I feel trapped, but I’m terrified out there.

I spend all of my time in my home. I feel safe and trapped at the same time. Basic things—like driving, going through the checkout line  at the grocery store, going outside for any reason — landed me somewhere between mortal unease and full-throttle terror. People just frighten me. Outside has everything. Whenever I think of a thing now like skis or fireworks or islands or elevators or yo-yos, I have to remember they’re real, they’re actually happening in Outside. It makes my head tired. And people too, firefighters, teachers burglars, babies, saints, soccer players and all sorts, they’re all really in Outside. I’m not there. Am I still real?

Agoraphobia is an anxiety disorder. People with agoraphobia avoid situations that might cause them to feel: trapped     helpless     panic     embarrassment     fear

Approximately 0.8 percent of the adult population has agoraphobia.

Risks

You may be at risk of developing agoraphobia if you:

  • have a panic disorder
  • are experiencing or have experienced stressful life events
  • have a history of childhood physical or sexual abuse
  • are a nervous or anxious person
  • have an alcohol or substance abuse problem

Agoraphobia is more common in women then men. It usually first appears in young adulthood. However it can occur at any age.

Signs & Symptoms

You may experience one or more of the following symptoms with either type of agoraphobia:

  • fear of leaving your house for long periods of time
  • dependence on others
  • fear of being alone
  • fear of being at places where it would be difficult to escape
  • fear of losing control of yourself in a public place
  • detachment or estrangement from others
  • feeling helpless
  • feeling that your body is not real
  • feeling that the environment is not real
  • agitation or anger

The following are symptoms of a panic attack:

  • chest pain
  • rapid heartbeat
  • shortness of breath
  • dizziness
  • trembling
  • feeling faint
  • choking
  • fear you are losing control
  • fear you are dying
  • fear you are going crazy
  • sweating
  • hot flashes
  • chills
  • nausea
  • numbness or tingling sensations

Diagnosis

 

Your provider will ask about agoraphobia symptoms. She may also examine you or perform blood tests. These are intended to rule out physical causes for your symptoms.

To be diagnosed with agoraphobia, your symptoms must meet certain criteria. You will not be diagnosed with agoraphobia if your symptoms are caused by illness. They also can not be caused by substance use or another disorder.

There are additional criteria for a diagnosis of panic disorder with agoraphobia. You must have recurrent panic attacks. Furthermore, at least one panic attack must have been followed by:

  • fear of having more panic attacks
  • worries about the consequences of the panic attacks – such as having a heart attack, losing control, or going crazy
  • changing your behavior because of the attacks

Treatments

 

There are a number of different treatments for agoraphobia.

Cognitive Behavioral Therapy (CBT) can help you understand the distorted feelings and views associated with agoraphobia. CBT can also teach you how to replace the distorted thoughts with healthy thoughts.

Exposure Therapy can help you overcome your fears. Exposure therapy gently and slowly exposes you to the situations that cause you fear.

Medications can help relieve your agoraphobia or panic attack symptoms. Some medications used for agoraphobia include selective serotonin reuptake inhibitors (SSRIs), antidepressants, and anti-anxiety medications.