Agoraphobia is anxiety about, or the avoidance of, places or situations from which escape might be difficult or embarrassing, or in which help may not be available in the event of a panic attack or panic-like symptoms. Agoraphobia is not a fear of open spaces and does not necessarily involve remaining at home, or becoming housebound, although some individuals are unable to leave their homes unless accompanied by a trusted person. Individuals with agoraphobia often report being afraid of fainting, having a heart attack, being trapped, losing control, or experiencing some other frightening event. They experience unpleasant physical sensations when they anticipate having to leave areas they consider safe as well as during the excursion (Rachman, 2004). Not all agoraphobics experience panic attacks (see above) in response to feared situations. While they experience physical and psychological sensations, these sensations do not escalate into a ‘full-blown’ panic attack.
Individuals with agoraphobia may fear traveling on public transportation, going over bridges, being in open spaces, being in crowded places, any situation where an individual previously experienced a panic attack, or any situation from which the person perceives it to be difficult to escape. Agoraphobic individuals avoid these situations, although the degrees of avoidance vary: some individuals are able to push themselves to confront their feared situations whereas others avoid the situations entirely. Oftentimes the avoidance behaviour is triggered by physical signals (e.g., increased heart rate from walking up stairs); consequently, the individual’s anxious symptoms increase and the person may begin to avoid physical activity or any situation that triggers physical symptoms (Stein, 2004).
Some individuals who experience agoraphobia may experience it with symptoms of panic. See Persistent Panic for further details.