For some people, leaving home can be a reason to panic. Translated from Greek as "fear of the marketplace," agoraphobia refers to a fear of any place where escape may be difficult, including large open spaces or areas with crowds, as well as various means of travel. People with agoraphobia may avoid situations such as being alone outside of the home, traveling in a car, bus, or airplane, being in a crowded area, being in enclosed spaces such as shops and cinemas, or being on a bridge or in an elevator.
People with agoraphobia fear such situations because they focus on thoughts that escape might be difficult in the event of an emergency or that help might not be available if they were to develop panic-like or other embarrassing symptoms. They feel high discomfort and stress and may require another person's company in such situations.
For agoraphobia to be considered as a diagnosis, the agoraphobic situations must almost always create fear and anxiety that are out of proportion to the actual danger posed; the distress typically lasts for a minimum of six months. In its most severe form, people with agoraphobia are completely unable to leave their home.
Approximately 1.7 percent of adolescents and adults are diagnosed with agoraphobia. Women are twice as likely as men to experience agoraphobia. Initial onset is typically in late adolescence or early adulthood, although agoraphobia can occur in childhood as well. The thoughts that usually cause fear and anxiety tend to change with age: Children often fear becoming lost, adults may fear experiencing panic-like symptoms, and older adults may fear falling. Agoraphobia often accompanies other anxiety disorders (such as panic disorder or a specific phobia) and depressive disorders.
In panic disorder, panic attacks recur, and the person develops an intense fear of having another attack. This fear—called anticipatory anxiety or fear of fear—is present most of the time and can seriously interfere with the person's life, even when a panic attack is not in progress. The majority of people with panic disorder showed signs of agoraphobia and anxiety before they developed panic disorder.
Typically, people with agoraphobia restrict themselves to a zone of safety that may include only the home or the immediate neighborhood. Any movement beyond such a zone creates mounting anxiety.
People with agoraphobia can be seriously disabled by their condition. Some are unable to work, and they may rely heavily on other family members to do their shopping and household errands, as well as accompany the affected person on rare excursions outside the safety zone. People with agoraphobia may become housebound for years, resulting in impairment of their relationships. It has been estimated that more than one-third of people with agoraphobia do not leave their home and are unable to work.