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Agoraphobia is an anxiety disorder characterised by a fear of having a panic attack in a situation that is difficult to escape from or where help may not be available. This fear leads people with agoraphobia to avoid certain situations, resulting in feelings of isolation.

This can help if:

  • you worry about having panic attacks
  • you’d like more information about agoraphobia
  • you’re worried about a family member or friend who may be experiencing agoraphobia.
Boy at window looking down

What is agoraphobia?

People with agoraphobia experience anxiety about having a panic attack. They are likely to fear specific places or situations where escape or getting help may be difficult if a panic attack were to occur. This can include fear of crowded places or public transport, or any situation where they’ve had a panic attack before. People with agoraphobia will usually avoid these situations or engage in ‘safety behaviours’ to help manage their anxiety (such as only catching the bus with a parent or friend). Avoidance and safety behaviours can lessen anxiety in the moment, but in the long term they cause the anxiety to worsen and make a panic attack more likely.

Signs of agoraphobia include:

  • avoiding situations because you’re concerned you’ll have a panic attack
  • worrying that if you have a panic attack you won’t be able to get away easily or that nobody will be able to help you
  • agreeing to go to certain places only in the company of others
  • experiencing anxiety or panic when you can’t avoid certain situations.

What causes agoraphobia?

There’s no one, single cause of agoraphobia. It can be associated with a range of individual and environmental factors. A family history of agoraphobia or other anxiety disorders, and having experienced a panic attack or traumatic event in the past, both increase the likelihood that a person will develop agoraphobia.

Because people with agoraphobia tend to resort to avoidance (of places or situations) and unhelpful thinking patterns (e.g. ‘My heart is racing. I must be having a heart attack’), effective treatment targets these factors.

What treatment is available?

The first step in getting effective treatment is to seek professional help. The most common type of treatment for agoraphobia is called cognitive behavioural therapy (CBT), which is based on:

  • Education – learning about panic symptoms and why they occur.
  • Change in thinking – identifying and reframing unhelpful thoughts that worsen the anxiety.
  • Change in behaviour – exposure to situations and symptoms that have been avoided in the past because they feel dangerous (such as a crowded place or a racing heart).

Changing your behaviour is often the most difficult, yet the most important, part of treatment. If it feels scary to think about putting yourself in uncomfortable situations, just remember that a mental health professional will work at a pace that suits you.

When you find yourself in a situation that causes you to panic, try these suggestions:

  • Focus on your breathing – feelings of panic and anxiety get much worse when you breathe too quickly. Try to breathe slowly and deeply, counting to three on each breath in and again on each breath out.
  • Focus on something non-threatening – remind yourself that your frightening thoughts are a sign of your panic, rather than of what’s actually happening, and that they’ll soon pass. Try counting backwards from 100, or recall the words of a favourite song.

What can I do now?