Fear is a powerful feeling that causes people a great amount of anxiety and emotional distress. Many people experience phobias, or extreme fears of people, places, things and situations that typically seem as relatively harmless to others. A phobia is a form of anxiety as it causes symptoms of anxiety and panic attacks in reaction to exposure to the feared trigger. One common phobia people suffer from is called agoraphobia. Agoraphobia is an intense fear of crowded, busy, (seemingly) threatening, and high-energy environments. Agoraphobia can manifest in many different forms, like fear of a crowded environment, fear of enclosed spaces, and even a fear of the world outside one’s own home.
The most well known form of agoraphobia is the fear of leaving the house. With this kind of agoraphobia, a person is afraid of leaving his or her home. He or she will become anxious when needing to interact with the environment outside of his or her own house or private property. A fear of leaving the house severely affects many people who suffer from agoraphobia. For those who suffer from a fear of leaving the house, the environment outside of their own home is believed to be unsafe, uncomfortable, and life threatening. This belief is enough to cause intense anxiety and distress, which will result in a panic attack. People who fear leaving the house fear situations like:
- Getting into an accident while running errands or spending time outside
- Needing to interact with others or running into people who they know but do not want to speak with
- Experiencing intense panic and anxiety attacks due to the overwhelming environment outside of their home
- Feeling trapped or unable to escape uncomfortable situations
- Doing something that is awkward or embarrassing
- The feeling of being helpless in the environment they cannot control
- Sensitivity to the activity of the outside world that seems overwhelming and chaotic
- Being exposed to other triggers that cause them to get anxious, panicky, afraid or uncomfortable
What Causes The Fear Of Leaving The House?
A fear of leaving the house is a fear that grows more intense over time. The fear often begins with a fear of enclosed or crowded spaces, and eventually progresses to a fear of the outside environment as a whole. This fear is developed as a result of chronic anxiety. Without understanding and properly coping with the general anxiety and the agoraphobia, the case of agoraphobia will become so severe that it will cause a fear of leaving the house.
A fear of leaving the house is a difficult fear to cope with because it can be difficult for the affected person to understand the source of the fear and how it affects him or her. A fear of leaving the house is developed by anxiety and resulting panic attacks. Eventually, the affected person will experience anxiety and panic attacks often enough that the brain will link the attack with being outside of the house, instead the poor internal regulation of stress and anxiety. This means that the person will believe that he or she is afraid and panicking as a result of the environment, when really it is his or her own fear of feeling anxious and panicky that has caused the affected person to associate the feelings of panic and anxiety with the innocuous environment outside of the house. This causes the affected person to believe that the only safe environment is his or her own home, where he or she is in control of the environment and know what to expect.
Risk Factors Of A Fear Of Leaving The House
There are several risk factors that contribute to a person’s likelihood of developing a fear of leaving the house. Those who are afraid to leave their home also suffer from anxiety-related issues. These issues can be caused by several factors, including:
- Genetics
- Upbringing
- History of agoraphobia or related phobias
- History of trauma or abuse
- Social anxiety
- Environmental influences, like entering a chaotic environment or being exposed to environmental and social influences that disrupt your core values, morals, or understanding of the world
A fear of leaving the house begins with agoraphobia, which can develop in children as young as five years old. The fear will start with anxiety regarding danger or threat of embarrassment and humiliation when a child is away from his or her house, family, and secure home environment. As the child grows, the fear will become more intense. If left untreated, the child’s case of agoraphobia can reach the point of a fear of leaving the house by the time he or she reaches mid to late 20’s.
A fear of leaving the house is closely linked with panic disorder. Those who suffer from untreated panic disorder are at higher risk to develop a fear of leaving the house than those who regularly attend treatment. This is because when a condition of agoraphobia is left untreated, the affected person will strengthen maladaptive coping strategies, like avoidance of uncomfortable situations and the intense need to control his or her environment. These maladaptive coping strategies will cause the case of agoraphobia to progress, resulting in the fear of leaving the house.
What Are The Symptoms Of A Fear Of Leaving The House?
A fear of leaving the house is a powerful fear. The fear is so powerful that many people spend months and sometimes years without stepping outside their front door or off of their own property. Many cases reach this severity with time, but there are also more mild cases in which a person is capable of leaving the house, but only does so when it is absolutely necessary. This fear causes many difficult symptoms, like:
- Severe anxiety
- Agitation and mood swings
- Panic attacks
- A need to be in control of one’s environment
- Social anxiety
- Feelings of embarrassment and shame
- Avoiding leaving the house until absolutely necessary
- Going without many necessities for long periods of time (groceries, medications, etc.)
- Avoiding responsibilities that involve leaving the house, like work and family gatherings
- Fear of open spaces and being outside
- Fear of public places, like parks, train and bus stations, stores, etc.
How Agoraphobia Is Diagnosed
It typically takes many years for a person to develop a fear of leaving the house. A person who has a fear of leaving the house will be diagnosed with either ‘Agoraphobia’ or ‘Panic Disorder with Agoraphobia’. This is because agoraphobia typically develops as a result of panic disorder, but recently has been deemed appropriate for a standalone diagnosis in some cases, according to the Diagnostic and Statistical Manual for Mental Health Disorders, 5th Edition. If a person who is afraid to leave the house is appropriate for diagnosis, he or she will meet the following diagnostic criteria:
- Intense fear of at least 2 situations that would trigger agoraphobia, such as a fear of being outside, a fear of leaving the house, a fear of public places, a fear of open spaces, a fear of standing in line or interacting with people, etc.
- Fear and active efforts to avoid stressful situations that may trigger anxiety and panic attacks.
- Prevalence of avoidant behaviors to prevent anxiety and panic attacks, like fleeing crowded, cramped or uncomfortable situations, avoiding places, people and situations that require the affected person to leave his or her comfort zone, or avoiding responsibilities that involve leaving the house.
- Having overall quality of life impacted as a result of the fear, anxiety and panic. Such examples include:
- Family and interpersonal issues
- Health issues related to not leaving the home
- Feeling anxious and afraid for most of the day on most days
- Developing a low self-esteem and depressed mood
What Are The Consequences Associated With A Fear Of Leaving The House?
Being afraid to leave home has a major impact on a person’s life. A home is meant to be a safe secure place to rest, make happy memories, and rejuvenate after a long day of being out and about. However, with a fear of leaving the house, the walls become a person’s whole world, and sometimes even a tomb that an affected person cannot escape. There are many consequences that come with a fear of leaving the house, like:
- Loss of employment or financial security
- Loss of friends and social life
- Inability to run errands
- Health issues, like malnutrition, obesity, poor diet, and a lack of Vitamin D
- Substance abuse and addiction
- Mental health disorders, like depression, panic disorder, personality disorders, or anxiety
The more time a person suffers from a fear of leaving his or her home the more severe the symptoms become. At first, the symptoms and consequences will be minor, like missing a social gathering here or there, or putting off responsibilities like grocery shopping until absolutely necessary. With time, these symptoms will become worse and have the potential to become so severe that the affected person may become afraid to even open the front and back door or windows. That is why it is important to seek treatment as early as possible. With early intervention, the affected person will reduce the chances of developing an intense fear of leaving the house.
Treatment for A Fear Of Leaving The House
If you have developed or think you may be developing a fear of leaving your home, or symptoms related to agoraphobia, it is important to seek professional attention. Professional counseling services will be able to help you learn ways to cope with symptoms related to your fear of leaving your home, and what you can do to feel more comfortable and confident in handling the issues related to the fear. Professional counseling will teach you how to manage your anxiety and control your fear of leaving your home, which will empower you to take control over your life and your future. If your fear of leaving the house has progressed to the point in which you cannot physically attend treatment, there are still options available to you. Two common types of professional counseling for a fear of leaving the house are:
- Online Therapy: Online therapy is a form of virtual therapy in which you speak to a licensed therapist via text, live phone conferencing, or live video conferencing. Research supports the effectiveness of online therapy, reporting that it is as effective as live in-person therapy. Keep in mind that such therapeutic services are a bit different than traditional therapy, and may take a few sessions before you feel comfortable with the online mode of communication. Online therapy for agoraphobia will be geared toward cognitive behavioral therapy (CBT). CBT aims to identify triggers for the fear of leaving the house and challenges the fear with rational thinking. CBT also incorporates mindfulness and relaxation exercises that reduce anxiety and lessen the fear that the phobia of leaving the house creates.
- There are also ‘home visit’ services that some therapists will provide. This means your therapist will come to your home for scheduled sessions. Traveling therapists are often trained in issues related to agoraphobia and a fear of leaving the house. They will be able to provide coping skills, techniques, and tools that help reduce the fear of leaving your home. For example, traveling therapists may use virtual reality programs that help reduce the anxiety associated with leaving the house. This exercise is referred to as Exposure therapy, or systematic desensitization. The goal of exposure therapy is to take baby steps in exposing the patient to situations that cause stress. With enough exposure the patient becomes desensitized, meaning the fear response becomes less intense with repeated exposure via virtual reality technology. It has been proven effective in decreasing symptoms associated with agoraphobia.