Agoraphobia

Shahida, 50, lives on Elephant Road, ten minutes’ walk from New Market, where she bought every Eid saree of her married life. Three years ago, two days before Eid, she was in the lane by the churi shops when the crowd stopped moving. Her heart raced, her hands went numb, and she was sure she was dying. A shopkeeper gave her water and a stool. She has not been back. Then she stopped going to Gausia, then to Dhanmondi, then on any rickshaw beyond the corner.

Now her daughter Moyna’s biye is in February, and the shopping cannot wait. Her younger sister Shapla runs it by video call from the saree shops, holding katan and jamdani up to the camera. “Apa, this one, the maroon, see the zari? Wait, the signal’s going. Ei bhai, move, I’m showing my sister.” The shopkeepers now wave at Shahida through the phone. It is funny, and she laughs, and after the call she sits very still, because she is the mother of the bride and she has not left the neighbourhood in a year.

An illustration drawn from common experience. The person is invented; the pattern is not.

Understanding agoraphobia

Agoraphobia is marked fear or avoidance of situations where escape might be hard, or help unavailable, if panic or other frightening symptoms come: crowds, markets, buses, open or enclosed spaces, or being out alone. It often follows panic attacks, and over time the list of avoided places grows. In DSM-5 it is a diagnosis in its own right, with or without panic disorder. In the World Mental Health Surveys, most people with agoraphobia also had at least one other mental disorder. A psychiatrist will check physical causes of panic-like symptoms, such as thyroid or heart rhythm problems, caffeine or medicines, and ask about depression.

How common is agoraphobia?

In the World Mental Health Surveys, which interviewed 136,357 adults in 27 countries, about 1.5% had agoraphobia at some point in life and 1.0% in the past year. Among those who met both older and newer criteria, 44% reported severe impairment in their daily roles. Figures for agoraphobia alone in Bangladesh are not available.

Signs and symptoms of agoraphobia

• Avoiding markets, crowds, buses or traffic jams for fear of panic
• Needing a companion to go anywhere beyond home
• Planning every outing around exits and ways to leave
• Panic symptoms: racing heart, breathlessness, dizziness, numb hands, fear of dying
• A life shrinking to fewer and fewer safe places

Treatment for agoraphobia

UK national guidelines (NICE) recommend cognitive behavioural therapy for panic disorder with or without agoraphobia, usually 7 to 14 hours in total, and consider an antidepressant if the problem is long-standing or therapy has not helped or is declined. They advise that benzodiazepine sedatives should not be prescribed for panic disorder, because they are associated with a less good outcome in the long term. In CBT a person learns what panic is and what it is not, then returns to avoided places in planned steps, staying long enough for the fear to fall: the corner shop, a rickshaw ride, a quiet hour at New Market on a weekday morning.

What getting better can look like

Shahida’s day might be walking into New Market on a Tuesday morning with Moyna beside her, heart thumping, and choosing the maroon katan herself, while Shapla complains on the phone that she has been made redundant.

Common questions about agoraphobia

Can agoraphobia be treated?

Yes. UK national guidelines recommend cognitive behavioural therapy for panic with or without agoraphobia, with an antidepressant as an option in some cases. CBT usually includes a gradual return to feared places. The aim is a wider life, won back one place at a time.

Are sleeping pills or sedatives good for panic and agoraphobia?

UK national guidelines advise against prescribing benzodiazepines for panic disorder, because they are associated with poorer long-term outcomes. If you already take them, do not stop suddenly; talk to your doctor about a safe plan.

When to see a psychiatrist

If fear is keeping you at home or narrowing your life, please seek help; this is common and treatable. New chest pain or breathlessness should always be checked by a doctor first, and in an emergency call 999.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

Sources

• Roest et al., Depression and Anxiety, 2019 (PMID 30726581)
• NICE guideline CG113, Generalised anxiety disorder and panic disorder in adults (last reviewed 11 September 2026)