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By: Vivian Gao
Agoraphobia is an intense fear and anxiety of being in places where it is hard to escape, or where help might not be available. Agoraphobia usually involves fear of crowds, bridges or of being outside alone. During quarantine and COVID-era, agoraphobia has increased in prevalence, and pre-existing conditions have worsened in severity, with individuals becoming increasingly anxious about leaving their households in fear of contracting COVID-19.
Generally, the DSM-5 characterizes agoraphobia as involving the following: fear or anxiety about using public transportation, standing in line or being in a crowd, being in enclosed spaces (movie theaters, stores), being in open places (markets, parking lots); active avoidance of all situations that provoke fear and anxiety, anxiety or panic attacks, feelings of hopelessness, and feelings of detachment or estrangement from others.
According to the DSM-5, agoraphobia is placed in its own category of anxiety, and as with any anxiety disorder, is characterized by reactions that outsize any real threat. While the manifestation of agorpahobia is typically portrayed as becoming homebound, this is not necessarily the case, as individuals with agoraphobia may select to visit familiar places.
Over the summer, I took a course taught and organized by Dr. Krista Milich of Washington University in St. Louis that discussed the impacts of the pandemic on science and society (formally known as “The Pandemic: Science & Society”). In this course, we touched upon a wide range of topics related to the ways in which the pandemic has affected the individual, one of which was the worsening of psychological disorders.
Today, although many legal restrictions on quarantine have been lifted, there is still great uncertainty and conflict surrounding COVID-19, as infection continues to spread. In addition, as another effect of the pandemic, various safe spaces and resources for marginalized communities have been lost, which is important to note because these same communities are the ones facing higher rates of psychological disorders. Thus, with uncertainty around living during a pandemic and other environmental factors that may be associated with worsening psychological disorders, the risk for agoraphobia among the population has increased, with conditions existing pre-pandemic worsening in severity.
Consequently, I would encourage the public to become more familiar with the occurrence of agoraphobia, especially so that individuals are able to recognize its signs in a loved one. This awareness is particularly critical due to the lack of attention shed upon agoraphobia among the general public. While environmental stressors are the most prominent factor contributing to agoraphobia, there are individuals at a higher risk of developing agoraphobia. These individuals include those that live with another anxiety disorder, have a general tendency for being worried, identify as a woman, have a biological relative with agoraphobia, and are below the age of thirty-five. Though, it is important to reiterate that the following identifiers are merely risk factors—anyone experiencing signs of agoraphobia should seek help if possible.
Seeking help comes in a variety of venues, and admittedly, these options currently may be limited due to COVID-19. It is notable that treatment of phobias has a high success rate, with the most effective treatment methods being systematic desensitization (also referred to as exposure therapy). Although, regardless of whether an individual has diagnosed agoraphobia, social isolation and all impacts related to quarantine are detrimental to anyone’s health, and one may find it beneficial to talk with a professional psychiatrist regarding any concerns.
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