Agoraphobia is an anxiety disorder linked to a fear of being in situations or places that might make the sufferer feel scared, trapped, panicked, helpless or embarrassed.
It is thought to affect around 2% of the UK population and is twice as common in women as it is in men. (Source: NHS)
While agoraphobia is often thought of as a fear of open spaces, the condition is actually a lot more complex than that. Some people with agoraphobia might find it difficult to travel on public transport, go shopping or attend public events.
Depending on the severity of the agoraphobia, for some people this fear will become so overwhelming that they are unable to leave their home.
What causes agoraphobia?
According to the NHS, agoraphobia usually develops as a complication of a panic disorder. The condition can develop suddenly, after a traumatic event, or over time after multiple panic attacks or feelings of fear that become associated with different situations or places.
The condition has also been linked to fears of crime, terrorism, illness and accidents, although it is still rare for this to manifest in people with no history of panic attacks. It can also be brought on by bereavement or trauma, but again, is more likely to occur in someone who has a history of panic disorder.
While the exact cause of agoraphobia varies from person to person, there are a number of different things that make you more likely to develop it, including a history of mental illness, being genetically predisposed, a number of biological factors (listed here on the NHS website), bereavement, or being the victim of a violent crime or abuse.
What are the symptoms of agoraphobia?
Symptoms of living with agoraphobia typically include:
- being afraid to leave your home
- being afraid of leaving the home alone or for extended periods
- being afraid of social situations (particularly with strangers)
- being afraid of having a panic attack or losing control in a public place
- being afraid of going to places you haven’t been before
- feeling trapped or scared when in public places
- feeling anxious or agitated
- panic attacks
People who live with agoraphobia will often avoid situations that might lead to an onset of anxiety or a panic attack. Having a panic attack can be very scary and people who experience them regularly will often develop fear and anxiety around anticipating their next attack.
Symptoms of a panic attack
- shortness of breath
- chest pain
- dizziness
- palpitations or a racing heart
- numbness or a tingling sensation
- sweating
- shaking
- nausea
- diarrhoea
- a choking sensation or difficulty swallowing
- hot or cold flushes
- feelings of dread/doom
- intrusive thoughts
- overwhelming fear that you’re dying
Panic attacks can be extremely distressing and can leave you feeling drained and exhausted afterwards. If you experience panic attacks, please know that you are not alone and it’s nothing to be ashamed of. There are therapies and medications available that could help you manage your symptoms, so please ask for help from your GP. You don’t have to cope with this on your own.
Life with agoraphobia
Living with agoraphobia can significantly disrupt your daily life as day to day activities like going to the shop, attending a meeting or going to work can be impacted by the condition. The people who find it difficult to leave the house will be most affected day to day and may need to make significant lifestyle changes to accommodate their condition.
People who live with agoraphobia may need to rely on other people for help with completing certain tasks. If you’re living with agoraphobia, there may be certain services available that could help make certain aspects of daily living a bit easier. Online banking, delivery services and accessing counselling via telephone or zoom might be helpful to you.
If you live alone or have nobody who can help you get around safely or who can run errands for you, consider talking to your local council about the support available in your local area. Your GP might be able to write you a supporting letter to help you access the services you need.
There also could be financial support available to you, like the Personal Independence Payments you can apply for via the DWP here in the UK.
Lifestyle changes that could help
Lifestyle changes such as getting more exercise and practising relaxation techniques could be beneficial to those who are living with agoraphobia. Getting enough exercise can be especially difficult for those who can’t get outside, so consider finding some compact exercise equipment to use in your own home, if this feels right for you.
Mind Charity recommend breathing techniques as an important part of every day relaxing. They say you should breathe deeply with your hand on your stomach and try counting to 4 on both in and out breaths to work out what feels most comfortable to you.
The NHS also recommends eating well and cutting out alcohol and caffeine as a way to manage the underlying anxiety that could be contributing to agoraphobia. Taking the first steps towards sobriety can be scary, if you need help you can visit the drinkaware website for advice.
Therapies and medication
CBT (cognitive behavioural therapy) is the most common form of therapy used to treat people with agoraphobia. CBT can help you understand the thoughts and feelings that are feeding into agoraphobia as well as teaching you how to work through those feelings when they arise.
Other talk therapies such as person centred counselling may also be beneficial. You’ll get the opportunity to talk about your fears regularly with a licensed professional and hopefully gain a deeper understanding to what you’re experiencing, which could help minimise your agoraphobia.
Around 1 in 3 people who live with agoraphobia will eventually be completely cured and go on to live a life free of all symptoms. Around half will experience an improvement, but periods where the symptoms return. (Source: NHS)
Even for those who continue to experience symptoms and live with agoraphobia, accessing treatment will greatly improve your quality of life and help you manage the different aspects of the fear you’re living with.
I have agoraphobia due to my chronic illness/disabilities which are painful. In the USA they stopped prescribing most medications that helped me & after 10+ years doing good on them, boom, I didn’t do well afterwards.
Now I’m scared of falling or loosing my balance since it was what I already went through when I first became ill. I have became so weak & in so much pain. I was diagnosed with agoraphobia & other issues. I haven’t been offered any type of treatment except a different psychologist. I feel forgotten but I still try to do things with my son since I have some security in him being with me everywhere. He will be going to college though so I will be alone. I won’t leave the house by myself. I don’t really know what to do because my illness/disabilities are permanent & I am getting worse physically which means mentally too.
Thank you for recognizing agoraphobia. It needs more depth to how it can take over a person’s life. Allison
Allison, I’m so sorry to hear about how deeply agoraphobia is impacting your life. It must be especially frustrating to not have access to medication that helped you. I know how scary it is to leave the house without your safety person, as I struggle to go anywhere without someone I know and trust too. I hope you can prepare well in advance for your son going to college and try to find things that could help you manage while he is away? I wish I knew of a solution to share with you!