Have you developed agoraphobia?

For many people, the COVID-19 pandemic and its lockdowns meant long periods of staying indoors and self-isolating. Although the height of the pandemic has passed, its impact is still felt, particularly for those struggling with agoraphobia, a type of anxiety disorder that can leave people feeling housebound for years. For some, agoraphobia developed or worsened during lockdown, and even now, the lingering effects of prolonged isolation continue to make leaving the house feel overwhelming.

If you are naturally an introvert, lockdown may provide a legitimate excuse or the perfect alibi to stay at home. You might be affected more than others if you have been struggling with pre-existing anxiety disorders such as social anxiety, OCD, or a panic disorder that stems from severe anxiety. At times, it might feel like a hard condition to manage. In certain situations, you might develop a mindset that prevents you from stepping outside. The uncertainty of ‘small talk’ with neighbours fills you with dread. Working through the anxiety can positively help to stop the problem from growing into full-blown agoraphobia.

We all have personal ‘lockdown’ days when even answering the phone feels too much. If it normally takes an enormous effort to answer the phone, you might prefer to live with your phone set on ‘do not disturb’. Alternatively, you may choose to communicate via text messaging and email instead. For some, the ringing phone is like a force field that can trigger a freeze response. This feels more intense, especially if it’s from an unidentified caller. In extreme cases of anxiety, initiating important phone calls such as phoning the doctor or other official calls can be a struggle.

Agoraphobia, a similar mental health condition to social anxiety, is more of an extreme discomfort of being around people. Some people cannot stand being noticed, or simply the attention of being looked at can trigger anxiety. They are much more aware of hyper-vigilance, and so agoraphobia feels much worse in crowds.

Causes of agoraphobia

Childhood trauma and the resulting PTSD

These can exacerbate feelings of general anxiety. If you’ve experienced long-term trauma in childhood, adverse events in the present can feel more intense. Some people feel like these are ‘last straw’ traumatic events. The emotional calluses formed through all the years in survival mode can feel picked at, stripped off, and the world can feel a confusing, unsafe and overwhelming place.

If, for example, you are someone who has been repeatedly attacked in the school playground or experienced physical or sexual abuse at a very young age, you may be predisposed to struggle with your anxious feelings. This can take almost everything out of you, so leaving the house for work or visiting the doctors can seem daunting. Some of my clients have reported feeling faint if they’re out alone. Some people experience extreme anxiety and panic attacks.

Sexual abuse

Any attack on a person’s vulnerability, especially in the form of adverse sexual experiences, threatening and violent sexual behaviour, can be a cause for agoraphobia.

Some people can develop sudden and severe agoraphobia after a traumatic event in adulthood. A female client recently described severe agoraphobia after abuse from a stalker incident.

Domestic violence

Violence at the hands of an abusive partner can cause symptoms of agoraphobia that are rooted in a fear of men. There can be many reasons for this, such as: helplessness over legal outcomes, fear that perpetrators of sexual violence are ‘getting away with it’, that not enough is being done to protect victims, the perception that people who commit heinous crimes are not being held legally accountable, insecurity over feeling victimised and defenceless, fear of injustice and reverse assault charges.

For victims of sexual abuse, you may find it difficult to ‘rationalise’ your feelings because it may not seem logical to you or others. You may have other underlying mental health conditions, so it might feel real and plausible that a man will hurt you again. For you, it may feel much harder because, unlike some other anxiety disorders, your experience is founded in the abject truth of lived experience.

Complex mental health problems

Problems such as persistent and prolonged depression, if left ignored for a long time, can lead to agoraphobia. Some people who have been diagnosed with bipolar disorder are known to experience agoraphobia in between cycles of mania and depression.

If your anxiety is related to complex PTSD, you may want to keep it hidden from your family, especially if your trauma is related to abuse within the family. You may be concealing shame, hidden embarrassment or harbouring a pre-existing fear about going anywhere in case of a flashback ‘episode’ occurring in front of other people. Denial of your deeper-rooted toxic shame, ‘fibbing’ or making light about it being ‘simply a depression thing’ might feel more acceptable to you, while giving you a safe, temporary way to cover it up.

Serious illness

Agoraphobia can sometimes be triggered or intensified in individuals with a history of anxiety disorders or complex PTSD. Managing a serious illness alongside mental health challenges can be both mentally and physically exhausting. For those with compromised immune systems, such as after undergoing treatments like chemotherapy, the heightened concern around health and safety during the pandemic years may have amplified feelings of vulnerability and fear. Even now, years later, that heightened anxiety can linger. For individuals with conditions like epilepsy, this elevated stress can potentially lead to severe responses, including full-blown seizures.

Disabilities

“I developed it very quickly after becoming disabled and had to leave my job years ago. I went from being extremely active and social to rarely leaving my house. I was devastated. I was so embarrassed. I went from a good job to living on welfare. My family turned against me, accusing me of being lazy. I had been diagnosed with fibromyalgia and chronic fatigue syndrome, and I was so sick. Turns out it was severe complex PTSD. I couldn’t go grocery shopping if my life depended on it. Luckily, I had a friend who would do it for me. It’s come back again full swing since COVID”.

The pandemic caused a lot of stress for most people. It doesn’t help your condition to be around people in stores because of the widespread panic, violence and growing desperation.

Outside influences

Influences such as listening to the news and hearing traumatic news stories about shootings, acts of terrorism and violence can exacerbate anxiety and symptoms of agoraphobia. Such events remain largely out of your control and can trigger memories which serve as reminders of past trauma.

When it’s normal for it to be an ‘event’ to go outside, lockdown made it more of a difficult event because the fear of getting infected has made many people nervous about going out. The overhead of hyper-vigilance, the extra precautions of wearing a mask, keeping socially distanced, and strategising which areas to avoid make it even more uncomfortable for people to leave the house.

I’ve dealt with this for sure when things get rough. I know how tough it is, but you’ve got to keep going out before it gets to the point of no return.

Social isolation

For some, the long period of isolation during the pandemic led to a resurgence of agoraphobic symptoms, undoing progress they had made toward re-engaging with the outside world. Even years later, the shift to remote living continues to have an impact. Many people now work from home full-time or in hybrid roles, reducing everyday social contact that once came naturally in workplaces.

Activities that were once part of daily life, like going to the doctor, grocery shopping, or attending appointments, are now often handled online. This growing reliance on digital alternatives has made in-person interactions feel unfamiliar or even overwhelming, reinforcing a sense of disconnect from the outside world and making it harder to rebuild social confidence.

Symptoms and struggles with agoraphobia

For some, the sense of safety outside the home was deeply shaken during the pandemic, whether through tense interactions with others, fear of infection, or the pressure to follow constantly changing social distancing rules. Although much of that urgency has faded, the emotional imprint can remain. Encounters with crowds, enclosed spaces, or the unpredictability of social situations can still feel overwhelming or unsafe.

If the thought of meeting people again fills you with dread, you’re not alone. The desire to retreat, even years after restrictions have lifted, is a common response to lingering anxiety. Staying connected with the outside world is essential for mental health, but when your sense of connection used to come from regular social interaction and that now feels difficult or unavailable, it’s important to find new, healthier ways to meet those needs without triggering distress.

For some, agoraphobia manifests similarly to social anxiety, a fear of people, crowds, or being seen. The symptoms can fluctuate, from manageable one day to completely debilitating the next. On tougher days, the lines between agoraphobia, depression, and general anxiety can blur, especially when even basic tasks like getting out of bed or eating feel insurmountable.

Normally, on sad, empty days, I can go to bed and reset for the most part, but the uncertainty of not knowing when the anxiety of having to face others will lift is painful. I know how irrational it is, but just being aware of it doesn't help.

If you feel you’re suffering all alone with this condition, please know that you’re not the only one.

Some people feel ashamed about their feelings because they don’t feel safe or in control and find it hard to function outside the house. This gets worse the longer they stay in. Some of this anxiety can be related to past trauma and can easily be addressed through therapy.

Agoraphobia is a painfully bewildering condition that can affect your interpersonal relationships.

You may be familiar with the feeling of ‘going backwards’, when you want to hide and it feels more comfortable to stay at home rather than going anywhere, even after being invited by friends. Your relationships and friendships bring you a mixed sense, a push-and-pull feeling. You might feel bad about your feelings, that people are not approachable.

If you are not good at making friends, you might even make false self-judgements, thinking that you’re freaking other people out, or that you are being deceptive, bad or just different. You might withdraw from people, sheltering yourself, or staying home more often than normal.

“There's the rebound effect where I crave human connection, but it's pretty hard for everyone else when I've been so diligent in avoiding everyone during those ‘storms’.  It's rough because no one understands, but how can I expect them to when I realise how crazy it is!”

Going out can feel completely draining, like the life has been sucked out of you. Being in traffic, in front of crowds, and in small enclosures is deeply distressing. Waiting in store checkouts can cause reactions of nausea and sweating, ranging from minor anxiety to a full-blown cold sweat panic attack. Sometimes, it is triggered by certain noises and lights, you might find yourself restricting going out for things unless they are essential.

Fear grips people to an extent that the only way they can go places is with a partner, or to travel in a state of trance using sedative medication. A food shopping trip or a doctor's visit can be extremely daunting, and sometimes only possible to cope with by calling a taxi. Staying ‘inside’ protects from feeling ‘fully outside’ because asking for a ride to the shops or waiting in the car is the preferred option, while someone else, usually a partner or spouse, goes into the shop. It is not uncommon for agoraphobia sufferers to wait until it is dark before putting the rubbish out or leaving it until they’ve nearly run out of food before going shopping.

Treatment for agoraphobia

Therapy

Psychotherapy can help you by enabling a safe and confidential space with a psychotherapist for dealing with any persistent anxiety or underlying PTSD that is causing your agoraphobia. Some people have experienced relief from agoraphobia with CBT (Cognitive Behavioural Therapy). Although CBT can help someone to examine thoughts, resulting feelings and behaviour, many also experience relapse and find themselves back in therapy with returning symptoms. At times, it might feel a hard condition to manage; it isn’t a fun disorder, but working through the anxiety in therapy can help to make enjoying going outside possible.

Medication

Calming high arousal levels with medication can be viewed as a temporary fix, and it works by bringing everything down to a manageable level, reducing anxiety, calming the system just enough to give you the necessary lift to help you start getting yourself out gradually. The unfortunate downside of medication is the side effects that can leave you feeling very spaced out and lethargic.

Mindfulness

This is an east-meets-west approach for emotional regulation that can help you connect in a deeper way with your mind and identify parts of your body where you might be holding on to repressed negative energy.

Controlled exposure

Starting gently with familiar places such as your back garden.

Being more organised

This can be helpful to arrange your errands in such a way that you don’t have to go out more often than you have to.

Feeling safe with a pet

Like taking your dog with you when you leave the house.