Agoraphobia is an anxiety disorder that can cause sufferers to feel extreme fear and panic in situations where escape might be difficult or impossible, for example on public transportation. This intense fear can make everyday activities extremely daunting, such as leaving the house or being in a crowd.
Is agoraphobia hereditary?
The Diagnostics and Statistical Manual of Mental Disorders, fifth edition (DSM-5) states that genetic influences play an essential role in the development of agoraphobia. This means there is a high hereditary or genetic risk factor, and those with parents/relatives with agoraphobia are 61% more likely to get agoraphobia.[1] This genetic factor also depends on the upbringing received, so environmental influences also play a role.
Panic disorder, another type of anxiety disorder, is a condition that affects 1.2-8.4% of the population, with females being affected twice as frequently as males. The average age of onset for panic disorder is 25. This condition is one of the more familial diseases in psychiatry, with two-thirds of cases having relatives affected by the same condition. The risk to first-degree relatives is approximately three to four times the general population’s rate.[2]
Limited twin studies have looked at identical twins with anxiety disorder versus fraternal twins show that identical twins have a 20-39% likelihood of having an anxiety disorder if their twin has it. This likelihood is much lower in fraternal twins at 0-4%, showing an apparent genetic predisposition.[3]
Identical twins have the same genetic matter, yet one can often develop an anxiety disorder, such as agoraphobia, while the other doesn’t. This leads us to understand that environment and life experiences also play a crucial role in whether one develops agoraphobia. For example, one twin could experience a traumatic experience that triggers the agoraphobia, while the other twin does not and remains unaffected.
While agoraphobia can be a genetic disorder, the condition might not fully develop until late adolescence or early adulthood. The usual onset is between the ages of 25 and 30.[4]
Even if you do not have a family history of panic disorder or agoraphobia, you can still develop these following a traumatic experience, e.g., a motor vehicle accident.
How to prevent agoraphobia
While we all avoid certain situations that make us uncomfortable or scared, it is when you alter your behavior drastically (or in a harmful manner) in at least two scenarios that you can be classified as having agoraphobia.
If there is a genetic or environmental factor that makes you suspect you might develop agoraphobia, make sure to:
- Get professional help early. They might suggest therapy or prescribe medication to help control agoraphobia symptoms.
- Increase your support network of people who understand what you are going through, as agoraphobia often leads to social isolation, which can make recovery much harder
- Learn about the condition
- Be observant of yourself and understand whether you are developing any avoidant behaviors
- Use coping techniques such as deep breathing and muscle relaxation when the panic attack starts, rather than escaping the environment
- Don’t let your brain associate external events with internal anxiety by immediately acting on your fears
- Practice positive self-talk
- Although it may be difficult, try to ease yourself back into the space that scares you in a step-by-step manner
- If possible, ease back into situations that scare you with the help of a therapist and with the support of friends and family that understand your condition
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. https://doi.org/10.1176/appi.books.9780890425596
- Crowe, R. R. (1985). The genetics of panic disorder and agoraphobia. Psychiatric Developments, 3(2), 171–185.
- Distel, M. A., Vink, J. M., Willemsen, G., Middeldorp, C. M., Merckelbach, H. L., & Boomsma, D. I. (2008). Heritability of self-reported phobic fear. Behavior genetics, 38(1), 24–33. https://doi.org/10.1007/s10519-007-9182-z
- Michael T, Zetsche U, and Margraf J. Epidemiology of Anxiety Disorders. Epidemiology and Psychopharmacology 136:142, 2007.
- Gechter, J., Liebscher, C., Geiger, M. J., Wittmann, A., Schlagenhauf, F., Lueken, U., Wittchen, H.-U., Pfleiderer, B., Arolt, V., Kircher, T., Straube, B., Deckert, J., Weber, H., Herrmann, M. J., Reif, A., Domschke, K., & Ströhle, A. (2019). Association of NPSR1 gene variation and neural activity in patients with panic disorder and agoraphobia and healthy controls. NeuroImage: Clinical, 24, 102029. https://doi.org/10.1016/j.nicl.2019.102029
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Miriam Calleja is a pharmacist with an educational background from the University of Malta and the European Medicines Agency.
Talyer Hackett is a medical writer and researcher with 10+ years of experience, holding B.A. in Psychology from the University of Liverpool.
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