The Science of Agoraphobia

Ask Science tackles the science behind agoraphobia. Plus, how you can help a popular author who suffers from this debilitating mental illness.

Lee Falin, PhD
5-minute read
Episode #100

As with most mental health issues, there is a lot of confusion, misinformation, and stigma associated with panic attacks, panic disorders, and agoraphobia. It is estimated that around 2 out of every 100 people suffer from panic disorder, and one third of those will go on to develop agoraphobia. So chances are you know someone who is dealing with one of these debilitating illnesses.

One such person that I know is Robison Wells, who lost his full-time job shortly after being diagnosed with several mental illnesses. If you’re a fan of science fiction and fantasy, you can help Robison by sponsoring an anthology written by a bunch of amazing authors, including bestseller Brandon Sanderson, who have all banded together to help him raise money to get out of his current situation.

In order to dispel some of the confusion and myths surrounding these illnesses, let’s now take a look at the science behind them.


Nothing to Fear But Fear Itself

Have you ever been frightened? I mean, really frightened? Maybe you got a bad scare while coming around a corner in the dark, or perhaps you lost sight of a child in a crowded place for a short time, or maybe you just received news that a loved one was in an accident, but you didn’t know the details. Or maybe you have a severe fear of heights and one day you find that you have to climb up a really tall ladder. 

You break out in a sweat, your heart beat accelerates, you can’t breathe, you’re sure you’re about to die. You can barely think straight, let alone function. This is called a panic attack.

Now imagine that you have those same feelings, but for no apparent reason. You’re just sitting there working, or walking down the street, and suddenly you feel the same way. Or maybe you’ve had a panic attack in the past, and you’re so worried that you’ll have another panic attack, that you have a panic attack just thinking about it. Part of your mind knows that there’s nothing wrong, but that part is bound, gagged, and shoved into a corner, powerless to help you.

If this happens to you more than once within a month, you may have what is known as a panic disorder. Now suppose that you start to worry that you’ll have such an attack in public. What happens if you’re driving down the street, or you’re at the mall, or at work, and you have an attack? So you start to alter your behavior in order to avoid those locations. This is called agoraphobia.

Adding to the confusion of how to understand, diagnose, and treat these illnesses, is the fact that scientists still aren’t all agreed on how to define them. While the above situation is the current consensus, there is some evidence showing that agoraphobia can develop even if you’ve never had panic attacks.

As with most illnesses, there is both a genetic and environmental component to panic disorders and agoraphobia, though it’s still unclear how much influence genetics has on the severity of symptoms. 


Part of the problem with having a mental illness, (often worse than the illness itself), is the stigma associated with mental illness. The cost to a person suffering from a mental illness often goes beyond the time and money involved in medical treatment. While many employers are sympathetic if you need time off for something like cancer treatment, not as many feel the same way if you need time off for mental illness. Nor is it likely to be as easy for you to come back to the workforce if you’ve lost your previous job due to a mental illness. 

Many people lose their jobs once diagnosed, and the added financial stress can cause the illness to get worse. Because of this, many people don’t seek treatment early (or at all), which as with any kind of illness, makes it more difficult to find effective treatment later.

So given that treatment is often extremely effective, why don’t more people seek help? Aside from the fact that sufferers of mental illness often avoid treatment due to the social stigma associated with it, panic disorder often occurs jointly with other mental illnesses, such as depression, which can make seeking treatment more difficult.


Please note that archive episodes of this podcast may include references to Ask Science. Rights of Albert Einstein are used with permission of The Hebrew University of Jerusalem. Represented exclusively by Greenlight.

About the Author

Lee Falin, PhD

Dr. Lee Falin earned a B.S. in Computer Science from the University of Illinois, then went on to obtain a Ph.D. in Genetics, Bioinformatics, and Computational Biology from Virginia Tech.