Agoraphobia

Overview

Agoraphobia involves fear and/or anxiety related to using public transportation, being in open spaces, being in enclosed spaces, standing in line, being in a crowd, or being away from home and alone. Being in such situations in turn causes anxiety around it possibly being difficult to get help or escape should the person begin to experience symptoms of a panic attack or find themselves in an embarrassing situation.

The Details

Agoraphobia can be a bit confusing at first to fully understand. There is a common belief that Agoraphobia is simply fear associated with leaving one’s home. While this can and often is part of the issue, fear of leaving the home is just a part of one symptom of the larger diagnosis that is Agoraphobia.


A person with Agoraphobia must exhibit at least two of the following five symptoms:


  1. Fear of using public transportation such a city buses, taxis, trains, or airplanes

  2. Fear of being in open spaces such as parking lots, walking across a bridge, or spending time in a park

  3. Fear of being in enclosed spaces such as a store, movie theater, or subway system

  4. Fear associated with standing in line or being in a crowd of people

  5. Fear of leaving home without bringing someone else with you


In addition, a person with Agoraphobia will also experience fear or anxiety that they won’t be able to get help or escape if and when they either begin to have panic attack like symptoms or experience an embarrassing situation. As a point of clarification, fear is the response to an immediate and present threat, while anxiety is a response to an anticipated threat.


Examples include a person at a concert surrounded by others who is afraid of becoming incontinent and not being able to escape or get to a bathroom in time, a person standing in line for movie tickets and afraid of throwing up, a person in a mall parking lot who experiences anxiety about getting lost and not being able to find anyone willing to help, or a person afraid of being on a train alone when they start to get dizzy, shake and tremble, develop a rapid heartbeat or experience other symptoms of a panic attack, even if a full panic attack never materializes.


A person with Agoraphobia will almost always experience anxiety when the feared situation comes about and will actively seek to avoid being in such situations. When they can’t avoid the feared situation, they either need someone else with them to get through it, or they suffer intense levels of fear and/or anxiety.


When considering whether or not a person may have Agoraphobia, it’s important to rule out a few things. For example, certain cultural norms may dictate what is considered acceptable social behavior. Additionally, legitimate concerns for safety such as not wanting to take a public bus in an unsafe neighborhood should not be confused for symptoms of Agoraphobia. Similarly, Agoraphobia should be distinguished from Social Anxiety Disorder in that the fear is not about being evaluated, judged, or criticizing, but more about the inability to escape or access needed help.

Trends

Approximately 1.7% of adults and adolescents are diagnosed with Agoraphobia. Instances occurring in children are not common, and rates in older adults are only about 0.4%. Agoraphobia typically develops during late adolescence or early adulthood, while other times it comes up around age 40.


While women tend to be diagnosed twice as often as men. We should keep in mind however that this could, at least in part, be a reporting bias where men are less likely to admit having anxiety. There are no major differences in the rates of diagnoses between or amongst different racial and cultural groups.


Although it is not necessary for a person with Agoraphobia to experience full panic attacks, between 30-50% of people will.


Agoraphobia tends to be a long-lasting condition. Sometimes people may experience temporary remission, meaning that their symptoms disappear for a period of time (perhaps several years) only to later return.


Specific symptoms may also vary depending on a person’s age. For example, children are most likely to fear becoming lost or leaving home, while older adults tend to be more worried about standing in line or being in open spaces particularly if they should become disoriented or fall.


Further, there is strong evidence that Agoraphobia has a genetic component; in other words that it can be inherited. Similarly, people raised in overprotective or emotionally distant families tend to have a higher likelihood of developing Agoraphobia as well.

Summary

Agoraphobia is a complex diagnosis. It involves fear or anxiety associated with two of more out of five specific situations described above along with anxiety about not being able to escape or access help if either panic attack like symptoms emerge or the situation turns embarrassing.


People with Agoraphobia will try to avoid the situations that cause them anxiety, will suffer through them alone, or will bring along another person in order to get through the situation. The desire to avoid these anxiety provoking situations are so strong that over two-thirds of people diagnosed become homebound.


There are some scenarios in which a person may show signs of Agoraphobia for legitimate reasons such as not wanting to leave your home at night if you live in a dangerous neighborhood or being anxious about an upcoming flight if a relative was just in a plane accident.


Agoraphobia can be a long-lasting condition, specific symptoms may vary based upon a person’s age, and males may be less likely than females to fully admit to having symptoms. Those with Agoraphobia may also be susceptible to other Anxiety Disorders or Depressive Disorders.

Disclaimer

All information on this website has been professionally prepared, but also intentionally written in a manner that is not overly technical. The terms used here are usually, but not always the formal and proper terminology or diagnoses that would be used between professionals. Similarly, we made a decision to not provide the full and exhaustive diagnostic criteria here. This is done so as to be informative and more easily understood by people who are not in the field of mental health. At the same time all reasonable efforts are taken to assure that the information presented here is as accurate as possible. We also provide a list of common definitions and abbreviations that you may find useful.

While clinical descriptions are not intended to be overly technical, they do attempt to be accurate and consistent with the DSM standards. Any changes made are superficial and done so for the sake of ease of comprehension.

 

It’s important to point out that the information provided on this website is not designed to replace a proper clinical assessment performed by a qualified professional. The descriptions on this website are not intended, nor should they be used to self-diagnose or to diagnose those around you.

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