Agoraphobia is an intense fear of being in public spaces or situations where escape might be difficult or where help wouldn’t be available if things went wrong. People with Agoraphobia may also be scared of other everyday situations, such as travelling on public transport, visiting a shopping centre, or even leaving the house.

What are the symptoms?

If a person with Agoraphobia finds themselves in a stressful situation, they may experience a number of physical symptoms such as rapid heartbeat and breathing (hyperventilating), feeling hot and sweaty, feeling sick/faint and experiencing chest pain.

People with Agoraphobia can also experience cognitive symptoms, many of which are associated with panic attacks. These can include fear that:

  • A panic attack will make you look stupid or feel embarrassed in front of other people or that people may stare at you
  • A panic attack will be life threatening
  • You would be unable to escape from a place or situation if you were to have a panic attack
  • You're losing your sanity
  • You may lose control in public
  • You may tremble and blush in front of people
  • People may stare at you

Other psychological symptoms can include feeling you would be unable to function or survive without the help of others, a fear of being left alone in your house (monophobia), or a general feeling of anxiety or dread.

Agoraphobia can also lead to behavioural changes such as an avoidance of situations that could lead to panic attacks (e.g., crowded places, public transport, queues);

  • avoiding situations that could lead to panic attacks, such as crowded places, public transport and queues
  • being housebound – not being able to leave the house for long periods of time
  • needing to be with someone you trust when going anywhere
  • avoiding being far away from home

Cause and treatment

Agoraphobia most commonly develops as a complication of panic disorder and can develop when a person has a panic attack in a specific situation or environment. People who develop Agoraphobia will begin to worry so much about having another panic attack that they begin to feel the symptoms of a panic attack returning when they are in a similar situation.

The exact cause of panic disorder and agoraphobia isn’t fully understood; however, most experts believe it is caused by a combination of biological and psychological factors. Some biological factors could include:

  • The ‘flight or fight’ reflex being wrongly triggered, resulting in a panic attack
  • An imbalance of neurotransmitters which may impact mood and behaviour
  • A malfunction in parts of the brain known to generate both the emotion of fear and the corresponding physical effect fear can bring

Some psychological factors could increase your risk of developing agoraphobia, including:

  • A traumatic childhood experience, such as the death of a parent or being sexually abused
  • Experiencing a stressful event, such as bereavement, divorce, or losing your job
  • A previous history of mental illnesses, such as depression, anorexia nervosa, or bulimia
  • Alcohol misuse or drug misuse
  • Being in an unhappy relationship, or in a relationship where your partner is very controlling

There are a number of treatment options that may considered for those suffering with Agoraphobia. This most common include a number of self-help techniques and lifestyle changes, such as breathing exercises, eating a healthy diet, and exercise regimes.

If symptoms do not improve with these options, psychological therapies may be considered and in some cases medicine (including selective serotonin reuptake inhibitors / SSRIs) can be used as a sole treatment.

Medical Cannabis and Agoraphobia

There is growing evidence that medical cannabis can be useful for the management of various anxiety-related conditions. If other treatment options have failed to manage the symptoms of Agoraphobia, medical cannabis products can be considered.

Our specialist physicians are experienced in assessing individual cases and helping to determine whether medical cannabis could be an effective option.

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