Agoraphobia

Summary

Agoraphobia is an intense fear or anxiety about being in situations where it might feel difficult to escape, get help or feel safe if something goes wrong. For some people, this fear is linked to having a panic attack or experiencing physical symptoms of anxiety and worrying that they won’t be able to cope. It can lead someone to avoid certain places or situations, and in more severe cases, someone may find it very difficult to leave their home.

Agoraphobia can look different for everyone. Someone might avoid travelling on public transport, going to busy places, being in queues, going to shops or being outside alone. They may feel more comfortable when accompanied by someone they trust and may rely on a friend, family member or carer to help them leave the house or manage situations that feel frightening. The fear can sometimes feel difficult to explain, particularly when the situation may not seem dangerous to other people.

What can agoraphobia feel like?

Someone experiencing agoraphobia may:

  • Feel intense anxiety or dread when thinking about going somewhere or taking part in a particular situation, sometimes days or weeks beforehand.
  • Worry about having a panic attack or experiencing symptoms such as dizziness, breathlessness, a racing heart, sweating, shaking, nausea or feeling faint.
  • Avoid situations that feel unsafe or difficult to escape from, which can gradually make their world feel smaller.
  • Need a trusted person with them when travelling, going to public places or leaving home.
  • Plan carefully around where they can go, such as identifying exits, toilets, quiet spaces or places where they could sit down if they become overwhelmed.
  • Find leaving home increasingly difficult, particularly if avoidance has become a regular part of their life.
  • Feel embarrassed, frustrated or isolated because anxiety is preventing them from doing things they want or need to do.
  • Find it difficult to explain why somewhere feels frightening, even when they know logically that they are unlikely to be in danger.
  • Situations that can trigger agoraphobia

Agoraphobia commonly involves fear or anxiety about several types of situations:

  • Open spaces – such as parks, fields or large outdoor areas.
  • Enclosed spaces – such as shops, cinemas, lifts or other places where leaving quickly may feel difficult.
  • Crowds and queues – particularly when there are lots of people around or someone feels they cannot easily leave.
  • Public transport – such as buses, trains, underground trains or aeroplanes, where getting off or leaving may not feel immediately possible.
  • Being outside alone – particularly travelling away from home or going somewhere unfamiliar.
  • Being far from home – especially when someone feels that their home is the only place where they can feel completely safe.

Someone does not need to experience fear in all of these situations to have agoraphobia. The important feature is the fear or anxiety about being somewhere that feels difficult to escape from or where help may not be available, followed by avoidance or significant distress.

What keeps agoraphobia going?

Agoraphobia can sometimes develop after someone has experienced panic attacks or another frightening physical or emotional experience. They may begin avoiding the situation where it happened because they are worried it will happen again. Avoiding it can provide immediate relief, but it can also teach the brain that the situation really was dangerous. Over time, this can make the anxiety stronger and lead to avoiding more and more situations.

For example, someone might have a panic attack on a bus and then stop using buses. They may then start worrying about trains, shops or being away from home because they are afraid of having another panic attack without being able to escape. This can gradually make everyday activities feel increasingly difficult.

Although agoraphobia can occur alongside panic attacks, you do not need to experience panic attacks to experience agoraphobia. Someone may instead worry about becoming unwell, fainting, vomiting, losing control, embarrassing themselves or being unable to get help. These worries can have a significant impact on everyday life, including school, college, friendships, hobbies and travelling. Someone may stop doing things they enjoy or need to rely on other people to leave the house. Agoraphobia can be treated, and with the right support, people can gradually become more comfortable in situations that currently feel frightening.

Avoidance can feel like it helps at first. Staying at home, leaving a situation quickly or avoiding somewhere that feels frightening can make anxiety go down in the moment. However, this can sometimes teach the brain that the situation really is dangerous, which can make the fear stronger over time. Someone might also use “safety behaviours” to feel more comfortable, such as always having a trusted person with them, sitting near an exit or carefully planning where they can go if they feel anxious. These things can provide reassurance, but gradually learning that they can cope without relying on them all the time can help reduce anxiety.

How to help myself

If anxiety is making it difficult to leave home or go to certain places, start small and go at a pace that feels manageable. Avoiding situations can make anxiety feel better in the moment, but it can also make the fear stronger over time. Try breaking a difficult situation into smaller steps rather than expecting yourself to face everything at once. For example, you might start by standing outside your front door, then walking a short distance, before gradually working towards places that feel more difficult. Celebrate the effort rather than expecting yourself to feel completely calm.

Learn what happens when you feel anxious. Notice the thoughts, feelings and physical sensations that happen when you’re worried. Remind yourself that anxiety can feel intense without meaning that you are in danger. If you experience panic symptoms, slow your breathing, focus on what is around you and remind yourself that the feelings will pass. Grounding techniques, listening to music or carrying something comforting can also help you stay focused on the present moment.

Try to reduce avoidance and safety behaviours gradually rather than stopping everything at once. It is okay to have support from someone you trust, but you can gradually practise doing things with a little less reassurance when you feel ready. If you always sit near an exit, for example, you might eventually practise sitting somewhere else. These changes should feel achievable rather than overwhelming.

Keep doing things that are important to you, even if anxiety makes them feel difficult. Staying connected with friends, attending school or college, spending time outside and continuing with hobbies can help prevent your world from becoming smaller. You may need to make adjustments while you’re working on your anxiety, and that’s okay.

Most importantly, ask for support if you’re struggling. Talk to a parent or carer, teacher, GP, school counsellor or another trusted adult. A mental health professional can help you understand your anxiety and gradually work towards situations you are avoiding. You don’t have to wait until you can barely leave the house before asking for help.

How to help a loved one

If someone you care about is experiencing agoraphobia, try to understand their anxiety rather than telling them to “just get out” or “calm down.” Situations that seem ordinary to you can feel genuinely frightening to them. Listen to what they are worried might happen and take their feelings seriously, while reminding them that they don’t have to face everything at once.

You can help by supporting them to take small, manageable steps rather than avoiding everything that makes them anxious. Work together to identify situations they would like to feel more comfortable with and break these into smaller steps. For example, you might start with standing outside the house, taking a short walk together or travelling somewhere familiar before gradually working towards more difficult situations. Encourage their efforts rather than focusing on whether they completed the whole task or felt completely calm.

It can be tempting to do everything for someone or constantly reassure them that everything will be okay. While reassurance can help in the moment, too much reassurance or helping someone avoid situations can sometimes maintain their anxiety. Instead, support them to discover that they can cope with uncomfortable feelings themselves. You can still be there with them – the aim is to gradually build their confidence and independence rather than suddenly taking away their support.

During moments of intense anxiety or panic, stay calm and patient. Help them focus on the present, slow their breathing and remind them that anxiety symptoms can feel frightening without necessarily meaning that they are in danger. Avoid forcing them to stay in a situation if they are completely overwhelmed; instead, help them settle and consider what a manageable next step might be.

Agoraphobia can affect school, friendships, hobbies and everyday activities, so practical support can be really valuable. You might help them communicate with school or college, plan journeys, arrange quieter environments or gradually return to activities they have stopped doing. Encourage them to maintain connections with other people and continue doing things they enjoy where possible.

Finally, encourage professional support if anxiety is significantly affecting their life. A GP, school counsellor, CAMHS or another mental health professional can help them access appropriate treatment. You can offer to help them arrange an appointment or go with them if this would make things easier. Remember that you cannot remove their anxiety for them.

Myth Busting

Myth: “People with agoraphobia never leave their house.”

Truth: Agoraphobia can affect people in different ways and with different levels of intensity. Some people may find it extremely difficult or impossible to leave their home, while others are able to leave home but experience intense anxiety in particular situations. Someone may be able to go outside but avoid crowded places, public transport, unfamiliar areas or situations where they feel they could not easily escape or get help.

Myth: “People with agoraphobia don’t go outside.”

Truth: Having agoraphobia does not necessarily mean that someone never goes outside. The situations that cause anxiety will be different for everyone. Someone might be comfortable walking around their local area but struggle to travel somewhere unfamiliar, go into a busy shop or be outside without someone they trust. In more severe cases, someone may become unable to leave home because their anxiety and avoidance have become so intense.

Myth: “Agoraphobia is the same as panic disorder.”

Truth: Agoraphobia and panic disorder are different anxiety-related conditions, although they can occur together. Someone can experience panic disorder without having agoraphobia, and someone can experience agoraphobia without having panic disorder. Agoraphobia is mainly related to fear and anxiety about situations where escaping, getting help or coping with distressing symptoms may feel difficult. In the past, agoraphobia was often considered alongside panic disorder, but they are now recognised as separate conditions.

Therapy

  • Cognitive Behavioural Therapy (CBT) – Helps someone understand the connection between their thoughts, feelings, physical symptoms and avoidance. It can help challenge frightening predictions, develop coping strategies and gradually change patterns that keep anxiety going.
  • Exposure Therapy – Involves gradually approaching situations that cause anxiety rather than avoiding them. This is usually done in small, manageable steps, allowing someone to learn that they can tolerate the anxiety and that feared outcomes may not happen.
  • Graded Exposure – A structured form of exposure where situations are broken down into a hierarchy, starting with something that feels more manageable and gradually working towards more difficult situations. For example, someone might progress from standing outside their home to taking a short journey independently.
  • Interoceptive Exposure – Helps someone become more comfortable with the physical sensations associated with anxiety and panic, such as a racing heart, dizziness or breathlessness. The aim is to learn that these sensations, while uncomfortable, can be tolerated and are not necessarily dangerous.
  • Mindfulness-based approaches – Can help someone notice anxious thoughts and physical sensations without immediately reacting to them or trying to escape. This can support them to stay present while experiencing anxiety.
  • Acceptance and Commitment Therapy (ACT) – Helps someone make space for uncomfortable thoughts and feelings rather than allowing anxiety to completely determine what they do. It focuses on identifying what matters to the person and taking gradual steps towards those things.
  • Family therapy or family-based support – Can help parents, carers and other family members understand agoraphobia and learn how to support gradual progress without accidentally reinforcing avoidance or providing excessive reassurance.
  • Support for underlying difficulties – Agoraphobia can occur alongside panic disorder, depression, trauma or other anxiety difficulties. Therapy may therefore focus on these difficulties alongside the agoraphobia, depending on the person’s individual needs.

Helplines

Anxiety UK

Anxiety UK is a charity providing information, advice and support for people experiencing anxiety, stress and other anxiety-related difficulties. They support people with issues including panic attacks, phobias, obsessive-compulsive disorder (OCD) and other anxiety disorders. 

Phone: 03444 775 774
Opening times: 24 hours a day, 7 days a week
Website: www.anxietyuk.org.uk

No Panic

No Panic is a charity providing information, advice and support for people experiencing panic attacks, phobias, obsessive-compulsive disorder (OCD) and other anxiety-related difficulties. They also provide support for young people and carers.

Phone: 0300 772 9844
Opening times: 10 am–10 pm, every day of the year
24-hour crisis message: 01952 680835
Email: info@nopanic.org.uk
Website: http://www.nopanic.org.uk
Youth support: youth@nopanic.org.uk

Kooth

Kooth is a free online mental health and wellbeing service for young people. It offers a safe and confidential space where young people can access information, read helpful resources, take part in online discussions and receive support from trained professionals. Kooth can help with all sorts of issues that may affect young people’s mental health and wellbeing, including stress, anxiety, relationships, bullying, family difficulties, low mood and other challenges they may be experiencing.

Website: www.kooth.com
Online support: Available 24 hours a day, 365 days a year
Live chat with a practitioner: 12 pm–10 pm Monday to Friday; 6 pm–10 pm Saturday and Sunday

Shout

Shout is a free, confidential text messaging service that provides support to anyone who is struggling to cope. It can help with a wide range of issues, including stress, anxiety, low mood, loneliness, relationship difficulties, bullying, self-harm, suicidal thoughts, feeling overwhelmed and other mental health challenges.

Text: SHOUT to 85258
Opening times: Available 24 hours a day, 7 days a week, 365 days a year
Website: www.giveusashout.org

Mind

Mind is a mental health charity providing information, advice and support for people experiencing mental health difficulties. They cover a wide range of mental health and wellbeing issues, including anxiety, depression, stress, relationships, loneliness, coping with difficult experiences and managing everyday life. Mind provides information to help people understand what they are experiencing, know their rights, find appropriate support and feel less alone.

Phone: 0300 123 3393
Opening times: 9am–6pm, Monday to Friday (excluding bank holidays)
Email: info@mind.org.uk
Website: www.mind.org.uk 

Samaritans

Samaritans is a charity providing emotional support to anyone who is struggling to cope or needs someone to talk to. They are there for people experiencing all sorts of difficulties, including stress, anxiety, loneliness, relationship or family problems, bereavement, feeling overwhelmed and concerns about mental health or suicide.

Phone: 116 123
Opening times: 24 hours a day, 7 days a week, 365 days a year
Website: www.samaritans.org

The Mix 

The Mix is a charity providing free information, advice and support for young people on all sorts of issues that can affect their lives and wellbeing. This includes mental health, relationships, money, housing, work and education, drugs and alcohol, bullying, social media, family difficulties and many other challenges. They offer information and practical advice to help young people understand what they are going through, make informed decisions and find further support when they need it. 

Phone: 0808 808 4994
Opening times: 11 am–11 pm, 7 days a week
Website: http://www.themix.org.uk
Crisis Messenger: Text THEMIX to 85258 – available 24 hours a day, 7 days a week.

Childline
Childline is a free service for young people to talk to a counsellor about anything. The service is available 24 hours a day, 7 days a week. Childline is available to anybody who is 18 years old or younger.

Phone: 0800 1111- Available 24 hours a day, 7 days a week, 365 days a year
You can also find helpful resources, speak to a counsellor online or send a message on their site.
Website: www.childline.org.uk

For adults concerned about a child, the NSPCC can be contacted 

NSPCC

NSPCC is a children’s charity that works to protect children and prevent abuse and neglect. They provide support and advice for adults about child abuse, neglect, child safety, online safety and children’s mental and emotional wellbeing. 

Phone: 0808 800 5000
Opening times: 10 am–4 pm, Monday–Friday
Email: help@nspcc.org.uk
Email opening times: 11 am–4 pm, 7 days a week
Website: www.nspcc.org.uk

YoungMinds

YoungMinds is a national charity supporting the mental health and wellbeing of children and young people. They provide information, advice and support for parents and carers who are concerned about a young person’s mental health, and help people understand mental health difficulties, find appropriate support and access useful resources. Their Parents Helpline can provide information, advice, emotional support and signposting to other services. 

Parent helpline: 0808 802 5544 (9:30 am – 4 pm on Mondays, Thursdays and Fridays, and from 9:30 am – 6 pm on Tuesdays and Wednesdays)
Email: parents@youngminds.org.uk
Webchat: https://www.youngminds.org.uk/parent/parents-helpline/