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Agoraphobia

The below information is purely for educational purposes and does not constitute medical advice. This content should not be used as a substitute for professional medical advice.

Agoraphobia is a type of anxiety disorder that causes extreme fear of open or crowded places or places that are hard to escape. This typically leads to avoidance of the situation and can result in people affected by agoraphobia becoming more isolated from the outside world.

Agoraphobia Definition

Sad young woman crying while looking through the window.

Derived from the Latin word agora – a place of gathering – agoraphobia is defined as an irrational or disproportionate fear of being in crowds, public places, or open areas.

What Causes Agoraphobia?

Agoraphobia is a type of anxiety disorder. Research is ongoing to better understand panic disorder, but experts believe a combination of biological, psychological and social factors contribute to the development and then persistence of agoraphobia.

Risk factors for agoraphobia vary between individuals and often a specific reason or cause for the onset of agoraphobia is not possible to identify. However, there are several psychological factors that may increase the likelihood of developing agoraphobia, these include:

  • Traumatic or adverse childhood experiences
  • Experiencing a stressful event in adulthood, such as bereavement, divorce, or redundancy
  • A history of other psychological conditions, such as depression, anorexia, or bulimia
    • Agoraphobia affects 1 in 3 individuals with panic disorders
  • Alcohol or drug abuse
  • An unhappy relationship or a relationship with a controlling partner may also increase the risk of developing agoraphobia

Agoraphobia Symptoms

A person sits in a chair, reaching out and holding the hands of a person who is not in the photo.

The severity of the symptoms of agoraphobia varies between cases and affects the symptoms one may experience. For those with severe agoraphobia, leaving the house may feel impossible whilst for those with mild agoraphobia, short journeys and visits to places nearby might not present a problem.

When presented with a situation that triggers their agoraphobia, patients may experience similar feelings to that of a panic attack. Symptoms include:

  • Rapid heartbeat and breathing
  • Perspiration
  • Nausea
  • Chest pain or tightness
  • Stomach upset such as churning or diarrhoea
  • Difficulty swallowing
  • Shaking, dizziness or feeling faint
  • Ringing in the ears

Individuals with agoraphobia become versed in avoiding triggering situations making behavioural symptoms the main indication they are living with agoraphobia. Behavioural symptoms include:

  • Avoidance and isolation – avoiding crowded places and social gatherings, making excuses not to leave the house
  • The need to be with a trusted person when leaving the house, not wanting to go anywhere alone
  • Avoiding travelling far from home and ensuring they are in easy reach of their ‘safe place’

How is Agoraphobia Diagnosed?

To obtain a diagnosis of agoraphobia a GP will perform an assessment where they will ask about symptoms and any previous mental health issues. If there is any doubt about the diagnosis, a referral to a psychiatrist may be necessary.

In particular, they will assess for any fear or anxiety associated with the following situations:

  • Public transportation
  • Open spaces
  • Being in shops, theatres, or cinemas
  • Standing in line (queuing) or being in a crowd
  • Being outside of the home alone in other situations

Agoraphobia Treatment

Therapy session for a teenage girl

The treatment approach to agoraphobia depends on the severity of symptoms and impact on an individual’s life and may encompass medications, psychological therapies, lifestyle changes, or a combination of these approaches.

Self-help techniques and lifestyle changes are likely to be beneficial for all types of symptoms. Self-help techniques include practising coping strategies to during a panic attack, lifestyle changes include making healthy choices such as:

  • Taking regular exercise
  • Maintaining a healthy diet
  • Avoiding or reducing alcohol (whilst alcohol may make symptoms feel better in the short term it can make problems worse)
  • Reducing or avoiding caffeinated beverages such as coffee, tea, or caffeinated soft drinks

Talking therapies are a mainstay of treatment. Those which have the most evidence of their efficacy include cognitive behavioural therapy and exposure therapy.

Medications may be appropriate for some individuals, including anxiolytic medications for acute symptoms, as well as anti-depressant medications.

Agoraphobia and Medicinal Cannabis

Research into the effect of medicinal cannabis on agoraphobia is limited. However, following the legalisation of cannabis for medical purposes in 2018, there has been a rise in people looking towards medical cannabis. When first-line therapies have not proved effective at reducing symptoms, medical cannabis may be considered an option for agoraphobia.

For further information and to find out more about medical cannabis, click here to discover more about our award-winning Curaleaf Access Scheme. Alternatively, complete an eligibility assessment now. Once complete, one of our clinicians will review your application and advise whether you are eligible for progression to an appointment.

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Frequently Asked Questions about Agoraphobia

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A person living with agoraphobia may be triggered when confronted with the idea or requirement to leave their home or ‘safe space’ and enter a large open space or a place with lots of people. For example, if a visit to the doctor is necessary, a person with agoraphobia may feel anxious or panicked at the thought of having to leave the house.

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For someone living with agoraphobia, the following symptoms may arise when they have to leave their home or place in which they feel safe.

  • Rapid heartbeat and breathing
  • Perspiration
  • Nausea
  • Chest pain or tightness
  • Stomach upset such as churning or diarrhoea
  • Difficulty swallowing
  • Shaking, dizziness or feeling faint
  • Ringing in the ears

The signs to look out for that a person is living with agoraphobia include isolation and avoidance of situations and events that involve leaving their own home or safe place. People with agoraphobia are more likely to become isolated from the outside world and their friends and family.

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There are many coping techniques to make living with agoraphobia easier. Agoraphobia is a psychological condition for which there isn’t a cure, however, coping techniques and support from healthcare providers can allow a person with agoraphobia to lead a normal life.

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Agoraphobia is a type of anxiety disorder that causes panic at the thought of entering a large or crowded space. The idea of having to do so causes anxious feelings and panic in sufferers of agoraphobia. Many of the symptoms of agoraphobia are the same as those experienced due to anxiety.