Agoraphobia

Fear and avoidance of places or situations where escape might be difficult or embarrassing, or where help might not be readily available if a symptom suddenly develops (e.g. dizziness, derealisation, loss of bladder/bowel control, a panic attack). Typical triggers: public transport, crowded shops, and other confined or crowded spaces, or situations involving distance from home. Patients fear they may lose control, faint, or suffer embarrassment.

Most people with agoraphobia develop it as a response to recurrent panic attacks.

Management

Treat the underlying panic attacks first — see Panic Disorder for pharmacotherapy detail (SSRIs first-line). Once panic is controlled, use graded exposure to work through the phobic avoidance itself.