Agoraphobia is an anxiety disorder characterized by a fear of situations or places where escape may be difficult or impossible. People with agoraphobia often avoid crowds, public transportation, and enclosed spaces such as grocery stores or movie theaters [1].

Social anxiety disorder is characterized by a fear of social interactions or situations where one may be subject to scrutiny by others. People with social anxiety disorder may avoid attending parties or going on dates [2].

The fact that agoraphobia and social anxiety disorder are closely connected is true; however, the source or underlying reasons for the anxiety resulting from these disorders is different.

What is agoraphobia?

Agoraphobia is an anxiety disorder that can make people afraid of being in situations where escape might be difficult, or help may not be available. This can include seemingly ordinary places and activities such as being in a crowd, outside of the home alone, on a bridge, or traveling in a bus, train, or car.

People with agoraphobia often have difficulty leaving their homes. They may avoid going places where they fear they will feel trapped. The symptoms of agoraphobia can vary from mild to severe. Some people may only experience mild symptoms, while others may be severely affected and unable to leave their homes.

The most common symptom of agoraphobia is intense anxiety or fear when confronted with a situation that triggers the phobia. Other physical symptoms may include shortness of breath, rapid heartbeat, sweating, trembling, and feeling dizzy or faint.

Agoraphobia generally develops over time and becomes apparent in young adulthood. The exact cause is unknown; however, it is thought to be a combination of genetic and environmental risk factors. Treatment for agoraphobia typically includes exposure therapy and medication [1].

What is social anxiety disorder?

Social anxiety disorder (SAD), also known as social phobia, is a type of anxiety disorder that causes intense fear in social situations. This anxiety goes beyond feeling nervous, excited, or having butterflies in your stomach before an unusual event. People with SAD may worry about being judged or embarrassed in front of others and may avoid social situations.

Behavioral symptoms include fear of physical side effects that may cause embarrassment, such as sweating or blushing. Those living with social phobia fear being the center of attention and being analyzed by others who may notice their flaws. They expect the worst-case scenario from the experience of negative incidents in the past.

SAD can significantly impact the quality of life, making it difficult to work, go to school, or even leave the house, as even daily routines invoke anxiety. It will often affect relationships as it becomes challenging for loved ones and co-workers. Symptoms of SAD can include sweating, racing heart, shaky hands, and difficulty speaking.

The exact cause of SAD is unknown, but it is thought to be due to a combination of genetic and environmental factors. Treatment for SAD typically includes therapy and medication. With treatment, most people with SAD can manage their symptoms and live full, productive lives [3].

What are the similarities?

Agoraphobia and social anxiety disorder are both classified as anxiety disorders. They share many common symptoms, including fear, avoidance, and heightened physiological arousal. Both disorders can also be debilitating, preventing sufferers from enjoying a normal life.

Both disorders can cause significant fear and avoidance of situations that trigger anxiety symptoms like nervousness, sweating, and heart palpitations.

They are also similar in the fact that both agoraphobia and social anxiety disorder may lead to substance abuse as a coping mechanism. For example, individuals might use alcohol or drugs to mask their symptoms, which can worsen the situation not only because another problem is developing but also because the anxiety goes untreated [4].

Ultimately, both disorders can be debilitating, but treatment is available and can help people manage their symptoms.

What are the differences?

While agoraphobia and social anxiety disorder share some similarities, there are also some crucial differences between the two mental health conditions.

Agoraphobia is typically characterized by a fear of wide open spaces or being in situations where escape would be difficult, such as being on a bridge or in a crowded place. This can lead to avoidance of such places and situations and feelings of anxiety and panic when confronted with them [1]. On the other hand, social anxiety disorder is more specifically defined as a fear of social situations where one may feel judged or scrutinized by others. This may include activities such as public speaking, meeting new people, or networking events [3].

Agoraphobia is generally more severe and is often characterized by a fear of open spaces or enclosed spaces, while social anxiety disorder is typically focused on fears around social interactions. For example, those with social anxiety disorder will not fear being in the car alone. In addition, people with agoraphobia may avoid leaving their homes altogether, while people with social anxiety disorder may still be able to participate in some social activities. And, while those agoraphobia feel more secure with someone they know, with social phobia, this might make matters worse since they will get anxious about possible scrutiny.

In addition, agoraphobia often develops in response to a specific trauma, such as a panic attack, while social anxiety disorder may have no identifiable trigger.

It may be that both a diagnosis of agoraphobia and social anxiety disorder apply, because the disorders can occur together. Major depression is another condition that often appears with agoraphobia or social anxiety disorder [1] [5].

Resources:

  1. Balaram, K., & Marwaka, R. (2022). NCBI. Retrieved December 27, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK554387/#:~:text=Agoraphobia%20is%20the%20anxiety%20that,may%20occur%20in%20these%20situations.
  2. National Institute of Mental Health. (n.d.). Social anxiety disorder. Retrieved December 27, 2022 from https://www.nimh.nih.gov/health/statistics/social-anxiety-disorder
  3. National Institute of Mental Health . (2022). Social anxiety disorder: More than just shyness. Retrieved December 27, 2022 from https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness
  4. Smith, J.P., & Book, S.W. (2008). Anxiety and substance use disorders: A review. Psychiatric Times, 25(10), 19-23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904966/
  5. Koyuncu, A., Ince, E., Ertekin, E., & Tukel, R. (2019). Comorbidity in social anxiety disorder: Diagnostic and therapeutic challenges. Drugs in Context, 8, 212573. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448478/