The Symptoms of Agoraphobia

27 September, 2020
Have you ever heard of agoraphobia? Do you know the symptoms it causes? Learn all about it in today's article!

Agoraphobia is the intense fear of public spaces or situations where it would be difficult or embarrassing to escape from or hard to get help in case of a panic attack. Although people often think that agoraphobia makes you afraid of open spaces, it’s more related to a fear of public spaces. What symptoms does agoraphobia cause?

According to a study by Gomez Ayala (2012)the annual prevalence of agoraphobia is 0.3%. That prevalence might be higher today. It usually starts in late adolescence and affects twice as many women as men.

A woman with anxiety.

Symptoms of agoraphobia

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM5), these are the symptoms of agoraphobia:

Fear or intense anxiety

This fear or anxiety occurs in two or more of the following contexts:

  • Public transportation (trains, buses, boats, etc.).
  • Open spaces (markets, bridges, etc.).
  • Closed spaces (stores, movie theaters, etc.).
  • Standing in line or being in a crowd.
  • Going outside your home on your own.

Avoidance

Another symptom of agoraphobia is avoiding the situations we mentioned above. Individuals with this phobia avoid them because they believe it would be hard to escape. They also think that, if they had a panic attack or experienced other intense symptoms, they wouldn’t be able to get help. Consequently, they don’t just go out of their way to avoid them but they also fear them intensely.

If a person with agoraphobia has to face these particular situations, they always bring a friend or some kind of protective amulet or another object that provides comfort. If they have to face it alone, their only choice is to try to cope with their intense anxiety, which can be quite debilitating.

Constant fear

Another trait of agoraphobia is that agoraphobic situations (i.e. the object of the individual’s fears) almost always cause anxiety. In other words, it’s continuous and constant. It isn’t something that just happens occasionally.

“The oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown.”

-H.P. Lovecraft-

Disproportionate fear

Another characteristic symptom of agoraphobia is that the fear is disproportionate to the actual danger that the situation in question poses. It’s also disproportionate to the sociocultural context. This symptom isn’t unique to agoraphobia. In fact, it’s part of every kind of phobia.

The fear lasts for at least six months

To arrive at a diagnosis of agoraphobia, the DSM-5 states that the patient’s fear, anxiety, or avoidance must be continuous and last for at least six months. If those conditions aren’t met, the individual doesn’t have the disorder.

Significant distress

Agoraphobia causes clinically significant distress or affects the patient’s quality of life, whether that be on a personal, professional, or another level. In other words, the phobia interferes with the patient’s ability to function normally in their everyday life.

“Discomfort is very much a part of my master plan.”

-Jonathan Lethem-

Excessive fear

If the patient has another medical condition or mental disorder, their fear, anxiety, or avoidance must be clearly excessive. In other words, their symptoms can’t be explained by another condition other than agoraphobia.

A guy thinking about symptoms of agoraphobia.

Beyond the symptoms: other important information about agoraphobia

You’ve seen how agoraphobia symptoms can interfere with a person’s life, but what else is important to know? We mentioned above that this anxiety disorder is more common in women than in men. Women also usually have more serious agoraphobia and psychiatric comorbidity (Gomez Ayala 2012). Genetics also play a more significant role for women than environmental factors. As a result, the earlier the onset of the disorder, the greater the genetic load and seriousness of the phobia’s evolution.

A chronic disorder?

In general, agoraphobia is chronic. However, the intensity can vary significantly over the course of the person’s life. On the other hand, just because it’s usually a chronic disorder doesn’t mean there’s no available treatment. In fact, psychotherapy is one of the best options for agoraphobia treatment. Sometimes, mental health specialists will recommend medication in addition to therapy.

The association with panic disorder

According to the 2012 Gomez Ayala study, agoraphobia is frequently associated with panic disorder. In fact, 75% of people with agoraphobia also have panic disorder. Remember that panic disorder consists of two or more sudden panic attacks, along with distress and concern about the possibility of future panic attacks.

  • American Psychiatric Association (2014), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing.
  • Gómez Ayala, A.E. (2012). Agorafobia y crisis de pánico. Farmacia Profesional, 26(6): 32-39.
  • Jacobson, K. (2004). Agoraphobia and Hypochondria as Disorders of Dwelling. International Studies in Philosophy. 36 (2): 31–44.