Agoraphobia Dr Trisha Macnair Although agoraphobia is thought of as a fear of open spaces, the real underlying fear is more complex, encompassing several aspects of daily life.

In this article

What are the symptoms?

Who's affected?

What's the treatment?

The person feels especially vulnerable and exposed

The phobias or fears in agoraphobia involve activities such as leaving home, entering public places or travelling alone. In these situations the person feels especially vulnerable and exposed, with nowhere to escape to or hide if things go wrong.

An unusual but not uncommon feature of agoraphobia is a fear of crossing bridges (known as gephyrophobia). This has nothing to do with huge drops from the side of a bridge, but is related to a feeling that, once on the bridge, there is no immediately available exit.

The degree of fear and avoidance behaviour varies. Although many sufferers do manage to get out to work, some become completely housebound.

Agoraphobia typically affects women and begins in early adulthood. They may have other psychological problems too, especially:

• Anxiety
• Depression
• Depersonalisation
• Panic attacks - these can cause physical symptoms including shaking, sweating, palpitations, headache, nausea, chest pain, tingling or spasm of the hands
• Obsessive behaviour
• Social phobia - excessive fear that a performance or social interaction will be inadequate, embarrassing or humiliating

Unless agoraphobia is treated it can go on for many years, completely distorting the way a person leads their life.

There are effective treatments that will help most people return to a normal life. These include:

• Drug treatments - medicines developed in recent years that act on levels of a chemical called serotonin in the brain seem to be particularly effective
• Cognitive behavioural therapy - this type of psychological therapy helps people understand their problems and relearn ways of dealing with it
• Psychotherapy and group therapy - talking and sharing experiences can be vital to understanding and recovering from a phobia

This article was last medically reviewed by Dr Rob Hicks in October 2007