Agoraphobia: Treatments That Work

Imagine a busy city right when everyone’s rushing to get home. The sidewalks are crowded, the noise of traffic is overwhelming, and there are no clear exits. If this sounds like an unbearable situation, you may want to explore agoraphobia treatment.

Now imagine experiencing this scenario everywhere you go. This is how people with agoraphobia feel: fearful of entering many places, especially if there’s no easy way to escape.

For someone with this type of phobia, being in open spaces, among crowds or outside alone is terrifying and anxiety-provoking.

Agoraphobia can negatively impact someone’s daily life, as well as their overall quality of life. Just over one percent of the U.S. adult population experiences agoraphobia.

But fortunately, there’s more than one effective treatment for agoraphobia.

Read on to learn more about agoraphobia, including the signs, causes and ways to cope with this mental health condition.

Agoraphobia is characterized by intense fear or worry about a place that might be difficult to escape. The condition is considered an anxiety disorder due to the excessive anxiousness the individual feels in certain places and situations and during stressful life events.

These scenarios cause significant distress to people with this type of anxiety disorder. And while everyone experiences anxiety symptoms and agoraphobia differently, some common symptoms of agoraphobia include:

• Chest pain

• Rapid heart rate

• Excessive sweating

• Upset stomach

• Dizziness or feeling lightheaded

• Sudden chills

Causes of Agoraphobia

While the exact cause of agoraphobia is unknown, this mental health disorder is sometimes associated with panic disorders.

Panic disorders are another type of anxiety disorder characterized by panic attacks. A panic attack is the sudden feeling of intense fear or anxiety that occurs without a clear danger or trigger.

Like agoraphobia, panic attacks often happen along with other symptoms of panic disorder, like nausea, sweating, shortness of breath, shaking and feeling faint, as well as avoidance of situations.

Agoraphobia can occur with panic disorder. When two mental health disorders exist at the same time, it’s known as a comorbid disorder or co-occurring disorders.

Agoraphobia has also been found to co-occur with other anxiety disorders, such as generalized anxiety disorder (GAD) and post-traumatic stress disorder (PTSD), as well as mood disorders like major depressive disorder (MDD).

Additionally, agoraphobia can occur with anxiety-related disorders, including other phobias (an intense fear or anxiety about specific objects or situations).

Diagnosing Agoraphobia

To be diagnosed with agoraphobia, your symptoms need to meet certain criteria defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-IV).

DSM-IV criteria include feeling intense fear or anxiety in two or more of the following situations:

• Using public transportation

• Open spaces, such as markets or parking lots

• Enclosed spaces, such as stores and theaters

• Standing in a crowd

• Being alone outside your home

There are additional inclusion criteria for diagnosing panic disorder with agoraphobia. You must have recurrent panic attacks, and at least one panic attack must have been followed by:

• Fear of having more panic attacks

• Fear of the consequences of panic attacks, such as having a heart attack or losing control

• Changing your behavior as a result of panic attacks

Now that you know the symptoms of agoraphobia, we’ll discuss agoraphobia treatment.

Several treatments for agoraphobia can improve the symptoms and your daily life. An agoraphobia treatment plan usually involves a mix of therapy, medication and small changes to your habits and lifestyle.

Therapy

Psychotherapy — also known as talk therapy — involves meeting and working with mental health professionals regularly. Several types of therapy are used to treat panic disorder.

Cognitive behavioral therapy (CBT) involves changing the ways you think, behave and react to your emotions, including those associated with agoraphobia or that develop before or during panic attacks.

Generally, studies have found that cognitive behavioral therapy for panic disorder helps identify and alleviate panic symptoms, lessens other anxiety symptoms and improves quality of life, making this type of therapy an effective treatment for agoraphobia.

Exposure therapy is another type of behavioral therapy used to treat phobias and panic disorders, including agoraphobia. It involves confronting fears or anxiety triggers in a safe environment. For example, you might be exposed to an object that triggers your anxiety in a controlled setting.

Medication

Certain medications may also be used as a treatment for agoraphobia, especially for those with more severe agoraphobia symptoms.

Medications that may help relieve agoraphobia symptoms and keep panic attacks at bay include:

• Selective serotonin reuptake inhibitors (SSRIs). SSRIs work by increasing levels of the chemical serotonin in the brain. They’re commonly used as first-line treatments for depression and anxiety. SSRIs approved to treat panic disorder include fluoxetine (Prozac®), sertraline (Zoloft®) and paroxetine (Paxil®).

• Serotonin-norepinephrine reuptake inhibitors (SNRIs). SNRIs work similarly to SSRIs by increasing serotonin in addition to norepinephrine levels. The SNRI venlafaxine (Effexor®) has shown to be an effective treatment for panic disorder.

• Tricyclic antidepressants (TCAs). TCAs are older antidepressants that may be used when newer medications aren’t effective. They’re more likely to cause adverse effects and health issues than newer antidepressants. TCAs such as amitriptyline (Elavil®) or nortriptyline (Pamelor®) might be prescribed to treat panic disorder co-occurring with agoraphobia.

• Anti-anxiety drugs. Also known as benzodiazepines, these medications can provide rapid relief from panic attacks and other common anxiety symptoms. However, many people develop a tolerance to anti-anxiety drugs, and some users become dependent on them over time. Examples include alprazolam (Xanax®) or clonazepam (Klonopin®).

While medications may have a quicker effect on symptoms than therapy, you may also experience common side effects.

A mental health professional or another healthcare provider can help determine if an antidepressant will work for your agoraphobia and/or anxiety symptoms specifically.

Lifestyle Changes

Making changes in your daily life won’t necessarily treat agoraphobia, but it may help reduce everyday anxiety.

Some changes you can try include:

• Regular physical activity. Regular exercise has been found to reduce anxiety symptoms and has been known to lower stress levels and improve mental health overall.

• Relaxation techniques. Daily meditation or mindfulness can reduce anxiety, fight the onset of panic attacks, increase calmness and enhance overall health and well-being. If you’re new to this mindfulness practice, our guide will teach you how to meditate.

• Limiting caffeine consumption. Caffeine intake is associated with an increased risk of panic disorder. Try to limit your consumption of caffeine, especially if you feel like you’re more anxious after drinking caffeinated beverages.

While this anxiety disorder may seem overwhelming and even frightening, there are ways to treat agoraphobia.

First, you can talk to mental health professionals about your symptoms and collaborate on an agoraphobia treatment plan that works for you.

Additionally, you can access expert help by asking your primary care provider for a mental health referral or by using our online mental health services.

Talk with a healthcare professional today if you’re concerned about agoraphobia, panic disorder or other mental health conditions.