The main symptom of agoraphobia is an intense fear of being in public or crowded places. Though this is a challenging condition, there are many ways to manage and overcome your fears.

Agoraphobia is an anxiety condition in which you experience intense fear, worry, or panic in public places. In these situations, you may have the vague feeling that something dreadful might happen.

This anxiety arises because you feel that the situation would be difficult to escape, or that you might not be able to get help if you have a panic attack or experience panic-like symptoms.

Agoraphobia affects many people. The National Institute of Mental Health (NIMH) reports that around 1.3 percent of U.S. adults experience agoraphobia in their lifetimes.

In this article, we take a closer look at the symptoms of agoraphobia, and we discuss when it’s a good time to talk with your doctor.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), agoraphobia involves intense fear or anxiety that occurs in, or when anticipating, at least two of the following five situations:

  • using public transportation such as cars, buses, trains, ships, or planes
  • being in open spaces such as parking lots, marketplaces, or bridges
  • being in enclosed spaces such as shops, theaters, or cinemas
  • standing in line or being in a crowd
  • being outside the home alone

You might receive an agoraphobia diagnosis if your symptoms persist for more than 6 months and occur nearly every time you encounter the place or situation.

Agoraphobia is most often diagnosed in young adulthood and usually before the age of 35.

By definition, the fears linked with agoraphobia are irrational. This means the anxiety is out of proportion with the actual danger posed by the situation.

Most of the time, people with agoraphobia are aware their fears are irrational, but they still can’t stop believing them.

For instance, there’s little potential for danger while waiting in line at the bank, and millions of people do it every day without incident.

However, many people with agoraphobia may still feel dreadful at the thought of being in that situation.

As with all anxiety disorders, the symptoms of agoraphobia can be:

  • physical
  • mental
  • behavioral

If you have agoraphobia, you’ll notice a strong stress response in your body when exposed to the feared situations. This is part of your body’s fight, flight, or freeze response, a natural system that helps protect you from threats.

Agoraphobia involves experiencing strong anxiety or panic-like responses when you are in certain public or crowded places.

The physical and mental symptoms of agoraphobia can include:

  • a racing heart
  • shortness of breath
  • sweating
  • muscle tension
  • shaking
  • dizziness
  • feeling nauseous
  • muscle weakness
  • feeling hot or cold
  • fear of losing control
  • feelings of doom or dread
  • a general sense of unease
  • feeling detached from your body, known as dissociation

Many people with panic disorder have agoraphobia, though the DSM-5 considers them two separate conditions.

Panic disorder involves a fear of having a panic attack, and the anticipation of an attack causes intense anxiety.

If you have a panic attack in public once, your brain might associate those intense negative emotions with whatever situation you were in when they occurred.

This can mean that you feel anxious again when in a similar situation, which can even cause another panic attack.

Many people may begin to avoid situations that might provoke the uncomfortable and distressing symptoms of anxiety or panic attacks. These fears can build over time and lead to a general fear of open spaces, or agoraphobia.

Avoidance is a major symptom of agoraphobia. You might find yourself spending a lot of time and energy avoiding situations that might trigger your anxiety. Otherwise, you might endure the situations with serious discomfort.

You might ask a partner or friend to help you confront the feared situation, such as asking them to come with you to the grocery store or post office.

It is common for people with agoraphobia to feel unable to leave the house due to their intense anxieties over what may happen if they do.

Anxieties linked to these situations can lead to big changes in your behavior, daily routines, and your ability to show up in the world.

Feeling restricted or out of control of your daily life, known as having a lack of autonomy, can have a negative impact on your mental health and well-being.

The feelings can cause significant distress and impairment in your life, making it difficult — or sometimes impossible — to hold down a job, attend school or social engagements, or maintain friendships or relationships.

Agoraphobia affects each person in different ways. The symptoms can range from serious to mild, depending on how much it affects the person’s life.

According to survey data published in 2005, agoraphobia can have mild to severe impacts on a person’s life. The NIMH states:

  • 40.6 percent of people say agoraphobia had a serious impact on their lives
  • 30.7 percent reported a moderate impact
  • 28.7 percent reported a mild impact

Talking with a doctor or a mental health professional, such as a psychologist or psychiatrist, about your anxiety may feel daunting, but it can really help.

You can do this in a way that feels best to you. Many doctors will offer telephone consultations, online services, direct you to helpful sources, and provide treatment advice.

Some symptoms of anxiety or panic overlap with the symptoms of other medical conditions. Your doctor can help rule out other causes. They can also rule out other anxiety disorders that can have similar symptoms, such as:

As with all mental health conditions, the symptoms of agoraphobia cannot be explained by the direct bodily effects of substance use, including alcohol, drugs, or medications.

Agoraphobia is a treatable condition. Psychotherapy, or talking therapy, is an especially effective treatment for agoraphobia. Cognitive behavioral therapy (CBT) is a common method for anxiety disorders.

In CBT for agoraphobia, the therapist will work with you to develop a list of stressful situations that trigger your symptoms, starting from the least scary to those that are more triggering.

You will learn skills to work through these situations, and, eventually, the scariest scenario will feel significantly less threatening.

For some people, certain medications can also help. These include antidepressants and benzodiazepines.

Black box warning

It’s important to note that benzodiazepines, like Xanax and Ativan, have a black box warning from the FDA and may cause physical dependence or withdrawal.

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Learn about the treatments of agoraphobia here.

People can also take steps to reduce their daily anxiety levels and to cope with anxiety symptoms as and when they arise. Deep breathing exercises and other relaxation methods can calm the body’s stress response in the moment.

Bear in mind that learning to breathe deeply to reduce anxiety takes regular practice. If used only when you are feeling panicked, these strategies may not work very well.

Psychologists recommend practicing these breathing techniques daily for 5 to 10 minutes so that when you are feeling more anxious, your body will know what to do.

Practicing stress reduction techniques regularly can help you feel more in control of the anxiety when it arises, which can make the symptoms of agoraphobia easier to manage.

Read about 9 on-the-spot ways to manage your anxiety here.