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Most cases of agoraphobia develop as a complication of panic disorder.

It can develop if you have a panic attack in a specific situation or environment. You worry so much about having a panic attack that the symptoms return when you're in a similar situation.

This causes the person to avoid that particular situation or environment.

Panic disorder

We do not know the exact cause of panic disorder.

Most experts think it is a combination of biological and psychological factors.

Biological factors

Fight, flight or freeze reflex

Panic disorder is associated with your body's natural fight, flight or freeze reflex. This is your body's way of protecting you from stressful or dangerous situations.

Anxiety and fear cause your body to release hormones like adrenaline. This can cause your breathing and heart rate to increase. This is your body's way of preparing itself for a dangerous or stressful situation. When you feel threatened, your body gets ready to fight, run away or freeze. It does this in the belief that this is what you need to protect you from the threat.

With panic disorder, the fight, flight or freeze reflex may be triggered wrongly. This results in a panic attack, even if there is no threat.


An imbalance in levels of brain neurotransmitters can affect mood and behaviour. This can lead to a heightened stress response in certain situations. This can trigger the feelings of panic.

The fear network

This suggests that the brains of people with panic disorders may be wired differently.

They may be generating strong emotions of fear that trigger a panic attack.

Spatial awareness

There is a link between panic disorders and spatial awareness. Spatial awareness is the ability to judge where you are in relation to other objects and people.

Some people with panic disorder have a weak balance system and awareness of space. This can cause them to feel overwhelmed and disorientated in crowded places. This can cause a panic attack.

Psychological factors

Psychological factors that increase your risk of developing agoraphobia include:

  • a traumatic childhood experience
  • experiencing a stressful event
  • a previous history of mental health disorders
  • alcohol or drug misuse
  • being in an unhappy relationship

Agoraphobia without panic disorder

Occasionally, you can develop agoraphobia with no history of panic attacks.

This type of agoraphobia can be caused by different irrational fears (phobias). For example, the fear of:

  • being a victim of violent crime or a terrorist attack if you leave your house
  • becoming infected by a serious illness if you visit crowded places
  • doing something by accident that will embarrass or humiliate you in public

Content supplied by the NHS and adapted for Ireland by the HSE.

page last reviewed: 23/09/2018
next review due: 23/09/2021

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