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Causes - Agoraphobia

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

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

This causes you to avoid that particular situation or place.

Panic disorder

The exact cause of panic disorder is not known.

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

Biological factors

Fight, flight or freeze response

Panic disorder is associated with your body's natural fight, flight or freeze response. This is your body's way of protecting you from stressful or dangerous situations, whether they're real or imagined.

Anxiety and fear cause your body to release hormones like adrenaline. This can cause your breathing and heart rate to increase.

When you feel threatened, your body responds by preparing you to fight, run away or freeze. This automatic reaction is designed to protect you from the threat.

With panic disorder, your fight, flight or freeze response may be triggered when it is not needed. This results in a panic attack, even if there is no obvious or imminent threat.

The fear network

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

Their brains may create stronger emotions, including fear. This can 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 sense of balance and awareness of space. This can cause them to feel overwhelmed and disorientated in crowded places. This can lead to a panic attack.

Psychological factors

Psychological factors that increase your risk of developing agoraphobia include:

  • a traumatic childhood experience
  • 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
  • doing something by accident that will embarrass or humiliate you in public

Phobias: symptoms

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

Page last reviewed: 1 September 2022
Next review due: 1 September 2025