Currently, panic disorder is diagnosed as occurring with or without agoraphobia. It is also possible to be diagnosed with agoraphobia without a history of panic disorder. Doctors and other mental health providers use the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders (DSM) to determine which diagnosis is most appropriate. Below you will find information straight from the DSM, including diagnostic criteria, features, prevalence, and treatment options for agoraphobia. This information covers five common FAQs about agoraphobia that you should know.
What is Agoraphobia?
Agoraphobia is defined as a fear of having a panic attack in a situation where it would be challenging or embarrassing to escape. This fear often leads to persistent avoidance behaviors, in which the person begins to stay away from many places and situations in which they fear panic may occur. For example, some commonly avoided circumstances include driving a car, leaving the comfort of home, shopping in a mall, traveling by airplane, or simply being in a crowded area.
Due to these avoidance behaviors, the life of a person with agoraphobia can become very restrictive and isolating. Agoraphobia can greatly affect a person’s personal and professional life. For example, heightened fears and avoidance behaviors can make it difficult for a person with agoraphobia to travel for work or to visit with family and friends. Even small tasks, such as going to the store, can become extremely difficult to do. Fear and avoidance can become so severe that the agoraphobic person becomes secluded to their own home.
How is Agoraphobia Different From Other Phobias?
The avoidance behaviors present in agoraphobia differ from the diagnostic criteria of a specific phobia. For instance, a person with agoraphobia may avoid traveling by airplane due to a fear of having a panic attack on a plane and not necessarily due to aerophobia, or a fear of flying. Similarly, an agoraphobic may avoid crowds, fearing the embarrassment of having a panic attack in front of a lot of people. Such a fear is not the same as social anxiety disorder, which is a separate mental health condition that involves anxiety about being negatively evaluated by others.
Can Agoraphobia Occur Without Panic Disorder?
Although rare, it is possible to be diagnosed with agoraphobia without having a history of panic disorder. When this occurs, the person still has a fear of being stuck in a situation where escape would be difficult or humiliating. However, they do not fear having full-blown panic attacks. Rather, they are afraid of having some of the frightening physical symptoms of panic and anxiety or other intense physical issues, such as vomiting or having a severe migraine. For instance, the person may be afraid that they will lose control of their bladder in public or faint without any help being available.
What is the Prevalence of Agoraphobia?
Approximately one-third to half of those diagnosed with panic disorder will also develop agoraphobia. The National Institute of Mental Health (NIMH) reports that agoraphobia occurs to approximately 0.8% of adults in the U.S. population in any given year. This condition typically develops in adulthood. However, agoraphobia can emerge earlier in adolescence.
What are the Treatment Options for Agoraphobia?
If a person does develop agoraphobia with panic disorder, symptoms typically begin to occur within the first year that the person starts having recurring and persistent panic attacks. Agoraphobia can get worse if left untreated. For the best outcomes in managing agoraphobia and panic symptoms, it is important to seek treatment as soon as symptoms arise.
Treatment options typically include a combination of both medication and psychotherapy. The treatment process may include some systematic desensitization, in which the agoraphobic person gradually confronts avoided situations. Many times, the person will fare better in facing their fears if accompanied by a trusted friend.
Through the support of family and friends and professional help, a person who is struggling with agoraphobia can begin to manage their condition. Through medication and psychotherapy, a person with agoraphobia can expect to eventually experience fewer panic attacks, fewer avoidance behaviors, and a return to a more independent and active life.
American Psychiatric Association. "Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision" 2000 Washington, DC: Author.