Agoraphobia & Addiction | Prevalence, Symptoms, Risk Factors, & Dual Diagnosis Treatment

New situations and unfamiliar surroundings can be stressful and intimidating for anyone. 

But for some, the fear and anxiety of being in unfamiliar, unknown, or restrictive spaces is so intense that it becomes a deciding factor for much of their behavior, getting in the way of normal day-to-day experiences and peace of mind.

This condition is known as agoraphobia. Agoraphobia is a diagnosable anxiety disorder that, like many other mental health conditions, is strongly associated with substance use disorders and addiction.

Dual Diagnosis Of Agoraphobia & Addiction

When a mental health disorder or mental illness co-occurs with a substance use disorder (SUD), it is known as a comorbid or co-occurring disorder.  

Self-Medicating With Alcohol Or Drugs

These dual diagnoses are common for a variety of reasons, but in the case of anxiety disorders often develop as a result of self-medication.

By using drugs and alcohol, those with agoraphobia or other anxiety/panic disorders may attempt to control or escape their symptoms, using intoxication and euphoria to overcome their otherwise uncomfortable or crippling symptoms of anxiety.

Increased Anxiety & Stress

But while substance use can provide temporary relief, long-term, high dose, or high-frequency reliance on drugs or alcohol to manage anxiety can swiftly lead to the development of drug dependence, addiction, and increasing anxiety and agoraphobic distress as a result.

Those seeking treatment for a dual diagnosis will require special care and attention as well as an integrated treatment program able to provide therapy and support for both the substance use disorder and agoraphobia simultaneously.

Prevalence Of Agoraphobia & Addiction

According to the 2007 National Comorbidity Survey, 1.3% of individuals will develop agoraphobia without panic at some point in their lives, while 4.7% will develop a panic disorder, with or without some symptoms of agoraphobia.

Figures detailing the percentage of agoraphobics who engage in drug abuse or alcohol abuse are not readily available, but small-scale studies suggest that the rates are indeed significantly higher than rates of drug use in the general population.

Agoraphobia & Addiction Symptoms

Symptoms of agoraphobia are often similar to some symptoms of generalized anxiety disorder, social anxiety disorder, separation anxiety, post-traumatic stress disorder, and major depression.

These symptoms include:

• intense fear and anxiety related to public places, crowds, enclosed spaces, wide-open spaces, and public transportation
• avoidance behaviors related to these settings which impact quality-of-life
• panic attacks with racing heartbeats, trouble breathing, chest pain, sweating, and shakiness (if co-occurring with panic disorder)

Symptoms and side effects of substance use disorder (SUD) vary depending on the specific substance being abused, but may include:

• hyperactivity, lethargy, tremors, slurred speech, bloodshot eyes, and/or contracted or constricted pupils
• becoming fixated on or obsessed with the substance
• changes in personality, motivation, paranoia, and irritability
• dishonest or secretive behavior related to substance use
• financial irresponsibility related to substance use
• a decline in mental health and well-being, often including worsening symptoms of anxiety or depression
• continuing to take the substance despite negative consequences related to family, health, or personal responsibilities 
• being unable to stop using, even if one wants to
• experiencing withdrawal symptoms if one stops taking the substance

Dual Diagnosis Risk Factors

While the disorder is not fully understood, agoraphobia is believed to be caused by a combination of both genetic and environmental/developmental factors. 

Genetic Factors

Agoraphobia runs in families and typically (though not always) develops after the onset of repeated panic attacks, which can commonly be traced back to stressful or traumatic events, especially childhood traumas.

Interestingly, agoraphobics are noted to often have a weak vestibular system, meaning that an individual’s sense of special orientation and balance is less tuned and that it is easier for them to become disoriented or lost in unfamiliar spaces.

Substance Use & Psychiatric Disorders

Agoraphobia can also develop after chronic use and misuse of certain substances, including benzodiazepine use, alcohol use, and tobacco use, with symptoms of anxiety and panic (including agoraphobia) often improving during recovery.

Psychiatric disorders of any kind are also a major risk factor for substance use disorders, with other known risk factors including: 

• genetic predisposition (having a history of substance abuse in the family)
• poor parental involvement
• childhood traumas or insecurity
• early use of substances

Dual Diagnosis Treatment For Agoraphobia & Addiction 

Because comorbid mental health disorders and addiction feed into one another, recovery program participants likely achieve the best outcomes when they receive treatment customized to address both conditions. 

Agoraphobia Treatment

As an anxiety disorder, agoraphobia is typically treated with both psychotherapy and medication, including:

• in-home care or remote therapy
• counseling
• cognitive-behavioral therapy (CBT)
• antidepressants
• short-term prescription of anti-anxiety medications

SUD Treatment

SUDs are effectively treated with:

• medical detox and/or tapering
• individual or group therapy
• motivational interviewing
• cognitive-behavioral therapy (CBT)
• use of approved medications
• support group participation
• other supportive therapies including exercise, yoga, and meditation

If you or a loved one struggles with agoraphobia or some other personality disorder, as well as substance abuse, professional care and treatment are available. Please contact us today to learn more about dual diagnosis treatment programs and availability.