How Do I Know If I'm an Agoraphobic?

Agoraphobia symptoms include fast breathing (hyperventilating), fast heartbeat, feeling hot and sweaty, feeling unwell (malaise), dizziness, being unable to leave the house for long periods of time, and others.

An agoraphobic is a person who suffers from agoraphobia, which is defined as fear or anxiety about and/or avoidance of situations in which escape could be difficult, such as open spaces, crowded areas, or even modes of travel. Agoraphobia is frequently seen with panic disorder. 

You may be an agoraphobic if you have symptoms of agoraphobia such as: 

• Physical symptoms
  • These tend to occur in situations that cause anxiety, but many people with agoraphobia deliberately avoid these situations so they may not experience these physical symptoms often
  • Physical symptoms that can resemble those of a panic attack
    • Fast breathing (hyperventilating)
    • Fast heartbeat
    • Feeling hot and sweaty
    • Feeling unwell (malaise)
    • Dizziness
    • Lightheadedness
    • Chest pain
    • Trembling
    • Diarrhea
    • Ringing in the ears (tinnitus)
    • Difficulty swallowing 
• Cognitive symptoms
  • Feelings or thoughts that may be related to physical symptoms 
  • Can include fears related to panic attacks, such as: 
    • Feeling they look stupid or feel embarrassed in front of others
    • People staring  
    • Inability to escape from a place or situation if a panic attack happened
    • Losing control in public
    • A panic attack that will be dangerous or life-threatening 
    • Losing one’s sanity
  • May include feelings unrelated to panic attacks, such as: 
    • Fear of being alone in one’s own home
    • Feeling as if they are unable to function or survive without help 
    • A general feeling of anxiety or dread
• Behavioral symptoms
  • Being unable to leave the house for long periods of time
  • Avoiding being far away from home
  • Avoiding situations and places that may lead to panic attacks, such as crowded places, public transportation, and lines
  • Needing to be with a trusted person when going out

Agoraphobia is diagnosed with a comprehensive psychiatric assessment.

The DSM-5 criteria for a diagnosis of agoraphobia include: 

• Marked fear or anxiety about two or more of the following situations: 
  • Using public transportation 
  • Being in open spaces 
  • Being in enclosed places 
  • Standing in line or being in a crowd
  • Being outside the home alone
• Fear or avoidance of these situations because of thoughts that escape might be difficult or help might not be available of they develop panic-like symptoms or other incapacitating or embarrassing symptoms 
• The situations almost always provoke fear or anxiety. 
• The situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety. 
• The fear or anxiety is out of proportion to the actual danger posed by the situations and the sociocultural context. 
• The fear, anxiety, or avoidance is persistent, lasting six months or more. 
• The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. 
• If another medical condition (e.g., inflammatory bowel disease, Parkinson's disease) is present, the fear, anxiety, or avoidance is clearly excessive.
• The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder and are not related exclusively to:
  • A specific situation, as in specific phobia, situational type
  • Social situations, as in social anxiety disorder
  • Obsessions, as in obsessive-compulsive disorder (OCD)
  • Perceived defects or flaws in physical appearance, as in body dysmorphic disorder
  • Reminders of traumatic events, as in posttraumatic stress disorder (PTSD)
  • Fear of separation, as in separation anxiety disorder

Agoraphobia is not the same diagnosis as panic disorder. If a person meets the criteria for panic disorder and agoraphobia, they would be diagnosed with both conditions. 

Treatment for agoraphobia usually involves desensitization (also called exposure therapy). The patient is supervised by a therapist and is gradually exposed to situations they fear to learn that the outcomes they fear do not happen. 

Techniques used to treat agoraphobia include: 

• Graded real-life exposure 
  • Exposure to real situations that progresses from less to more extreme aversion
  • Working with a therapist to develop coping strategies 
• Cognitive behavioral therapy (CBT) 
  • Helps patients change or eliminate negative thought patterns that influence symptoms to help them change behavior
  • Takes at least 8 to 12 weeks or more
  • May also help reduce anticipatory anxiety and avoidance of feared situations 
• Self-help or support groups 
• Couples therapy 
• Stress management techniques 
  • Relaxation
  • Meditation
  • Biofeedback
  • Hypnosis
• Aerobic exercise 
• Avoiding caffeine, certain over-the-counter (OTC) cold medications, and some illegal drugs that can trigger or worsen symptoms of anxiety disorders

Patients who experience panic attacks along with their agoraphobia may be prescribed medications such as: 

• Antidepressants 
  • Tricyclics
  • Selective serotonin reuptake inhibitors (SSRIs) 
    • Often used to treat panic disorder when it occurs in combination with obsessive-compulsive disorder (OCD), social phobia, or depression
• High-potency benzodiazepines
• Monoamine oxidase inhibitors (MAOIs)