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Do you have a fear of open spaces like squares or riding public transport in crowded places? Does it cause problems in your life? Then you may be suffering from agoraphobia. Here we explain what this phobia is and how you can get help.

What is agoraphobia?

Agoraphobia is an anxiety disorder where you have a fear of places and situations that can cause panic or helplessness. These are often places where it can be difficult to quickly escape or get help, such as open squares, shopping malls, public transport and other large open spaces.

People with agoraphobia may experience severe anxiety or panic attacks in these environments and may avoid them altogether. This can lead to problems of isolation or avoidance of activities that would otherwise be beneficial. It is possible to treat agoraphobia and feel much better.

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What does agoraphobia mean?

The word ‘agoraphobia’ comes from the Greek language, where ‘agora’ means square or open space, and ‘phobia’ means fear. So agoraphobia means ‘fear of open spaces’. The term has been broadened in healthcare to include fear of open spaces in general and situations where escape may be difficult or embarrassing.

Panic disorder with agoraphobia

It is common to also have panic disorder if you have agoraphobia. This can mean that the fear becomes so intense that the body reacts with a panic attack. This is not dangerous but can be very uncomfortable. Physical symptoms may include rapid heartbeat, difficulty breathing and sweating.

People with agoraphobia may experience panic attacks in situations such as being in large crowds, standing in a queue, travelling by bus or train, and even being outside their own home. As a result, people with severe agoraphobia may become so afraid that they avoid things they would actually like to do, thus reducing their quality of life.


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How common are phobias?

About 3% of the population have agoraphobia and find squares, bridges and other open spaces very frightening. There are also other phobias and in total about 8-12% of the population suffer from one or more phobias during their lifetime so it is a fairly common anxiety disorder. Other phobias can range from fear of heights and social phobia to lesser known ones such as ‘hole phobia’ (trypophobia). Treatment for phobia is available.

What causes agoraphobia?

Agoraphobia can be caused by a combination of several factors. There is a hereditary component; if you have a relative with the syndrome, there is a risk that you will be affected. Biological factors can also contribute, as well as psychological factors such as certain personality traits where people are more anxious. If you are involved in traumatic events, you can also get the anxiety syndrome. You can also have a panic attack in a certain situation and then the anxiety has become associated with the place and later other places similar to the first one. The anxiety has then generalized and this is a typical development in anxiety disorders in general, but it can be treated in therapy. You can have one or more of these causes and it is important to identify what is causing difficulty in each individual’s life and adapt treatment accordingly.


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Symptoms of agoraphobia

The symptoms of agoraphobia can vary in severity from person to person, with some having mild symptoms while others have severe ones. An assessment always takes into account and investigates the client’s level so that treatment can be adapted accordingly. There are several symptoms that can indicate the presence of this syndrome:

  1. Intense fear or anxiety: The most prominent feature of agoraphobia is a strong fear of places or situations where escape may be difficult or where help is not available.
  2. Avoidance behaviour: People with agoraphobia tend to avoid situations that cause anxiety. These include places that are crowded, public places, travelling far from home, or being alone outside the home.
  3. Panic attacks: Many people with agoraphobia experience panic attacks, which can include heart palpitations, sweating, trembling, shortness of breath, feeling of suffocation, chest pain, nausea, dizziness, fear of losing control or fear of dying.
  4. Physical symptoms: In addition to the emotional symptoms, agoraphobia can also cause physical symptoms such as upset stomach, diarrhea, headaches and muscle tension.
  5. Dependence on others: People with agoraphobia may become dependent on a specific friend or family member to accompany them when they have to go out.
  6. Sense of powerlessness: A sense of powerlessness over their fear and the situation is common among those suffering from agoraphobia.
  7. Emotional distance: Feelings of being separated from others or not really being present can occur.

If one suspects they have agoraphobia, it is important to seek professional help, as there are effective treatments available.

Treatment for agoraphobia

Agoraphobia is a treatable anxiety disorder and if you have symptoms you should not be afraid to seek help. Treatment is tailored to each person and the severity of the problem. There are certain parts that the treatment usually contains and it is among other things:

Cognitive behavioural therapy (CBT): This is one of the most effective treatment methods for agoraphobia. CBT focuses on identifying and challenging negative thought patterns, managing emotions related to triggering situations, and changing behaviours that contribute to anxiety. Behaviours that are worked on often involve avoiding different places and situations where fear is stronger. The therapy helps individuals to gradually expose themselves to these in a controlled and systematic process, reducing anxiety over time. There is a re-learning process that stops associating the places with fear.

Medication: Some people with agoraphobia may be helped by medication, such as antidepressants (especially SSRIs) or anti-anxiety medication for more severe problems. These medications can help control anxiety symptoms, making it easier to participate in therapy and daily activities.

It is important to remember that treatment is individualized. What works for one person may not work for another. A combination of therapy, medication and support may be the most effective way to deal with agoraphobia. It is also important to seek help from a qualified health professional to design a treatment plan that is most appropriate for you.

How therapy can improve your life

Seeking professional help can significantly improve your quality of life. As it gives you effective tools to manage phobias and change the pattern you have developed that causes anxiety. Seeking help for psychological problems can be embarrassing, but talking to a psychologist can be incredibly liberating and helpful if you are living with a phobia that hinders your daily life.

Take the first step to booking a therapy session

Life is too short to let phobias limit you. Therefore, therapy is a step in the right direction to help you live a full and rich life. If you or someone you know is living with phobias, professional therapy can make a real difference. Our therapists and psychologists offer a confidential and safe environment to explore and treat your phobias.


12 common questions and answers about agoraphobia

What is agoraphobia?

Agoraphobia is an anxiety disorder where you have a fear of places and situations that can cause panic or helplessness.

How are phobias different from ordinary fears?

Ordinary fear is a natural reaction to an actual danger, while a phobia is an exaggerated fear that has no rational explanation. Phobias can be triggered even when there is no actual risk.

Is agoraphobia common?

Yes, it is common. In Australia 1,3% having agoraphobia. The rate is slightly higher for females, 0.9 percent, compared with 0.8 percent for males

How is agoraphobia treated?

Treatment can vary but often involves cognitive behavioural therapy (CBT), medication such as antidepressants or anti-anxiety drugs.

What causes agoraphobia?

Agoraphobia can be caused by a combination of several factors including heredity, biology, psychological factors, traumatic events and other mental health conditions such as panic disorder. What causes agoraphobia can vary from person to person.

Is it possible to get rid of a phobia?

Yes, with the right treatment and support, most people can overcome or at least reduce their phobic symptoms. However, professional help is usually required.

What is the difference between agoraphobia and panic disorder?

Agoraphobia is the fear of places or situations where you can also have panic attacks, which are sudden and intense anxiety attacks.

Can phobias lead to other mental health problems?

Yes, untreated phobias can lead to other problems such as depression or other anxiety disorders.

Can agoraphobia be medicated?

Some people with agoraphobia may be helped by medication, such as antidepressants (especially SSRIs) or anti-anxiety medication for a short period of time for more severe problems.

What is stage fright?

Agoraphobia is the same as agoraphobia but more of a word used in common parlance.

What is cognitive behavioral therapy?

CBT is an active evidence-based treatment method that works with thoughts, feelings and behaviours in different situations to improve quality of life and overcome certain symptoms.

Where can I seek help for my agoraphobia?

If you suffer from a phobia, we recommend that you contact a licensed psychologist or therapist. You can easily book a session online on our website. For more severe problems, we recommend that you contact your health care provider for a referral to a specialist clinic.

Treating agoraphobia step by step

This is what treatment for agoraphobia can look like, which can be overwhelming, but remember that you are not alone in overcoming your fear. There is help available and here is an idea of what treatment might look like:

Understanding and evaluation

The first step is to understand that you have a phobia and that it is okay to seek help for it. A professional psychologist can help you evaluate your situation and understand what is causing your fear. You may also be asked to fill in assessment forms.

Psychoeducation

You will learn about your phobia and how it affects you both physically and mentally. It is important to understand what happens in your body and mind when the fear occurs by looking at explanatory models for agoraphobia.

Tools for changing behaviours and patterns

You will work on identifying and changing patterns of thinking that are linked to your fear. This will help you develop a more nuanced picture and increase your ability to manage the phobia. Exposure therapy can feel scary, but it is an effective way to gradually get used to what you are afraid of. Together with your therapist, you will explore situations that trigger your phobia and learn how to deal with them. You will also be given homework to practice between sessions.

Medication (if needed)

In some cases, doctors may suggest medication to help with anxiety symptoms. This is something you and your doctor can discuss if appropriate.

Follow up and evaluate progress

You will have support from your psychologist throughout the process. At the end of the treatment, you will also receive a plan to continue practicing and maintain your progress over time.

Involve specialists (if necessary)

If you have severe symptoms, it may require more specialized care. Your psychologist can help you find the right help if necessary.

Book a first session with one of our licensed psychologists or therapists to see how we can help you.

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Written by melissa

Melissa is a Certified Kinesiologist who focusses on a client-centred, holistic and integrative approach to health and wellness. She has extensive experience in managing stress, anxiety, fears, phobias and trauma in her clients. Melissa uses visual and auditory feedback to directly access and solve the cause of psychological stressors in the body so that optimal well-being and balance is achieved.