Agoraphobia: What it is and how it’s treated.

Dr. Melissa Shepard Smiling in white lab coat

By Dr. Melissa Shepard

People with agoraphobia become anxious that they will have a panic attack (or other embarrassing or scary symptoms) somewhere they cannot leave or get help, or where doing so would be very difficult or embarrassing.


Agoraphobia is relatively rare, affecting about 1.7% of people each year. Most people develop agoraphobia in their teens or early twenties. Agoraphobia is most commonly associated with panic disorder, but it doesn’t have to be.


With most anxiety disorders, the natural response to fear is to avoid what is causing it. Agoraphobia is no exception. People with agoraphobia may begin to avoid the following situations (or endure them with great difficulty):

– traveling on public transportation


– driving in a car (especially when stopped in traffic, at a light, or on a bridge)


– standing in a line


– being in a crowded place


– going to a store or mall


– being in a large open space (such as parking lot, park, lecture hall, or stadium)


– being away from a safe place (such as your home or a family member’s home)


– leaving the house without a safe person or safe object (such as emergency anxiety medication, significant other, cell phone, or a bottle of water).


Avoiding these situations temporarily relieves anxiety for someone with agoraphobia. However, this temporary relief leads to long-term worsening of symptoms. Avoiding anxiety-provoking situations leads us to believe that our fears are justified. Avoidance also means we miss the opportunity to show ourselves that we can handle these feared situations.


When we avoid the things we fear, our fears get bigger and bigger, and our lives get smaller and smaller. People with agoraphobia start to limit where they go more and more as their anxiety increases. In extreme cases, people with agoraphobia may become unable to leave their homes. Thankfully, like other anxiety disorders, agoraphobia is treatable.


Therapy can be a great place to start for mild agoraphobia (or can be used alongside medications for more severe or complicated agoraphobia).


Therapy can help people with agoraphobia face their fears and tolerate their anxiety. Therapeutic approaches like Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) have research evidence supporting their efficacy in treating agoraphobia.


I find that ACT techniques (pioneered by Steven Hayes) are the most helpful strategies for many of my patients. ACT also played a big role in getting my own panic disorder and agoraphobia under control.


ACT helps us to develop a mindful acceptance of our anxiety. Why in the world would you want to accept something that has caused you so many problems? Well, ACT practitioners argue that it’s not the anxiety itself that causes the problems. It’s your response to the anxiety.


Think about it. No matter how strong, anxiety itself can’t destroy you. Anxiety can’t cause you to miss out on the things that are important to you. Anxiety can’t hold you back or limit your progress. Anxiety is a set of feelings and bodily sensations. And these feelings and bodily sensations can’t force you to change your behavior or abandon the things that matter to you, no matter how strong they are. ACT teaches us techniques that we can use to stop struggling with anxiety and instead allow it to be there while we move forward with our lives.


The surprising (and maybe counterintuitive) result is that when we stop fighting our anxiety and start accepting it, it loses its hold on us. Remember earlier when I mentioned that avoidance causes your life to get smaller and smaller? Well, acceptance does the opposite. It shows your brain that you can handle all of the things you fear, and your life expands in response.


In addition to these therapeutic approaches, we can also use medications to treat agoraphobia and related anxiety disorders. We typically use antidepressants (like SSRIs), but other medications can be useful as well. If you struggle with agoraphobia or any other anxiety disorder, talk to your doctor or therapist- it can definitely get better!




References and Further Reading:


Please note that some links may include Amazon links. As an Amazon Associate, I earn from qualifying purchases. This means that I get commissions for purchases made through links in this post. This helps me run the site, including this resources section.


Mindfulness and Acceptance Workbook for Anxiety by John Forsyth and Georg Eifert


The Anxiety and Phobia Workbook by Edmund Bourne


The Anxiety and Worry Workbook – The Cognitive Behavioral Solution by David Clark and Aaron Beck


Disclaimer: My content is for educational purposes only and cannot serve as medical advice or therapy. If you have specific questions or need advice, please talk to your doctor or therapist.


If you are in crisis, please call the National Suicide Prevention Hotline at 1-800-273-8255 or text HELLO to 741741 in the US or UK or 686868 in Canada.


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If you need help managing anxiety, check out my Anxiety Bootcamp course here:


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