Have a total lack of interest in leaving your house lately? And between agoraphobia and social anxiety, not sure where you fall?
Can social anxiety become agoraphobia?
You had social anxiety before all the recent lockdowns, but it seemed to ease. Now the world is opening up again, and it’s back with a vengeance. You are worried that it’s not just anxiety anymore, but agoraphobia.
Instead of one becoming the other, it’s more likely you have both at the same time. Agoraphobia and social anxiety have many similarities, and do intersect as a common ‘co-morbid‘ (occurring together) diagnosis.
But there are also differences, and understanding them can help you get the right treatment.
What is agoraphobia?
The cliché of agoraphobia is someone cowering at home, afraid to leave. But the condition is far more complex. And the fear is not just of ‘leaving the house’ or of ‘wide open spaces’.
Agoraphobia is a fear is of being in any sort of situation where you might be trapped, or could only escape in an obvious and embarrassing way. You are afraid that in that situation you will have a meltdown. So essentially, the fear is of having a public panic attack with an audience.
And that fear is enough that often, yes, it seems easier to stay home.
The NHS estimates that two in 100 people in the UK have panic disorder. And of those people, a third go on to have agoraphobia. And they suggest that women are more than twice as likely to have agoraphobia than men.
Symptoms of agoraphobia
Agoraphobia can mean you:
are afraid to leave the house alone
avoid crowded places like malls and public transport
don’t like ‘trapped’ places like elevators, tunnels
sit near the door or by the aisle if you must take a bus or train
Social anxiety isn’t really about places, it’s about people. And more than just people, it’s about the thoughts you believe people are having.
If you have social anxiety disorder, you are afraid of being looked at and judged negatively. So you fear places full of people, but only as that involves possible scrutiny.
And you can just as easily have social anxiety over meeting one person as being in a crowd, if you think that one person might judge you.
Similarities of agoraphobia and social anxiety
Both of these conditions will:
make your social life a challenge
involve racing thoughts and feelings of fear.
When it comes to agoraphobia vs social anxiety, the difference is:
fear of cf closed in or too big places vs fear of people
avoiding a public meltdown vs avoiding being judged
don’t like being trapped vs don’t like being looked at
feel better with a friend vs often feel better alone.
Other related mental health disorders
So we’ve already seen that panic disorder often comes alongside agoraphobia.
In fact most cases of agoraphobia develop as a result of panic disorder. You have a public panic attack, then become so afraid of this embarrassing situation recurring you become agoraphobic.
Depression is another ‘co-morbid’ condition here. The loneliness and sense of being ‘flawed’ that can arise from your inability to just go out and be social can mean you have issues with low moods and negative thinking.
But I never had a panic attack before
It is possible to become agoraphobic without panic. In such rare cases, it would be about other phobias. You might, for example:
or simply be afraid of doing something embarrassing if you are in public.
Why do I have this condition?
So why did you end up with panic attacks, fears and phobias? Why are you agoraphobic when your friends aren’t?
Like most mental health conditions, scientists don’t have an exact answer, but think it’s a combination of biological and environmental causes (the situations you lived through).
Biology wise, you might have been born with a genetic leaning towards experiencing anxiety and panic. Research shows this seems to be a dysfunction in the way certain brain circuits manage themselves, a sort of ‘imbalance’ of neurotransmitters, as well as issues in how your brain responds to perceived threats.