Agoraphobia: causes, symptoms and therapy

By Cristiano Antonino On Mar 20, 2023

The term agoraphobia, from the Greek phobia – fear – and agora – square – is used to indicate the fear of open and crowded spaces

The Diagnostic and Statistical Manual of Mental Disorders – DSM IV – classifies agoraphobia as an anxiety disorder, the main symptom suffered by agoraphobia sufferers.

The anxiety is not so much related to the fear of large, open places, but to the fear of finding oneself in situations in which leaving or escaping may be difficult.

Often agoraphobia manifests itself as a secondary disorder to panic attacks or anxiety crises, which is confirmed by studies according to which about 90 per cent of agoraphobics suffer from panic attacks.

What are the causes of agoraphobia?

The causes that lead to developing a fear of open spaces are not entirely clear but are defined through the knowledge of the person suffering from the disorder.

Since agoraphobia often occurs following panic attacks, it is possible that the causes can be traced back to traumatic events or severe stress.

According to some studies, the genetic factor also plays a role: in a pair of homozygotic twins, for example, it is possible to find the same disorder in both.

Symptoms of agoraphobia

Some of the symptoms of agoraphobia are anxiety, feeling lost, dyspnoea, dizziness, sweating, trembling, choking, chest pains, fear of losing control, paresthesias, chills or flushing.

All symptomatic manifestations of the disorder can be traced back to anxiety and panic.

In order to avoid the occurrence of these symptoms, agoraphobia sufferers implement a series of behaviours to avoid the feared situations that could trigger fear: they avoid going to crowded places or leaving the house alone.

In the most severe cases, it seems impossible to leave one’s home even in the company of trusted people.

Avoidance has enormous repercussions on daily activities and the inability to cope with the disorder triggers a vicious circle that reinforces agoraphobia.

How to treat agoraphobia?

Cognitive-behavioural therapy can be adopted in the treatment of agoraphobia and aims to modify the negative behaviour and thoughts that underlie the disorder.

During the course of therapy, those with agoraphobia are guided in the management of anxiety and in the teaching of those practices that reinforce positive thinking in order to break the vicious circle of avoidance-avoidance, including through exposure techniques.

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