An Integrated Approach to Young Adult Mental Health Rehab

Fear of Leaving the House? It Might Be Pandemic Agoraphobia

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If you’ve been experiencing a new or heightened fear of leaving the house, you’re not alone. After a year and a half of constantly changing guidelines around daily activities, it’s not easy to determine what’s safe to do in the outside world. As new COVID variants like Delta and Mu are identified, normal behaviors like shopping, riding the subway, or meeting friends—not to mention going to crowded events like concerts or festivals—can seem scary and threatening.

Feeling anxiety related to COVID is a rational response to a real threat to one’s health and safety. Over time, however, coronavirus anxiety sometimes becomes exacerbated to the point that people are unable to leave their houses, due to extreme fear of being in public places where they might become infected with the virus. Mental health experts are calling this condition “pandemic agoraphobia.”

What Is Agoraphobia?

Agoraphobia is an anxiety disorder related to being in open or enclosed spaces, crowds, or unfamiliar situations. The term comes from the word agora, which is Greek for “marketplace.” People with agoraphobia avoid places where they feel trapped, helpless, and out of control.

Because agoraphobia is associated with panic disorder, people with this condition are also afraid of experiencing the discomfort and embarrassment of a panic attack while in a public place. As a result, about a third of people with panic disorder develop agoraphobia as well. Consequently, they begin to avoid activities outside of the home whenever possible.

In order to be given an agoraphobia diagnosis, a person must experience extreme fear or panic in at least two of the following situations:

  • Public transportation
  • Open spaces, such as a mall, park, or parking lot
  • Enclosed spaces, such as small stores, elevators, or a conference room
  • Crowds or lines
  • Being out of their home alone.

Can Coronavirus Anxiety Cause Pandemic Agoraphobia?

While coronavirus anxiety may contribute to the development or worsening of agoraphobia, the condition typically arises from a combination of underlying factors. In addition to having panic attacks or other phobias, one of the biggest risk factors for developing agoraphobia is experiencing stressful life events, such as a death of a loved one or another type of traumatic event. Furthermore, people under the age of 35 are more likely to develop agoraphobia.

Hence, many young people may be vulnerable to agoraphobia, particularly because they are struggling with their mental health more than any other age group. A recent Pew Research poll found that a third of young adults in the United States are experiencing high levels of psychological distress, and another third are feeling medium levels of distress. The poll also found that young adults are especially likely to report anxiety, depression, or loneliness. Furthermore, 45 percent of those under 30 described being “nervous, anxious, or on edge” at least “occasionally or a moderate amount of time” during the week prior to the survey. Not surprisingly, people who see the virus as a major threat to their personal health have particularly high levels of distress.

Intense coronavirus anxiety is more closely associated with Obsessive Compulsive Disorder (OCD) than with agoraphobia or panic disorder, mental health experts say. However, it’s clear how this anxiety could increase a person’s fear of leaving the house—and enhance their likelihood of developing full-fledged pandemic agoraphobia. Some researchers have coined the term “coronaphobia” to describe the excessive fear of contracting the virus, and the stress and avoidance of public places and situations that results from that fear.

Signs of Agoraphobia

Are you concerned that normal COVID-related anxiety has crossed the line into pandemic agoraphobia? Below are some of the signs of agoraphobia. This condition usually lasts six months or longer, and typically manifests in a number of physical symptoms that resemble panic disorder symptoms. Signs of agoraphobia almost always manifest as a result of direct exposure to a situation, and include:

  • Chest pain or pressure
  • Rapid heart rate
  • Shakiness
  • Hyperventilation
  • Difficulty breathing
  • Lightheadedness or dizziness
  • Sudden chills or flushing
  • Excessive sweating
  • Feeling of choking
  • Numbness or tingling
  • Upset stomach or diarrhea
  • Feeling a loss of control
  • Fear of dying.

As a result, people with agoraphobia do whatever they can to avoid situations that trigger these symptoms. Hence, agoraphobia can disrupt a person’s social life, work, education, and daily functioning.

Agoraphobia vs. Social Anxiety Disorder

While agoraphobia is a very different mental health condition than social anxiety disorder, there is some overlap of symptoms between the two. Like those with social anxiety, people with agoraphobia often have an intense fear of situations in which they may feel judged or be embarrassed, such as a party or a meeting. 

In the same way the pandemic has intensified agoraphobia symptoms for some people, it has also made social anxiety worse. Many young adults experienced social anxiety symptoms for the first time when they began to re-emerge last spring after months of social distancing or limited socializing. For those who suffered from social phobias before the pandemic, IRL connections became even scarier. 

In general, whether young people struggle with anxiety, depression, or another mental health condition, the stressors of the pandemic tend to make it worse. Research shows that the pandemic has increased stress levels for people with social anxiety as well as those with agoraphobia.

How to Overcome Agoraphobia

For most people, pandemic agoraphobia is a temporary condition that should gradually improve as they become more accustomed to being out in the world and coping with changing COVID restrictions. Increasing self-care and limiting your consumption of news and social media can be helpful in easing this type of coronavirus anxiety.

However, if signs of agoraphobia continue, it’s important to seek treatment. Cognitive Behavioral Therapy (CBT) is one of the most effective therapeutic modalities for agoraphobia. CBT helps people recognize their thought patterns and gain skills for tolerating and managing difficult emotions, like fear of leaving the house. Through techniques like relaxation and desensitization, CBT gradually exposes patients to anxiety-producing situations so they can learn how to overcome agoraphobia.

Treatment for agoraphobia should also include addressing underlying issues, such as childhood trauma and attachment wounds. At Newport Institute, we guide young adults to heal the root causes of mental health and co-occurring disorders, so they can move forward with self-knowledge, confidence, and healthy coping skills.

Sources

BMC Psych. 2020 May; 20: 259.

Asian J Psychiatr. 2020 Dec; 54: 102384.

Front Psychol. 2020 Nov;11: 586246.

 

Mental Health / September 9, 2021

Newport Institute

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