if they get anxiety or have a panic attack

Outside of therapy, the doctor might have you expose your child to their fears little by little. For example, going on bus trips might help your child feel safer on public transportation. But you might need to break down the experience into smaller steps before you go for a long ride. 

There are ways to manage your anxiety or panic no matter how serious your symptoms are. 

Here are some tips to live well with agoraphobia: 

  • Work with your doctor and stick with the treatment they suggest.
  • Learn calming strategies and use them even when you’re not anxious.
  • Practice going to places that cause anxiety. Ask friends and family to help. 
  • Care for your mental health by avoiding alcohol and other drugs. 
  • Join a support group for people with panic disorders or agoraphobia,

If you’re working with a therapist, tell them exactly what agoraphobia keeps you from doing. They can help you come up with ways to manage your fears so that you can enjoy life.

Agoraphobia disability

Psychiatric disabilities include panic disorders or other mental health conditions that limit one or more parts of your life. This may include your ability to learn or go to work. 

Under the Americans with Disabilities Act (ADA), employers have to make “reasonable accommodations” for people with psychiatric disabilities to help you do your best at work. You might need your doctor to provide medical documents to support your agoraphobia diagnosis.

Find more disability resources through: 

  • Job Accommodation Network
  • Center for Psychiatric Rehabilitation’s Reasonable Accommodations page
  • U.S. Department of Labor Office of Disability Employment Policy
  • ADA National Network

Accept that your loved one doesn’t have control over their fears. Be sensitive to how serious and life-limiting their symptoms are, even if you think they’re overreacting. 

Other tips for friends and family include: 

Learn all you can. Research the physical and emotional symptoms and behaviors linked to agoraphobia. This can help you recognize and understand when your loved one is in a situation that causes panic or anxiety. 

Validate their feelings. Even if you think your loved one is scared over something silly, it’s important that you recognize that their anxiety is real and help them feel safe. .

Show concern. Be kind but honest with your loved one if their behavior worries you. Ask what you can do to help them feel less afraid.

Offer to help with treatment. If they’re open to it, ask your loved one if you can call their doctor or therapist to set up an appointment. Offer to go with them to their visit if they’re afraid or unable to leave their home alone. 

Here are two big things NOT to do if your loved one has agoraphobia:

Don’t push them too hard. Your loved one may be avoiding situations that aren’t dangerous. But you shouldn’t force them to face their fears before they’ve learned how to manage their anxiety. This could backfire and make their panic worse. 

Don’t reinforce their anxiety. While you shouldn’t make your loved one to do something they’re not ready for, you also shouldn’t go out of your way to help them avoid the safe situations that make them anxious.

If left untreated, agoraphobia can impact your life in big and little ways. 

Complications of agoraphobia include: 

  • You can’t go to work, school, or run errands on your own.
  • You give up on hobbies or group activities like sports.
  • You depend on other people for money or to meet basic needs. 
  • You lose close relationships. 
  • You have to avoid any situation that might trigger a panic attack. 
  • You become isolated because you can’t leave your home.

Untreated agoraphobia or other panic disorders may also lead to: 

  • Depression or other emotional problems
  • Poor physical health
  • Frequent trips to the emergency room
  • Misuse of alcohol or other drugs
  • Suicidal thoughts or attempts

Call 911 or get medical help right away if you think you might hurt yourself. You can also talk to someone night or day by calling the 988 Suicide & Crisis Lifeline. 

Agoraphobia is a serious type of anxiety. If you have it, you get disabling fear when you’re in places or situations where you feel trapped or helpless. You may get so upset that you have a panic attack. 

Your doctor can help you gain control over your anxiety symptoms. Treatment for agoraphobia mainly includes cognitive behavioral therapy and exposure therapy. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) may also help.

What is having agoraphobia like?

Agoraphobia is different for everyone. Your anxiety can be mild or so intense that you can’t leave your home. Mentally, you may worry about your safety or feel trapped when you’re out in public. Physically, this kind of panic can give you a racing heart, chest pain, dizziness, or a sense that you can’t breathe.

What is the main cause of agoraphobia?

Doctors aren’t sure what causes agoraphobia. You’re more likely to get it if someone else in your family has it, so your genes might play a role. Your odds are also higher if you’ve had a lot of stressful or traumatic life events.

Can agoraphobia be treated?

Yes. Cognitive behavior therapy with exposure therapy is the most effective way to treat agoraphobia. Your doctor may also suggest medication, including antidepressants such as selective serotonin reuptake inhibitors (SSRIs).

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