Agoraphobia
Diagnostic Criteria
• DSM-5 Criteria
• Marked fear or anxiety about 2+ of the following:
✅ Public transportation
✅ Open spaces
✅ Enclosed spaces
✅ Crowds/lines
✅ Being outside alone
• Key Features:
• Fear of being unable to escape or get help
• Situations always trigger fear/anxiety
• Avoided, need a companion, or endured with distress
• Fear is excessive & persistent (6+ months)
• Causes significant life impairment
• Not better explained by another condition
Prevalence
• Agoraphobia affects 1-2% of the
population over a lifetime and 0.9% of
U.S. adults yearly. It is twice as
common in women and typically begins
before age 35. The condition often
occurs with panic disorder but can
develop independently.
Etiology
• Agoraphobia develops due to a combination of
biological, psychological, and environmental
factors:
• Genetics: Higher risk if a close relative has anxiety
disorders.
• Brain Chemistry: Dysfunction in the amygdala
and fear-processing networks.
• Psychological Factors: Learned fear responses
from past panic attacks or trauma.
• Environmental Triggers: Stressful life events,
childhood trauma, or overprotective parenting.
• Cognitive Biases: Tendency to overestimate danger
and lack confidence in coping skills.
Treatments
• Cognitive-Behavioral Therapy (CBT) – Helps reframe
anxious thoughts and gradually face feared situations.
• Exposure Therapy – Gradual, controlled exposure to
feared environments to reduce avoidance.
• Medications:
• SSRIs (e.g., fluoxetine, sertraline) – First-line treatment
for anxiety.
• Benzodiazepines (short-term use) – Reduce acute
anxiety but risk dependence.
• Lifestyle Changes – Regular exercise, mindfulness, and
stress management techniques.
• Support Groups & Therapy – Provides encouragement
and coping strategies.
Misc Facts
• Onset: Usually begins in the late teens to
early 30s, but can develop at any age.
• Common Comorbidities: Often occurs with
panic disorder, depression, and other
anxiety disorders.
• Duration: Can be long-term if untreated, but
early treatment improves recovery.
• Impact on Life: Can cause social isolation,
difficulty working, and reduced quality of
life.
• Notable Cases: Some believe Charles
Darwin may have had agoraphobia.