Managing Day-to-Day With Agoraphobia
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Severe panic disorder can lead to agoraphobia, a fear of places that can leave you a prisoner in your own home.
By Diana Rodriguez
Medically reviewed by Niya Jones, MD, MPH

People who suffer from frequent panic attacks are constantly afraid of having another one, and will often steer clear of places where they've had a panic attack before. Eventually, they may become so terrified of having a panic attack in public that they avoid leaving the house altogether. This severe, disabling fear reflects an anxiety disorder known as agoraphobia.

Agoraphobia: Extreme Anxiety Disorder
"Agoraphobia is really territorial avoidance or limited territorial avoidance where a person fears going outside of their safety zone. They're afraid they might re-experience the panic that they've felt before," explains Martin N. Seif, PhD, a clinical psychologist in New York City and Greenwich, Conn. Over time, this desire to avoid places outside of their comfort zone may become so intense that many agoraphobics are unable to leave their home.

Agoraphobia is nearly always associated with panic disorder, but not everyone with panic disorder has agoraphobia.

Agoraphobia: How it Affects Your Life
Agoraphobia places significant limitations and restrictions on a person's day-to-day life. It can make jobs, relationships, and even daily responsibilities increasingly difficult.

"I wouldn't go anywhere without my husband or kids, and I couldn't go to the bank even with them," recalls Rita Clark of Lake Forest, Calif., the consumer chair for the Anxiety Disorders Association of America. Clark first experienced a panic attack one night while playing cards with her husband and friends, and endured agoraphobia for 20 years before she recognized her symptoms in a newspaper article, visited her doctor, and began treatment.

Clark would shake badly in many public places, and refused to go anywhere she would have to sign her name, like a bank, because she was afraid people would notice her shaking.

"If I had to go to the grocery store, I always took my kids, even thought they were 5 and 4. I felt that if I had a panic attack I could escape and say they were sick, so the focus wouldn't be on me. The fear was that the focus would be on me and people would see that I was really crazy," Clark remembers. “It manipulated my life."

After many years of exposure therapy and other treatments, Clark slowly managed to control her anxiety and conquer her agoraphobia. Today, there's no place she won't go.

Agoraphobia: How to Cope
To manage agoraphobia and overcome your fears, you have to face them. Here are some tips that can help agoraphobics learn to cope with their anxiety and take control of their lives again:

Get therapy. Psychotherapy (talk therapy) and structured exposure to anxiety-provoking situation are very helpful in overcoming agoraphobia. Seif recommends slowly exposing yourself to uncomfortable situations, becoming more comfortable, and gradually expanding your comfort zone.

Use relaxation techniques. When you start to feel anxiety, Seif suggests trying to soothe your mind by using relaxation techniques. These can include deep breathing, meditation, and visualizing a peaceful, relaxed place.

Stop avoiding places you fear. "Anxiety is maintained by avoidance, and if you want to overcome that anxiety you have to learn to move in manageable steps toward areas of greater discomfort," advises Seif. Ask friends and family for support as you venture to places you previously viewed as off-limits. Spending increasingly longer periods of time out in public, in the company of loved ones, can make leaving your home feel less daunting.

Consider medication. As you begin spending more time in public, anti-anxiety or antidepressant medications can help give you more confidence and remain motivated. Clark initially took medication to make it into the grocery store, and slowly took less and less until she was able to go shopping on her own without her therapist or the drug.

You shouldn't have to go through life avoiding places or events because of anxiety. Fortunately, panic disorder and agoraphobia can be managed effectively. Seeking treatment for your symptoms is the first of many steps that will eventually lead you to wherever you choose to go.

Last Updated: 06/02/2009 This section created andproduced exclusively by the editorial staff of
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