What is agoraphobia?

A crowd rushing around a person seated on a bench outside.

Agoraphobia is a psychiatric anxiety disorder in which a person perceives that they are unable to escape from a particular situation. This includes fearing and avoiding situations that might induce panic or feeling trapped. While a person with agoraphobia might opt to stay home to avoid these situations, they are not classified as introverts.

“A lot of times, people don’t like to be around other people, and we usually call them introverts. That’s not a disorder, but a personality trait. It’s not associated with anxiety – they don’t have a fear of not being able to escape or losing control,” said Dr. Asim Shah, professor and executive vice chair in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor.

Introverts are people who feel more comfortable focusing on themselves or don’t want to be around people, not because they fear they can’t escape their environment, but because they don’t enjoy being around others. People with agoraphobia might not hate the crowds or being with others, but they feel panic in these situations.

Symptoms of agoraphobia include feeling like you are losing control (i.e., at the grocery store or shopping mall) and fearing you cannot escape or leave that place. This can lead to panic episodes, which may be characterized by chest pains, palpitations, anxiety, sweating of the palms and edginess.

While agoraphobia is an anxiety disorder, social anxiety is more closely related to a particular event.

“Social anxiety is not a fear that you will lose control or can’t escape. The problem is the fear of performance or lack of performance during that social situation and feeling embarrassed or judged,” Shah said.

Agoraphobia can be treated by therapy with systematic desensitization, which slowly exposes a person to their fear. They are encouraged to be with someone they trust so they develop confidence. If one experiences agoraphobia driving over bridges, they should start driving on small roads with a trusted person, then drive on bigger roads before finally driving on a bridge.

Another successful approach is cognitive restructuring in which a therapist coaches the individual on how to replace the irrational belief with more factual beliefs. There are also prescription medications available to treat agoraphobia that people can use for a short period of time.

When panic episodes occur, Shah recommends doing relaxation techniques: take a deep breath, think about a nice place and let your body go.

Learn about psychiatry and behavioral health services at Baylor Medicine. 

By Homa Warren

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