Agoraphobia is a phobia, or intense fear, that a person develops when he or she is afraid of certain places or situations that he or she finds threatening, uncomfortable, or stressful. People with agoraphobia will be afraid to be trapped in or unable to avoid or escape places that may cause them to feel threatened, embarrassed, restrained, or exposed to elements that are uncomfortable or unpleasant. Agoraphobia is a progressive disorder, meaning that it will get progressively worse with time if it is not properly addressed with a mental health professional. In the most severe cases of agoraphobia, a person will be fearful of leaving his or her own home. This prevents him or her from being able to step outside the front door to run errands, go to work, or take care of other responsibilities.

Agoraphobia: Causes & Risk Factors

Agoraphobia is a phobia, which means that is linked to anxiety. Anxiety is felt as a result of being stressed. The stress response, or ‘fight-or-flight’ response, triggers the brain to engage the central nervous system, which is responsible for reacting to stressful or threatening situations. People with agoraphobia tend to have an overactive fight-or-flight response, which results in having a fear reaction when exposed to certain environments, people or situations. The following can cause an overactive fight-or-flight response, which results in the onset of agoraphobia:

Panic Disorder Or A History Of Panic Attacks

Agoraphobia is most often linked to panic disorder. In fact, up until the most recent diagnostic and statistical manual for mental health disorders, agoraphobia was considered to be directly linked to panic disorder and was not a standalone diagnosis. This means that previously a person could not be diagnosed with agoraphobia on its own, but was rather a qualifier for panic disorder. Recently, researchers and mental health professionals have seen that agoraphobia causes symptoms and issues that made it appropriate for agoraphobia to be its own disorder. However, panic attacks remain a symptom for agoraphobia.

Panic disorder is a disorder in which a person regularly experiences panic attacks. Panic attacks are difficult to live with and cause a great deal of distress within an affected person. The link between panic attacks and agoraphobia is the people who were diagnosed with panic disorder with agoraphobia developed agoraphobia because the places in which they had a panic attack would become a trigger for them. This means that if a person had a panic attack on a bus, the affected person believed that being on the bus was the reason for the panic attack. Therefore, the affected person who developed the fear of buses associated the bus with panic attacks, and concluded that buses were dangerous. With time, this thought pattern generalizes to other places, resulting in agoraphobia.

History Of Trauma Or Abuse

Those who have a history of abuse or trauma may develop agoraphobia as a reaction to the stress induced by the traumatic or abusive situation. There are several situations that can result in the onset of agoraphobia, including:

  • Witnessing a violent act
  • Being a victim of domestic abuse
  • A history of verbal, mental, physical, or sexual assault or abuse
  • Being a victim to a natural disaster
  • Witnessing or being victim to an act of terror

Each of these situations is very traumatic for a person and can cause a person develop a fear of the outside world. A traumatic or abusive situation is a powerful experience that warps a person’s sense of self, perception of the world, and expectations for the future. For many, the traumatic event or abuse experienced is so intense that he or she associates places and situations with danger. Many situations may remind them of the traumatic situation, and eventually they will perceive the world as an unsafe place. This perception causes a great deal of anxiety and emotional distress, causing them to shut themselves away from the world in an effort to keep safe.

Social Anxiety

Agoraphobia can also be the result of social anxiety. People with agoraphobia tend to feel anxious or uncomfortable in social situations. This discomfort typically stems from a fear of embarrassment and distrust for other people. For example, if a person is abused as a child, he or she learns that people are dangerous. This would contribute to a fear of being in public places or a fear of being humiliated by or around others.

Agoraphobia can also result from being bullied as a child or teenager. Childhood is a critical time to learn how to relate to others, and when a child is bullied, he or she develops a poor sense of self, and a poor outlook on the world and his or her own future. By the time the affected child enters adulthood, he or she has the risk of developing agoraphobia as a result of the low self-esteem and fear of others. Keep in mind that bullying is not limited to school peers. Anyone can be considered a bully, including adults, teachers, parents, family members, siblings, and even close friends.

Germaphobia

Another possible way to develop agoraphobia is to suffer from germaphobia. Germaphobia is a fear of germs and contamination.  People who suffer from germaphobia go to extremes to avoid germs, bacteria, and any foreign substance that they deem dangerous. The outside world is covered with germs, bacteria, and substances that can be passed from one thing to another, so in effort to avoid being contaminated, a person with germaphobia will avoid many places that are considered unsanitary. As a result, those who are germaphobic are at a higher risk of suffering from agoraphobia, as they actively avoid places that they feel may pass on contamination.