Agoraphobia vs social anxiety: Are they the same?
It's common for people to feel nervous in public settings or large social situations. However, when this anxiety starts to impact your day-to-day quality of life, it may mean you have an anxiety disorder. Two types of anxiety disorders that can contribute to these challenges are social anxiety and agoraphobia. While both of these mental health conditions can cause intense distress that leads you to avoid certain situations, they have different underlying causes: agoraphobia specifically involves an intense fear of being in situations where escape would be difficult, while social anxiety revolves around the fear of being judged or scrutinized in social social interactions.
In this article, we explain the differences—and similarities—between agoraphobia and social anxiety, as well as treatment options to help you overcome these situations and live your life a bit more at ease.
What is agoraphobia?
Agoraphobia is a type of anxiety disorder where you feel trapped and afraid in situations where escape might be challenging or difficult. If you have agoraphobia, you may feel unsafe on public transportation or in a large crowd without having an easy way out. You might feel panicked leaving the house alone, waiting in long lines, being in enclosed public places like an elevator, or even being in more open spaces with more people like a mall or outdoor concert. If these types of situations make you feel panicked, and the symptoms last six months or longer, then you may be dealing with this type of anxiety disorder.
In some cases, people who have agoraphobia may also come with diagnosis of panic disorder, which results in panic attacks from anxiety. Your fear may intensify into physical symptoms, like a rapid heart rate, trouble breathing, chest pain, lightheadedness, feeling shaky or numb, sweating or chills, upset stomach, and feeling a loss of control.
Talking with a mental health professional can help you understand any agoraphobic symptoms as well as potential panic disorder and provide a treatment plan to help you feel better.
What is social anxiety disorder?
Social anxiety disorder, also known as social phobia, is a mental health condition that causes you to have intense fear and anxiety regarding social situations. If you have social anxiety disorder, you likely struggle with feeling self-consciousness and embarrassment in social settings, and fear others will scrutinize or judge you. Social anxiety goes beyond shyness, and its effects can seep into everyday situations like work, school, and other activities that involve interactions with others. It can put a strain on your relationships with loved ones since your heightened self-consciousness might cause you to avoid social events altogether.
The likelihood of you having this disorder is a bit more common compared to agoraphobia; it is known to be the second most common anxiety disorder, affecting 7% of U.S. adults.
To learn more about the symptoms of social anxiety disorder, check out: Social anxiety vs shyness
What’s the difference between agoraphobia and social anxiety?
Agoraphobia and social anxiety are both anxiety disorders and phobias, but agoraphobia is a fear of not having a route for easy escape, while social anxiety is fear of interaction with others where they can easily be embarrassed or judged.
Here’s a closer look at the two disorders side by side.
Can you have both?
According to research, it’s quite common for people to experience more than one type of anxiety disorder, and as many as 90% of people with social anxiety also experience another mental health condition. So, it's possible for someone to have both agoraphobia and social anxiety disorder at the same time. When two or more health conditions occur together, we call it comorbidity.
Although the specific fears between agoraphobia and social anxiety are different, it can still be difficult to make a diagnosis between the two given their similarities in terms of where and how the anxiety is triggered. For instance, public situations with large crowds can set off anxiety symptoms for either condition—although one is an anxiety of feeling trapped while the other is an anxiety of having to interact with others.
If you’ve wondered which one you might have, or if you have both, it’s a good idea to speak to a professional, like a psychiatrist. They can give you a diagnosis and help you understand what it is you’re experiencing. Both agoraphobia and social anxiety disorder are also linked to a higher likelihood of developing other mental health disorders like depression and alcohol or substance dependence.
How to treat agoraphobia and social anxiety
There are different forms of treatment that can help the intensity of symptoms of agoraphobia and social anxiety disorder and make you feel a little more comfortable in crowded places and social settings.
Talk therapy
Psychotherapy, also known as "talk therapy," is a widely used treatment option where you have conversations with a psychologist, psychiatrist, or another mental health professional. One specific type of talk therapy is cognitive behavior therapy (CBT) which focuses on understanding your feelings and emotions. You’ll learn to identify and challenge negative thought patterns and gain new ways of thinking that’ll help react and respond better in specific settings. The goal is to empower you to navigate the settings that trigger your anxiety with more ease and confidence.
Exposure therapy
Exposure therapy is another treatment for agoraphobia, social anxiety, and other specific phobias that’s more hands on. It involves gradually facing whatever it is you’re afraid of and the things that cause you anxiety in a safe and controlled way. A therapist typically guides you through the process.
For agoraphobia, exposure therapy could involve going outside as a first step and gradually taking on more situations outside of your comfort zone. That might mean simple outings, like walking around the neighborhood, and working your way up to the pharmacy, a movie, and then the subway, and eventually a baseball game.
For social anxiety, exposure therapy might focus on practicing conversational skills and participating in group activities. You might start out with having a small gathering with a few close friends and then gradually work your way up to larger events and unfamiliar settings like a workplace happy hour with people from different departments.
It can feel scary, but each of these small exposure can help you build up your confidence and lessen your anxiety over time.
Medication
If you have social anxiety or agoraphobia, know that medication can help, too. Your doctor may prescribe anti-anxiety medications and antidepressants along with therapy. SSRIs (selective serotonin reuptake inhibitors) are often recommended as the first line of defense for anxiety disorders, and benzodiazepines like Xanax (alprazolam) are also effective treatments for the short-term.
To learn more about the different types of treatment available, check out: Which anxiety medication is best for you?
If you think you have social anxiety or agoraphobia, don’t wait to get help. Talkiatry is a national psychiatry practice that provides virtual in-network care so you can see a mental health professional from the comfort of your home. We treat a variety of conditions, including generalized anxiety disorder, social anxiety, and agoraphobia. Fill out a quick assessment to get matched with a psychiatrist and schedule your first appointment.
The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.
Dr. Austin Lin is a double board-certified adult and addiction psychiatrist who has been in practice for over 9 years. At the center of Dr. Lin’s clinical approach is a strong emphasis on establishing trust and using a collaborative approach to help patients develop an individualized and cohesive plan so that they are able to achieve their goals.
Dr. Lin's practice focuses on medication management. Typically, he offers this in conjunction with supportive therapy, motivational interviewing, and/or cognitive behavioral therapy in 30-minute follow-up visits. Occasionally, Dr. Lin may recommend that additional therapy is needed and ask that you bring a therapist into your care team in order to provide the best outcome.
Dr. Lin received his medical degree from St. George’s University School of Medicine. He went on to complete his residency in psychiatry at Harvard South Shore, an affiliate of Harvard Medical School, where he served as Chief Resident and earned his 360° Professionalism award. He then had additional training in Addiction Psychiatry through his fellowship at the University of Texas Southwestern Medical Center. After completing training, Dr. Lin has worked as an Addiction Psychiatrist and Director of Adult Services in the Trauma and Resilience Center (TRC) at the University of Texas Health Science Center at Houston (UTHealth). He specialized in treating patients with a history of depression, anxiety, trauma, and substance use disorders.
Dr. Lin has held an academic appointment at UTHealth, and he has spent his professional career supervising and teaching medical students and psychiatry residents.
