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Information on Agoraphobia
What is it?
Agoraphobia is a very complex phobia usually manifesting itself as a collection of inter-linked phobias.
For example many agoraphobics also fear being left alone (monophobia), dislike being in any situation where they feel trapped (exhibiting claustrophobia type tendencies) and fear travelling away from their 'safe' place, usually the home. Some agoraphobics find they can travel more easily if they have a trusted friend or family member accompanying them, however this can quickly lead to dependency on their carer.
The severity of agoraphobia varies enormously between sufferers from those who are housebound, even room-bound, to those who can travel specific distances within a defined boundary.
DIY Self diagnosis
If you can answer YES to most of the questions it is likely that you are affected by that condition.
During the past 6 months:-
- Do you regularly avoid situations because you are frightened of having a panic attack?
- Do any of the following make you feel anxious:-
- Going outside away from your home
- Standing in long lines
- Being in a confined space such as being in a tunnel, on the underground etc.
- Being at home alone
- Being in wide open spaces, such as in a field, in a park
- Being in crowded places
- Do you avoid being in any of the above situations?
ANXIETY UK strongly advises that people seek further information and guidance from their GP who will be able to make a formal diagnosis.
DSM-IV criteria for Agoraphobia
The Diagnostic and Statistical Manual of Mental Disorders (DSM) lists the different categories of mental disorder and the criteria used for diagnosing them. We have more information on the DSM-IV information page.
Agoraphobia is not a codable disorder. Code the specific disorder in which the Agoraphobia occurs (e.g. 300.21 Panic Disorder with Agoraphobia or 300.22 Agoraphobia without history of panic disorder.
- Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed Panic attack or panic like symptoms. Agoraphobia fears typically involve characteristic clusters of situations that include being outside the home alone: being in a crowd or standing in a line; being on a bridge: and traveling in a bus, train, or automobile. Note: consider the diagnosis of Specific Phobia if the avoidance is limited to one or only a few specific situations or Social Phobia if the avoidance is limited to social situations.
- The situations are avoided (e.g. travel is restricted) or else are endured with marked distress or with anxiety about having a panic attack or panic like symptoms, or require the presence of a companion.
- The anxiety or phobic avoidance is not better accounted for by another mental disorder, such as social phobia (e.g. avoidance limited to social situations because of fear of embarrassment), Specific phobia (avoidance limited to a single situation like elevators), Obsessive Compulsive Disorder (e.g. avoidance of dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g. Avoidance of stimuli associated with a severe stressor) or Separation Anxiety Disorder (e.g.avoidance of leaving home or relatives).
DSM-IV diagnostic criteria for 300.22 Agoraphobia without history of Panic Disorder
- The presence of Agoraphobia related to fear of developing panic- like symptoms (e.g. dizziness or diarrhea).
- Criteria have never been met for Panic Disorder.
- The disturbance is not due to the direct physiological effects of a substance (e.g. a drug of abuse, a medication) or general medical condition.
- If an associated general medical condition is present, the fear described in criterion A is clearly in excess of that usually associated with the condition.
Summary of DSM-IV diagnostic criteria for 300.01 Panic Disorder without Agoraphobia and 300.21 Panic Disorder with Agoraphobia
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Both (1) and (2)
- Recurrent unexpected Panic Attacks
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At least one of the attacks has been followed by at least a month of the following:
- Persistent concern about having additional attacks
- Worry about the implications of the attack or its consequences (e.g losing control, having a heart attack, “going crazy”)
- A significant change in behavior related to the attacks
- This criterion differs for Panic Disorder with and without Agoraphobia as follows: For 300.21 Panic Disorder with agoraphobia: the presence of Agoraphobia. For 300.01 Panic Disorder without Agoraphobia: absence of Agoraphobia.
- The Panic Attacks are not due to the direct physiological effects of a substance (e.g. a drug of abuse, medication) or a general medical condition (e.g. hyperthyroidism).
- The Panic Attacks are not better accounted for by another mental disorder, such as Social phobia (e.g. occurring on exposure to feared social situations), Specific Phobia, (e.g. on exposure to phobic situation), Obsessive Compulsive Disorder (e.g. on exposure to dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder, (e.g. in response to stimuli associated with a severe stressor), or separation Anxiety Disorder (e.g. in response to being away from home and close relatives).
Want to know more
This ANXIETY UK site has information on a range of resources to get more detailed information and help.
ANXIETY UK Publications
- ANXIETY UK publishes a fact sheet and tapes dealing with Agoraphobia available from the ANXIETY UK online shop
Recommended Reading
Overcoming Agoraphobia by Melissa Murphy
'Overcoming Agoraphobia is an essential read for anyone affected by this very disabling anxiety disorder. Interspersed with real life case studies, it provides detailed information on all aspects of agoraphobia, including helpful sections on recognizing triggers and women's health and the relationship between hormones and anxiety... an excellent read' - Nicky Lidbetter, Chief Executive, Anxiety UK
Purchase online
Life isn't just a panic: stories of hope by recovering agoraphobics
A. Pace
ISBN 0963166638
Life Isn't Just a Panic is filled with stories and information from the National Institute of Mental Health to give hope to those like me who thought they'd spend the rest of their lives in a living hell. There is hope. There is recovery. You do have a life and this book tells how others like you did it.
Purchase online | More recommended reading
Recommended web sites
There are no websites that specifically deal with agoraphobia. There are however lots of other websites of interest dealing with specific phobias and conditions.
Useful workbook
- click here to download a copy of Professor Karina Lovell's agoraphobia self help workbook
Personal experiences
Do you suffer from agoraphobia and want to share your experience with other people? Send us your experience and we will put selected ones here.
I was agoraphobic for almost 15 years
For a long time, I was too afraid to try my CPN's suggestion of trying to go a little further each day, so eventually he stopped coming and concentrated on working with someone who would try out his ideas!
Around 2002, I just decided however to give it a try. It took a few months of hard work, minor (thank goodness) panic attacks and a lot of sweat, but now I can go out and about as if I had never suffered in the first place. I realise however that I must remember that I will always be a 'recovering agoraphobic' and that I might therefore relapse at some point, though god willing, this will never happen.
For everyone who is totally housebound, and who feel that there is no hope for them, DO NOT GIVE UP. I felt like giving up less than 3 years ago, and look at me now. Agoraphobia can be beaten.
I started with agoraphobia approximately 3 and a half years ago.
It began when I started suffering initially with stress and anxiety. I then had a seizure in a shop as my body could not cope with the stress. I now find it really difficult to go out alone and will not go anywhere outside the house unless I really have to. I recently went on holiday for a week but had a massive panic attack on the way back and am still recovering from it. My partner bought me a dog to keep me company at home as I also hate being alone in case I have a panic attack. I have however learnt to control the attacks by occupying myself with the dog and the internet. I have also started trying to go into shops - even if it is only going down one aisle and then coming straight back out. I'm absolutely terrified if anyone says anything to me, but I am trying to push myself further and further each day, and one day I know I will conquer it. I think you can overcome agoraphobia, but it takes time. If you push yourself and set yourself a task every day, then eventually you will conquer it. I'm at the stage where I can now walk to the corner shop, buy something and walk back home on my own, which I feel very proud of. I never thought that I would go out again at one point in my life, but I am putting this all behind me. Life is too short. Set yourself small goals/tasks and try to stick to them. Do the same task for a couple of weeks every day until you can complete it without anxiety.
I had my first agoraphobic panic attack aged 12.
I am now 59 and still get them and my life has been a series of work arounds. Although I have great difficulties with the Great Outdoors I have found a way to get to most places I want to. I found all those years ago that I could manage to get out with a bike and then with a car although I still have a bike in the boot. Now my latest aquisition is a bike that weighs only 6 kg and folds into nearly nothing so I bought a decent rucksack and bingo I managed to get up the peaks in Glen Coe. I hope this helps someone. I don't think I'll ever be free of the Agora but at least I've got it in a corner so to speak. Still can't fly anywhere which is a pity.
Hi I'm 42 and its been several years now that I have been without my agoraphobia type phobia.
My CPN (Community Psychiatric Nurse) assisted my recovery by making me understand the Cognitive Behavioural Therapy (CBT) method. I was staying indoors nearly all the time and had done so for over 15 years. I wish now that I had managed to get better and get onto the path to recovery much sooner. I missed out on enjoying so much of my 20s and 30s and although I still experience difficulty around social situations, I'm slowly improving. So anyone who has a phobia I'd recommend you try CBT. If you stick at it you will eventually stop feeling self conscious and will get out of the habit of staying at home.
Hello, I'm a teacher and I've been suffering from agoraphobia for 23 years.
I've had individual/group psychotherapy... that helped for a while until the next major life-event came along. The root cause of my fear of open-spaces came from my parents neglecting me as a baby. They used to leave me in my pram alone in a park, and during a thunderstorm. I was unaffected by agoraphobia until the age of about 30 - that's when my wife started threatening me with divorce and this triggered the anxiety. I had a nervous breakdown and after another 8 years I let her go. The panic associated with agoraphobia can be mild or severe depending on the level of stress/phobic-situation. It seems to come and go for me. It's the open-spaces that affect me most. As there are 1001 phobias, I consider myself to be 'normal'....you know, we all know someone with a fear of spiders presenting with panic-disorder like ours and we can't understand theirs and vice-versa. Theirs is a 'specific-phobia' and they can remove/exit the situation but with agoraphobia, it envelops you. Having read the other readers' experiences, it seems that the answer lies with extending your comfort-zone/radius by gradual exposure and attending self-help groups. Regards.
Hello, I hope this gives some encouragement.
I suffered from agoraphobia from the age of 12 but I'm sure that I might have had the symptoms of this condition even before this. I was put on Valium and ignored. I forced myself to get on with my life - hiding my problem from most of my friends. When I did have an attack I usually ended up in casualty somewhere because whomever I was with thought I was about to die and called an ambulance. Eventually the agoraphobia took hold completely and I became a prisoner in my bedroom - terrified out of the outside world. One day I decided enough was enough and I sought help. That was 15 years ago and I have not had a full blown panic attack since. I know how to deal with anxiety now and stop panic it its tracks. I have travelled the world solo - going to some of the most remote places in the world and some of the most populated. The day I stood looking at Everest was my proudest - I was free.
My anxiety centres around being ill whilst away from the safety and comfort of my own home.
As sson as I know I'm going to be more than half an hour from my home, or equally if I'm not in control of getting myself back to my home, e.g. travelling with a companion, then the anxiety kicks in. When I'm anxious I get the palpitations and sweats but it goes more to my stomach than my chest so I get acute diarrhoea and nausea. If I can't get the anxiety under control it starts making me physically sick and therefore compounding my fear of being ill. This has lead to such a vicious cycle that I'm starting to become agoraphobic.